Tag: Healthcare Billing Challenges

healthcare billing

How AI Revolutionizes Healthcare Billing: Tackling Payment Delays and Denials

During pediatric cardiology internship, witnessed this firsthand. A claim filed nearly a year earlier remained unpaid. The initial denial was due to a missing prior authorization number, a detail buried within the EMR. Unfortunately, the outsourced healthcare billing team took months to decipher this information, causing significant delays in reimbursement. This year-long ordeal highlights the […]
New Billing Codes-for Prior Authorization Work Proposed by AMA

AMA Aims to Streamline Prior Authorization Billing with New Codes

New billing codes: Medical experts might consider creating new billing codes for the time doctors and their support staff spends working on prior authorizations. The American Medical Association (AMA) Current Procedural Terminology (CPT) Editorial Board meets May 9-11 in Chicago. On the meeting’s agenda are three potential new CPT codes “for reporting services (physician, QHP, […]
Surprise-Billing-Dispute-Resolution

Surprise Billing Dispute Resolution: Challenges, Lawsuits, and Proposed Changes

This year, the CMS has frequently halted and resumed arbitration due to court cases causing disruptions in the regulatory process aimed at settling surprise billing disputes. Summary Overview: Last Friday, the CMS finalized its revamp of the No Surprises Act resolution process, fully reopening the portal for resolving disputes, including batched and single disputes for […]