Tag: Documentation

Healthcare online Forms

Paperless Healthcare: 5 Reasons to Transition to Online Healthcare Forms

The healthcare industry has long been burdened with paperwork, from patient intake forms to insurance documentation. While many healthcare providers have already adopted Electronic Medical Records (EMRs), there’s a growing realization that going paperless can extend far beyond just digitizing patient records. One significant area where healthcare can continue to evolve is through the use […]
Learn More
Surgery Modifiers

Surgery Modifiers Require Specific Documentation

Using surgery modifiers to accurately represent the role of assistant surgeons has become increasingly important over the past three decades. Initially, a simple mention of the assistant surgeon’s name in the operative note header sufficed. However, as the healthcare landscape evolved, payers began demanding more granular details about the assistant surgeon’s role and contributions to […]
Learn More

Tips to Avoid Billing Errors in Radiology Practices

Have you ever received a medical bill that left you perplexed, questioning how the expenses added up and left you scratching your head? If that’s the case, you’re certainly not alone. Billing for radiology can be intricate and confusing, involving numerous codes and procedures. Unfortunately, errors in medical billing are all too frequent, resulting in […]
Learn More
Medicare Advantage Insurers

Senators seek accountability from Medicare Advantage insurers on claims denials

In Congress this week, it wasn’t just pharmacy benefit managers facing scrutiny. The Senate’s Permanent Subcommittee on Investigations directed its attention towards Medicare Advantage (MA) plans, seeking explanations for claims denials. During the hearing, the committee’s chairman highlighted that letters were sent to the three largest MA plans—UnitedHealthcare, Humana, and Aetna—requesting documentation regarding their decision-making […]
Learn More
Medical Coding Error Prevention Methods

Mastering Medical Coding: Strategies To Avoid Revenue Loss

Medical coding is an essential aspect of healthcare in that it translates diagnoses, procedures, medical services, and equipment into alphanumeric codes. The processes involved in medical coding is complex, however, so errors can often result in payment delays and significant financial losses. The most common errors leading to delays and lost revenue are tracking down […]
Learn More
Administrative-Challenges-Medical-Practices-2023

Administrative Challenges for Medical Practices in 2023

The number of prior authorization requests continues to increase — despite promises to the contrary by payers — costing physicians time and money. A Medical Group Management Association (MGMA) poll found that 70% of medical groups indicated that prior authorizations increased in the last year. Physicians say that their practices continue to struggle with either […]
Learn More
Time based EM Guidelines

2021 E/M Guidelines Based on Time

Below is a listing of questions and answers regarding some of the nuances of billing Evaluation and Management office visits based on time. The new 2021 E/M coding guidelines for office visits (99202-99205, 99212-99215) allow physicians and qualified health professionals (QHP) to choose whether their documentation and code-selection level for E/M services provided is based […]
Learn More
Coding Denials

Coding Denials: Back to Basics

Coding must be supported by documentation, but also by the Official Coding Guidelines. While preparing for a clinical validation presentation on acute kidney injury denials, I took inventory of the most common denials and recoveries obtained by payers. It came as no surprise that sepsis, severe malnutrition, and encephalopathy were at the top of the […]
Learn More
E&M revised Codes

What to Expect with the 2021 E&M Revisions

  A work group put together by the American Medical Association (AMA) that also represents the AMA’s Current Procedural Terminology (CPT) Editorial Panel and the AMA/Specialty Society RVS Update Committee (RUC) has put together revisions to office and outpatient evaluation management (E&M). These will take effect on January 1, 2021. So how will this affect dermatologists? Well, […]
Learn More
Artificial Intelligence in Medical Coding

Artificial Intelligence Meets Medical Coding

  Medical billing and coding is an integral component of healthcare. The medical coding outsourcing market alone is projected to reach16.9 billion dollars by 2021. However, coding accuracy is an ongoing challenge. To maximize efficiency and accuracy of the medical coding process, companies are testing the possibilities of Artificial Intelligence (AI) applications. The current problem […]
Learn More
x