Tag: Medical billing and coding

CPT 95165

CPT Code 95165: Reimbursement Updates for Allergen Immunotherapy

Allergen immunotherapy remains a cornerstone of treatment for many patients suffering from allergic conditions, offering long-term relief and potentially altering the course of disease. For allergy and immunology practices, CPT code 95165, which covers the professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, is a vital component of their […]
Learn More
Automated Insurance Eligibility Checks: Improving AR Days

Automated Insurance Eligibility Checks: Improving AR Days

Table of Contents Understanding the Impact of Denials and AR Days The Role of Automated Insurance Eligibility Checks Benefits of Automated Insurance Eligibility Checks Implementing Automated Insurance Eligibility Checks Insurance Eligibility Verification Service: A Critical Step for Healthcare Practices One significant challenge that healthcare providers face is the high rate of insurance claim denials and […]
Learn More
ICD-10-CM code updates

ICD-10-CM Updates: What You Need to Know

The accuracy of medical coding in the ever-evolving healthcare industry is not only crucial for accurate billing, but it is also crucial for quality reporting, compliance, and patient outcomes. The ICD-10-CM codes for 2024 have been updated, resulting in new and revised codes for healthcare providers that have an impact on multiple aspects of patient […]
Learn More
The Power of Business Process Automation in Medical Claims Processing

The Power of Business Process Automation in Medical Claims Processing

Medical claims processing has traditionally been a labor-intensive and error-prone task, involving manual data entry, verification, and adjudication. However, the advent of Business Process Automation (BPA) has revolutionized this process, making it more efficient, accurate, and cost-effective. Beyond the Basics: Advanced BPA Features While the core functionality of BPA in medical claims processing involves automating […]
Learn More
Prevent Coding and Billing Errors

Preventing coding and billing errors can reduce claims denials

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 […]
Learn More
RCM in Physician Practices: Key Steps Revealed by AMA

RCM in Physician Practices: Key Steps Revealed by AMA

Physician RCM: This guide dives into key areas physician private practices can target to strengthen their revenue cycle management (RCM), as outlined by the American Medical Association (AMA) in recent News. By optimizing these eight steps, practices can ensure timely and accurate reimbursement for services provided. 1. Patient Registration: Accuracy First The foundation of a […]
Learn More

Medical Coding Audits: Trends and Guide for Providers

The landscape of medical coding audits is constantly evolving.  Staying informed about these trends and implementing best practices can significantly reduce stress and ensure a smooth audit experience. The Shifting Landscape of Medical Coding Audits Traditionally, medical coding audits felt like a lottery. Providers faced the uncertainty of random reviews, often scrambling to address issues […]
Learn More
Modifier 58 Versus 78 – Which Should You Use?

Modifier 58 Versus 78 – Which Should You Use?

Modifier 58 vs Modifier 78:  Modifier 58: Same underlying condition, planned or unplanned additional procedure. Modifier 78: New problem caused by the initial surgery (complication) requiring a return to the OR. Medical Coders often struggle to differentiate between modifier 58 (staged/related procedure) and modifier 78 (unplanned return to OR). Let’s break down the key differences […]
Learn More
How AI is streamlining medical billing and coding processes

How AI is streamlining medical billing and coding processes

Coding and medical billing with AI: Billing and coding processes in the healthcare industry are notoriously complex. The manual entry of data, the interpretation of physician notes, and maintaining compliance with ever-changing regulations all contribute to a system that is ripe for inefficiency and error. Healthcare providers and patients can save time, money, and frustration […]
Learn More
x