Tag: Healthcare billing

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 […]
Learn More
Medical coding guide

14 Things To Know About Medical Coding

In this blog, you should know why healthcare providers need to be aware of the medical coding guide. 1. What is Medical Coding? Medical coding is the process of translating medical diagnoses, procedures, and services into universal alphanumeric codes for proper documentation and billing purposes. 2. Importance of Accuracy: Accurate medical coding is crucial for […]
Learn More
Improve-RCM

Boost Your Bottom Line: 4 Keys to Healthcare RCM Success

In 2024, factors like declining reimbursement rates, the shift towards value-based care, and ever-changing regulations demand a proactive approach to improve RCM. Here, we explore four key strategies to optimize your healthcare revenue cycle and ensure financial stability in the coming year. 1. Break down Silos: Merging Front-End and Back-End Functions Many healthcare organizations struggle […]
Learn More
Compliance in medical coding

Navigating Regulatory Compliance in Medical Coding for Accurate Billing

Explore the intricacies of codes for a better understanding of regulatory compliance in medical coding. Healthcare billing and documentation are based on medical coding. An accurate representation of the patient’s health journey, appropriate reimbursements, and avoiding potential legal pitfalls are crucial to ensuring accurate representation of the patient’s health journey, not just an administrative formality. […]
Learn More
Preventive-Visits-VS-Office-Visits

Differences: Preventive vs. Office Visits in Medical Coding & Billing

Preventive Services Vs Office Visits: It is important to note that Medicare does not cover preventive services in the same manner as commercial payers. Therefore, it is important to know the patient’s policy and insurance coverage. Table A shows a breakdown of the coverage parameters. Understanding the distinction between Preventive Services Vs Office Visits is […]
Learn More
Top-3-Revenue-Cycle-Hurdles

Top 3 Critical Challenges for Revenue Cycle Leaders in 2024

Revenue cycle leaders ought to contemplate including these three challenges in their organization’s roster of New Year’s resolutions. 1. Automating Payer Processes: Similar to healthcare organizations, payers have also started embracing automated solutions, intensifying challenges in managing denials and causing delays in payment for rendered care. At the 2023 Revenue Tech Exchange in Raleigh, leaders […]
Learn More
8-Powerful-Strategies-to-minimize-Denied-Claims

8 Successful Tactics for Reducing Denied Claims 2024

Roughly 65% of rejected claims aren’t reprocessed for resubmission (Zindl, 2021). As one of the healthcare industry’s numerous challenges, the upward trend of denied claims persists, with many left unaddressed. This has repercussions for both providers and patients alike. When denied claims remain unsubmitted, providers face substantial losses. Beyond revenue, these rejections strain staffing resources. […]
Learn More
3-Key-Strategies-for-Revenue-Cycle-Leadership-for-Operational-Success-in-2023

3 Key Strategies for Revenue Cycle Leadership for Operational Success in 2023

To ensure both financial stability and operational efficiency, revenue cycle leaders must reinforce three essential areas. The challenges of grappling with low operating margins, diminished reimbursements, and escalating costs will persist throughout 2024. In an era where a subpar financial journey could overshadow a top-tier clinical experience for patients, the burden on revenue cycle leaders […]
Learn More

Medical Coding Strategies to Prevent Payer Denials

As a former emergency department physician from the U.K., this individual was well aware of claim denials and rejections, with payers frequently withholding or reducing payments. However, it was only when his personal insurance company, denied his medical claim for a vitamin D test that he decided to delve deeper into the issue. He found […]
Learn More
x