Accurate medical coding and billing are essential components of a healthcare practice’s financial health. When codes for procedures and diagnoses are recorded correctly, providers can receive timely reimbursements for the services they deliver. However, Prevent coding and billing errors can lead to claim denials, delays in payments, and increased administrative burden This blog post will […]
Medical billing is shaped by healthcare reform, which is one of the most dynamic forces at play. Legislation, regulatory changes, and shifts in healthcare delivery models have led to a significant change in how providers bill. In response to the continued push for value-based care, increased patient responsibility, and technological advancements, medical billing is evolving. […]
Medicare, the federal health insurance program for people aged 65 and older, has been at the forefront of healthcare innovation. In recent years, telehealth has emerged as a powerful tool, transforming the way healthcare services are delivered. As technology continues to advance, the future of Medicare telehealth looks increasingly promising. Telehealth: A Brief Overview Telehealth, […]
Healthcare Claim Denials can be a frustrating and costly setback. However, with the right strategies, you can significantly reduce denials and improve your revenue. This article outlines four effective approaches to handling denied claims and ensures timely resubmissions. 1. Establish a Routine for Denial Handling Create a standardized procedure: Develop a clear and efficient process […]
Modifier 50 is used to indicate that a procedure or service was performed on both sides of the body during the same operative session. It’s essential to use this modifier correctly to ensure accurate billing and reimbursement. Key points for appropriate use: Bilateral Procedures: The procedure must be performed on identical, opposing structures (e.g., eyes, […]
Medical billing is experiencing significant changes as the healthcare industry rapidly evolves. Healthcare providers are facing new challenges managing their revenue cycles as the sector becomes more complex. The future of medical billing services is not without obstacles. However, medical billing services play a critical role in ensuring providers receive timely and accurate reimbursement for […]
With the proliferation of quality measures in value-based contracts, many primary care physicians feel overwhelmed and set up to fail. Research conducted at the healthcare system shows that these clinicians are inundated with an excessive number of quality metrics, often leading to administrative burdens and reduced patient care. One of the primary criticisms of value-based […]
Understanding Modifier 95: A Brief Overview Modifier 95 is a medical billing code used to indicate that a service was provided via telehealth. This modifier is essential for ensuring that healthcare providers receive appropriate reimbursement for remote services. Here are the key points about Modifier 95: Purpose: Modifier 95 is appended to the CPT or […]
The Role of Medical Codes in Reimbursement Methodologies: Medical codes, such as CPT, HCPCS, and ICD-10 (CM and PCS), are essential components of various reimbursement methodologies. The Inpatient Prospective Payment System (IPPS), used by Medicare fee-for-service, categorizes patient stays into Medicare Severity Diagnosis Related Groups (MS-DRGs) based on ICD-10 codes processed through a computerized system. […]
Medical billing is at the forefront of a transformational industry in healthcare. Medical billing trends 2024 promise to make this a pivotal year for medical billing due to rapid technological advancements, regulatory changes, and evolving patient expectations. Providing insights that can help healthcare providers, billing professionals, and administrators navigate these changes effectively, this newsletter explores […]