Tag: EMR

Electronic Claims Management

Electronic Claims Management: Overcoming ERA and PA Challenges

The U.S. healthcare industry continues its digital transformation, with providers and payers embracing electronic transactions to streamline revenue cycle management (RCM) processes. According to the CAQH Index, adoption of electronic claims management transactions—such as eligibility verification, claim submissions, and claim status inquiries—has reached or surpassed 80% for many transaction types. However, significant gaps remain in […]
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Outpatient Medical Billing Process

8 Steps to Clean Up Your Outpatient Medical Billing Process

Is your outpatient medical billing process feeling more like a tangled web than a well-oiled machine? You’re not alone. In the fast-paced world of healthcare, billing errors and inefficiencies can easily creep in, leading to delayed payments, increased denials, and a significant drain on your practice’s resources. The good news? You don’t have to overhaul […]
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Paperless Healthcare: 5 Reasons to Transition to Online Healthcare 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 […]
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Stop Authorization Denials in Tracks

Stop Authorization Denials in Tracks

Getting bogged down by authorization denials? You’re not alone. Here, we explore common roadblocks and effective strategies to keep your revenue flowing smoothly. Challenge: Drowning in Last-Minute Authorizations Solution: Divide and Conquer with a Multi-Team Approach Separate teams can tackle present and future authorizations. The “Today” team verifies benefits and identifies authorization needs for upcoming […]
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How To Improve The EHR And Make It More End-User-Friendly

How To Improve The EHR And Make It More End-User-Friendly

Erica Remer, MD, CCDS, a Member Board of Directors of American College of Physician Advisors, have been talking about improving the electronic medical record and making it more end-user-friendly. Today, she grouses about documentation in general. Her husband, who is a radiologist, and she were commiserating at how awful and uninformative provider documentation has become […]
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5 Medical Billing Trends

5 Medical Billing Trends

The global medical billing outsourcing market is poised to expand for years to come as medical practices face challenges related to multiple payers and medical code representation, and large practices consolidate, according to a new report by Grand View Research. Five billing trends, based on the report: The global medical billing outsourcing market is projected to reach […]
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The Facts Surrounding The Coding Chronic Kidney Disease

The Facts Surrounding The Coding Chronic Kidney Disease

Chronic Kidney Disease (CKD) is a serious health condition affecting millions of people worldwide. In the United States alone, 15% of adults, or approximately 37 million people, suffer from CKD. This condition, often insidious in its onset, can lead to severe complications and significantly impact quality of life. Key Facts about CKD: Prevalence: More common […]
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New Rules Issued for Modifiers 59, XE, XS, XP, and XU

New Rules Issued for Modifiers 59, XE, XS, XP, and XU

The Centers for Medicare & Medicaid Services (CMS) issued a policy change modification to the claims processing logic for Modifier 59 Distinct procedural service (and the optional patient-relationship modifiers XE, XS, XP, and XU) on February 15, 2019. These modifiers are only processed when applied to the Column 2 code in a bundled pair, per Correct Coding Initiative […]
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Medicare Advantage Plans and the Two-Midnight Rule

Medicare Advantage Plans and the Two-Midnight Rule

Controversy continues to swirl around this subject. A recent article of mine focused on the argument that Medicare Advantage (MA) plans have to follow the two-midnight rule. It certainly generated buzz; I received a number of emails with comments and questions. First, I want to note that I love getting comments and questions. I can’t […]
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