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 […]
Interoperability role in medical billing: A growing number of physicians practice in an interconnected world, which means that medical practices and hospitals need to seamlessly share information in order to be able to provide good health management and ensure that patients are treated safely and effectively. Health care interoperability is an important concept that has […]
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. […]
Denials within the realm of healthcare persist as a perpetual and escalating issue. By 2022, denials constituted over 11% of claims, posing a significant threat if left unaddressed, as they can severely compromise an institution’s financial well-being and prospects. The combination of outdated technology and manual processes exacerbates the burden on staff, time, and finances […]
While not every policy alteration by the Centers for Medicare & Medicaid Services (CMS) grabs headlines, it’s often these less-publicized changes that lead to the most billing complications. Here are a couple of recent adjustments made by CMS that you might have overlooked. New Place of Service Code CMS introduced a new Place of Service […]
With the arise of indirect health practices such as telehealth, it is becoming increasingly indispensable to play with bill payments and claims orderly. The medical billing cycle is a complex system encompassing procedures such as medical recordkeeping and patient data processing. Medical claim processing is the keystone for healthcare insurance companies since it needs data […]
Federal healthcare leaders say they are committed to helping physicians, patients, and health insurance companies by improving the prior authorization process for medical care. On Jan. 17, Center for Medicare & Medicaid Services Administrator and U.S. Surgeon General Vice Admiral, held a listening session with health care stakeholders. That was followed by a conference call […]
Health care leaders are anticipating a turbulent 2023, according to a report. Staffing, inflation, shrinking margins, and supply chain issues are among the top concerns that will continue to challenge hospitals and health systems and have an outsized effect on overall strategy. Here are the four factors identified as being the most likely to impact […]
Cluster coding is a new feature for coding professionals. The World Health Organization (WHO) began developing the International Classification of Diseases, Eleventh Version (ICD-11), in 2007, and first released a preliminary version for evaluation and testing in 2016 – ironically, just one year after the U.S. finally adopted a clinical modification of the WHO’s ICD-10 […]
For most readers the results of this analysis will be amazing but true. Longtime RACmonitor contributor and R1 Physician Advisory Services Vice President Dr. Ronald Hirsch recently pointed site Publisher Chuck Buck in the direction of something that, frankly, wowed him: a PhD thesis from a young Columbia University student on the topic of […]