Tag: Claim Denials

Possible-Changes-in-Prior-Authorizations

A Surgeon General Touts Possible Changes in Prior Authorizations

Federal healthcare leaders say they are committed to helping physicians, patients, and health insurance companies by improving the prior authorization process for medical care. On Jan. 17, Center for Medicare & Medicaid Services Administrator and U.S. Surgeon General Vice Admiral, held a listening session with health care stakeholders. That was followed by a conference call […]
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Optimizing the Billing and Collection Process for Medical Billing Companies

The billing and collection process in medical offices can be a time-consuming and error-prone process. This can lead to denied claims, uncollected revenue, and frustrated patients. Medical billing companies are looking for ways to optimize this process to improve efficiency, accuracy, and patient satisfaction. One way to optimize the billing and collection process is to […]
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Guide-to-Coding-and-Documentation-Best-Practices

Guide to Coding and Documentation Best Practices

The difference between a financially and clinically successful practice and one that is struggling often comes down to whether they have the code right and document thoroughly. Changes in 2021 to major coding categories, such as evaluation and management (E/M) coding for office visits means major change that can hamper your operations if not done […]
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Payers-Wrongly-Cutting-Payments-To-Physicians-For-EM-Services

Payers Wrongly Cutting Payments To Physicians For E/M Services

Payers have been wrongly cutting payments to physicians for evaluation-and-management (E/M) services—often automatically through the use of claim-editing algorithms. A new AMA resource helps physicians fight back against health insurer downcoding. Downcoding happens when a payer changes a claim to a lower-cost service than what was submitted by the physician, leading the practice to get […]
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Outsourcing-RCM-Services-can-Lead-to-Better-Outcomes

Outsourcing RCM Services can Lead to Better Outcomes

A report highlights pandemic-related impacts of the past year on revenue cycle challenges. As the labor shortage continues to hamper healthcare organizations, outsourcing has become a common strategy to mitigate costs. Nearly one-third of hospital and health system leaders (63%) have pursued at least one outsourcing solution, with revenue cycle functions at the top of […]
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10-Steps-Will-Help-You-Prevent-Denials

10 Steps Will Help You Prevent Denials

Healthcare policies and rules are continuously changing, and it’s important to stay on top of what all insurance carriers are doing and how their changes impact your practice’s revenue cycle. This, as well as managing your accounts receivable (A/R), is the best way to ensure your cash flow does not bottleneck and cause damage to […]
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