Tag: medical-billing

Top 13 Reasons For Claim Denials

Top 13 Reasons For Claim Denials

Denied claims are one of physicians’ chief complaints when it comes to dealing with payers. To a certain extent, every practice deals with claim denials. It’s those practices that eliminate the most common reasons that experience a smoother revenue cycle and find greater financial success. Here are the 13 most common reasons for why claims […]
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Medicare-IRF-Proposed-Rule

CMS Posts 2020 IRF Proposed Rule

The focus on electronic health record implementation has turned to how to make use of the vast data stored within to improve revenue cycle operations (IRF). Proposed rule calls amending regulations clarifying the determination as to whether a physician qualifies as a rehabilitation physician is made by the IRF. The Centers for Medicare & Medicaid […]
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What Providers Need to Know Right Now About PDPM

The Centers for Medicare & Medicaid Services’ Patient-Driven Payment Model (PDPM) takes effect on Oct. 1. When the reform takes effect, long-term post-acute care (LTPAC) facilities will see a big change in how they receive payment for delivering valuable patient care. While the payment reform will inevitably bring challenges, it will also present a significant […]
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AI in Medical Billing

Could AI-Driven Medical Billing be The Key to Keeping Struggling Hospitals in the Black?

The entrepreneurs behind Sift Healthcare are using predictive analytics (AI) to crack the code on unpaid medical bills, helping health facilities work smarter when managing budgets. Last month, Alabama’s Georgiana Medical Center closed its doors, making it the 13th Alabama hospital to close in eight years. Seven of the 13 shuttered hospitals served rural communities. In […]
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Insurers, Providers Spar Over Solution to Surprise Medical Bills

America’s Health Insurance Plans called on Congress to set a fixed reimbursement rate based on what insurers pay in a region. Providers are pushing back against an insurer proposal for legislation to set reimbursement rates to avoid surprise medical bills. In a letter to Senate and House leaders this week, America’s Health Insurance Plans and 16 other […]
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HCPCS Level II Drug Codes

21 New HCPCS Level II Codes for April

The new codes include drugs for migraines, to initiate blood-clotting in patients on certain coagulants, chronic and hairy cell leukemia, and folic acid for chemotherapy patients. The home health codes help facilitate the Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (CMMI) Pioneer ACO initiative. New HCPCS Level II Codes […]
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ICD-10 Coding Errors, Diagnostic Errors, Payment Reform. Coding Errors

ICD-10, Diagnostic Errors & Payment Reforms to Improve Diagnostic Accuracy

In October 2015, physicians across the United States transitioned from the International Statistical Classification of Diseases and Related Health Problems, Ninth Revision to the tenth revision (ICD-10-CM, the US version of the World Health Organization [WHO] ICD-10). Although the ICD-10-CM was a new concept for physicians in the United States, the international variant has been available since […]
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Patient Satisfaction, Medical Billing, Healthcare business model, Healthcare Providers, Patient Payment, Healthcare, Consumerism, Health Plans, Digital Healthcare, Patient Collections, Healthcare Technology, Machine Learning, Healthcare Automation, Medical Practice, Consumer Engagement.

How to Drive Patient Satisfaction and Financial Results with a Modern Medical Billing Process

Most industries embrace the motto “the customer is king.” They are acutely aware their success is driven by it. While the complexity of the healthcare business model has made it challenging for provider organizations to adopt such an ethos, the recent rise of consumerism in the industry necessitates that providers prioritize the patient experience if […]
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