While revenue cycle management (RCM) involves many steps, payment posting processes often gets overlooked. Optimizing this process acts as the cornerstone for smoother billing, reducing administrative burdens, and uncovering new revenue streams. By providing a clear view of daily income, accurate payment posting helps practices proactively address errors that could otherwise complicate medical billing and […]
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 […]
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 […]
Claim scrubbing enables the potential for increased accuracy in claims, enhanced client relationships, and improved patient interactions. Claim scrubbing is the process of identifying and rectifying coding errors in medical claims prior to their submission to insurance providers. Whether conducted manually or through automated systems, claim scrubbers validate medical claims before they are sent to […]
It’s common for people to feel surprised by the cost of hospital, medical imaging, or outpatient surgery bills. Unfortunately, it’s difficult for them to verify whether the bill is accurate or not. This is because incorrect medical bills have become increasingly common. To address this issue, organizations are turning to technologies such as artificial intelligence […]
With the arise of indirect health practices such as telehealth, it is becoming increasingly indispensable to play with bill payments and claims orderly. The medical billing cycle is a complex system encompassing procedures such as medical recordkeeping and patient data processing. Medical claim processing is the keystone for healthcare insurance companies since it needs data […]
Error-free medical billing and coding are critical characteristics of a revamped revenue cycle system. Appropriate billing and coding are not only needed in terms of compliance but are also pivotal in bringing down medical claim denials and rejections. When you take a more dynamic approach to your billing and coding operation, you not only get […]
Medical claims denials are on the rise and continue to be a costly problem for health systems. Unfortunately, the vast majority of providers focus their resources on reactive responses, working to appeal denials and recover payments after denials have already occurred. In a Becker’s Healthcare podcast an expert, discussed the problem of rising denials, why […]
The 2023 CPT code set will update the rest of the E/M code section after significant changes in 2021, as well as revise AI and virtual care codes. The American Medical Association (AMA) has released the Current Procedural Terminology (CPT) code set for 2023, which contains updates that aim to reduce medical coding burden for […]
CMS released the fiscal year (FY) 2023 inpatient prospective payment system proposed rule with proposals for new calculations for FY 2023 rate setting. Although CMS is proposing to use FY 2021 data for FY 2023 Medicare Severity Diagnosis-Related Groups (MS-DRG) rate setting, the agency wants a modified methodology to account for the historical and potential […]