Tag: insurance claims

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 […]
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Medicare Advantage denials

Understanding the Rise of Medicare Advantage Denials: What Need to Know

Medicare Advantage (MA) plans, a type of private health insurance, have become increasingly popular among seniors. These plans offer additional benefits beyond traditional Medicare, but they also come with their own set of complexities.  One of the most significant issues faced by MA beneficiaries is Medicare Advantage denials for medical services. Recent data has revealed […]
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Inaccurate Medical Bills

How to Avoid and Correct Inaccurate Medical Bills

Inaccurate medical bills can be a frustrating and costly experience for patients. From coding errors to duplicate charges, these mistakes can lead to financial strain and unnecessary stress. Understanding the common causes of Medical billing errors and taking proactive steps can help you avoid these issues. Common Causes of Inaccurate Medical Bills 1. Medical Coding […]
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Need-for-Eligibility-Checks-for-Visits

Understanding the Need for Eligibility Checks for Visits

While these activities oftentimes become challenging, they should help in facilitating reimbursement. This month, we’ll dive into the next steps needed for medical practices to take after being credentialed to maximize the chances of receiving reimbursement. The next critical steps after getting credentialed are (1) to conduct eligibility checks for patient visits and (2) get […]
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Union Lowers Medical Bills With Direct Negotiations

As companies shift more and more healthcare costs to their employees, the doormen, office cleaners, cafeteria staff and other members of the union 32BJ SEIU remain among the lucky few who pay no premiums and have no deductibles as part of their benefit plan. Keeping it that way has been no easy task. With each new collective-bargaining agreement, the […]
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3 Tips To Take Your Denial Management Process To The Next Level

In the dynamic realm of medical billing, the persistence of denied claims poses a significant challenge for providers. Research indicates that an alarming portion of claims – exceeding 10% – face initial denial by insurance companies. This leads to revenue loss, wasted administrative efforts, and frustration for both providers and patients. A robust denial management […]
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