Tag: Denial Management

compliant coding and billing

Compliant Coding and Billing for Physicians: Expert Tips

The article explores common billing mistakes and offers tips for four healthcare services that can cause payment headaches for physicians. 1. Annual Wellness Visits vs. Physicals: Understanding Medicare Requirements Differentiating between Annual Wellness Visits (AWV) and Initial Preventive Physical Exams (IPPE) is crucial for accurate billing. Both are covered by Medicare for preventive care, but […]
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Revenue Cycle Challenges

How Healthcare Leaders Are Conquering Revenue Cycle Challenges

Ideally, revenue cycle processes should flow seamlessly from one stage to the next. However, challenges can arise at any point, from the front end to the back end, requiring leaders to be vigilant and strategic in their efforts. Here are some highlighting executive approaches to various revenue cycle challenges: How Healthcare Services Revamped Their Billing […]
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denial management makeover

Denial Management Makeover: Proven Tactics to Reduce Denials

Embrace the Denial Management Makeover and discover how to improve cash flow, streamline billing, and finally conquer denied claims. There are few things worse than denies for any healthcare provider. They disrupt patient care, but they also add to their financial burden. Denied claims mean lost revenue, impacting your cash flow and making it hard […]
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Medical coding Audits

Medical Coding Audits: Trends and Guide for Providers

The landscape of medical coding audits is constantly evolving.  Staying informed about these trends and implementing best practices can significantly reduce stress and ensure a smooth audit experience. The Shifting Landscape of Medical Coding Audits Traditionally, medical coding audits felt like a lottery. Providers faced the uncertainty of random reviews, often scrambling to address issues […]
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CPT Modifier

Six Tips to Getting Paid for CPT Modifiers

In medical coding, CPT modifier are vital for accurate reimbursement of healthcare services. These special codes, attached to primary procedure codes, provide additional details about the complexity or extent of a service. However, using modifiers incorrectly can lead to claim denials and lost revenue. This blog post shares six key tips to help you get […]
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Survey: High Initial Claim Denials Impact Healthcare Providers

The Rising Denial Rates in Healthcare Claims Processing Initial Claim Denials: In a new survey conducted by healthcare Company an increased percentage of initial claims are denied by private payers, including pre-approvals for medical claims. Hospitals, health systems, and post-acute care providers may have a difficult time getting paid for medical services. The survey respondents […]
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5 Ways to Reduce Claims Denial in Your Revenue Cycle

Reduce Claims Denial in Your Revenue Cycle

Claims Denial: Healthcare Leaders report an increase in payer denials, putting increasing pressure on the system’s finances. Going back and forth with denied payers is a long and expensive process, and low reimbursement rates don’t help either. In a new survey conducted by the Healthcare Financial Management Association, CFOs noted a significant increase in denials, […]
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Steps-to-reduce-claim-denials

Effective Revenue Cycle Management Strategies to Reduce Denials & Boost Revenue

Healthcare organizations consistently grapple with the complexity of overseeing their revenue cycles—a comprehensive process spanning patient registration, appointment scheduling, and concluding with balance payments. Yet, a pivotal hurdle disrupting this cycle’s seamless operation is the prevalent occurrence of claim denials. Vital for any healthcare institution’s financial well-being is the imperative to diminish these denials and […]
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Darker side of AI in healthcare

AI in Healthcare: Revealing the Risks and Challenges Ahead

AI represents a promising frontier, especially in healthcare, where leveraging vast information could revolutionize problem-solving. However, a shadow looms over AI, as anticipated by many. In the realm of health insurance and patient care denials, AI has already stirred controversy, leading to a notable class action lawsuit. According to reports from healthcare News, Health Insurance […]
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