The world of medical billing and accounts receivable (AR) can feel like a labyrinth for healthcare providers. Lost in a maze of codes, claims, and denials, it’s easy to see revenue slip through the cracks. But fear not! Here’s our guide to mastering AR and ensuring your practice thrives. Medical Billing & Accounts Receivable Medical […]
Here are some steps to guide you through the process of appealing a denied health insurance claim: 1. Understand the Reason for Denial Review the Denial Letter: Carefully read the denial letter from your insurance company. It should explain why your claim was denied and how you can appeal the decision. Check you’re Policy: Refer […]
Outsourcing Vs Offshoring in Medical Billing: Targeting Cost Savings with a Global Reach: Both medical billing outsourcing and offshoring involve delegating billing tasks to another entity, but there’s a key difference in their destination: Medical Billing Outsourcing: In general outsourcing, the Medical Billing company can be located anywhere. It could be in the same state, […]
The US health care system, one of the best in the world, with qualified doctors trained in world medical schools, faces a major flaw: reduce medical errors, which cause about 1 in 1 10 Americans died and cost the country $20 billion age. Almost 2 out of 3 of these errors are based on poor […]
The HCPCS Level II quarterly update for July 2024 is now available on the Centers for Medicare & Medicaid Services (CMS) website. The update includes: 134 added codes 9 discontinued codes 32 codes with long description changes 3 codes with payment changes New HCPCS Level II Codes Effective July 1, 2024, there is one new […]
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 […]
Modifiers 52: Professional fee-for-service guidelines for modifiers do not apply in the clinical setting. Reduced, Failed, Aborted, Aborted… which one? What are the requirements for using modifiers 52, 73 and 74? These questions are common in the coding center world, and the answers never seem to be clear. Confusingly mix up the medical code instructions […]
The Rising Denial Rates in Healthcare Claims Processing Initial Claim Denials: In a new survey conducted by healthcare Company an increased percentage of initial claims are denied by private payers, including pre-approvals for medical claims. Hospitals, health systems, and post-acute care providers may have a difficult time getting paid for medical services. The survey respondents […]
The importance of Revenue Cycle Management (RCM) is no longer just a best practice in today’s ever-changing healthcare landscape – it has become a necessity. In a market where costs are rising, regulations are becoming more complex, and patients are becoming more responsible for their own finances, optimizing the revenue cycle is essential to maintain […]
The official April 2024 update to the HCPCS Level II code set is now available on the Centers for Medicare & Medicaid Services website. April update includes: 62 new codes 2 changes to scope and long description 21 obsolete codes 11 changes to long description 1 change to changes miscellaneous changes Below are some code […]