Tag: claim submission

medical billing audit services

Optimize Billing Practices with Medical Billing Audits

A domestic medical billing audit is an operation that inspects and estimates the value and dependability of clinical documentation and the overall medical billing process. This technique closely examines health records upheld by the practice and evaluates medical billing data presented to the payers to make sure that the practice picks out, observes, and rectifies […]
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Why Healthcare Providers Need Medical Claim Clearinghouses

Medical claim clearinghouses enhance the efficiency of claim submissions for healthcare providers, thereby reducing costs and improving payment accuracy. Each year, healthcare payers and providers exchange billions of claims to finalize patient encounters, a number that continues to rise. As claim volumes increase annually (except for a dip in 2021 due to the COVID-19 pandemic), […]
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Healthcare Revenue Cycle Management

How Revenue Cycle Management Improves Healthcare in 2023

Discover how healthcare providers can accelerate cash flow, minimize denials, reduce operational costs, and enhance patient satisfaction through streamlined Revenue Cycle Management (RCM). RCM is a strategic approach to overseeing all financial aspects of a patient’s journey, from initial appointment scheduling to final bill payment. This article highlights the critical role RCM plays in maximizing […]
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Benefits of Compliance in Medical Billing

How Medical Billing Compliance Can Protect Your Medical Practice?

The process of medical billing encompasses multiple stages, starting with patient registration and eligibility verification, followed by capturing charges, coding, submitting claims, and posting payments. When a patient receives medical services from a healthcare provider, the provider documents the services and associated costs within an electronic health record (EHR) system. Subsequently, a medical billing entity […]
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10 Tips to Clean Medicare Part-B Claims

10 tips to Squeaky Clean Your Medicare Part-B Claims

Don’t allow preventable error to disrupt your revenue cycle. In order for a claim to be considered clean, it must contain all necessary information for the payer to fully process it without requiring further investigation or development. This includes being submitted within the designated timeframe, passing all necessary reviews, having any required medical evidence or […]
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MSP Billing Rules

CMS Issues Reminder on MSP Billing Rules, Appeal Options

  CMS is reminding organizations of Medicare Secondary Payer (MSP) billing and appeal processes after the agency inappropriately denied some claims. Organizations are advised that they must continue to provide services to patients who have open or closed secondary payer records on file or if Medicare inappropriately denied a claim, according to MLN Matters SE21002. Organizations are […]
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In-patient COVID-19 Billing

CMS Revises Billing Instructions for Inpatient Covid-19 Claims

CMS provided clarification on submitting inpatient claims for patients diagnosed with novel coronavirus (COVID-19) without a positive viral test, in an update to MLN Matters SE20015 released September 11. Earlier this year, the CARES Act increased the MS-DRG weighting by 20% for a COVID-19 diagnosis. Although the CARES Act doesn’t specify that the diagnosis must be supported by a […]
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