Tag: Medical billing compliance

RCM Compliance Challenges

Top 10 Revenue Cycle Management Compliance Challenges

Revenue cycle management (RCM) is the financial backbone of any medical practice, ensuring timely reimbursement while maintaining compliance with ever-evolving regulations. However, many practices unknowingly face significant compliance risks that can lead to claim denials, audits, financial penalties, and even legal consequences. Common pitfalls include billing and coding errors, fraud and abuse violations, HIPAA breaches, […]
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Future of Medical Billing

2025 Medical Billing: Navigating the Future of Healthcare Payments

As we step into 2025, the healthcare industry stands at a pivotal juncture where innovation, technology, and evolving regulations converge to reshape the medical billing landscape. At Allzone Management Services, we recognize that staying ahead in this rapidly changing environment requires foresight, adaptability, and a commitment to excellence. This newsletter explores key trends, challenges, and […]
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Historical Medical code set

Mastering Historical Medical Code Sets for Audits, Appeals, and Research

Remaining up-to-date is essential in the healthcare industry, but relying solely on current codes isn’t always the best approach. When auditing, handling appeals, or researching code usage for past encounters, a solid grasp of the descriptors and guidelines applicable during the date of service (DOS) can profoundly impact outcomes. Here’s a concise guide on effectively […]
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Prior Authorization Transformation

How Prior Authorization Transformation Benefits Patients, Providers and  Payers

Prior authorization transformation of consent is a source of worry and concern for everyone involved: patients, members, providers, and payers. What was needed was a structure to coordinate all stakeholders and organize the program. In January 2024, the Centers for Medicare and Medicaid Services (CMS) finalized requirements to expedite the authorization process; this requirement will […]
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Intricacies-of-Evaluation-and-Management-Coding

Navigating E&M Code Changes

It is expected that the Centers for Medicare & Medicaid Services (CMS) will release a completely revamped version of the evaluation and management (E&M) codes by 2021, particularly for the office visit codes (999201-99205 and 99211-99215). In addition to the changes to the office visit codes, there were significant changes to the 2023 guidelines. These […]
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