Tag: Revenue Cycle Management

Reducing Claim Denials

Mastering Healthcare Claim Denial Management: Strategies & Solutions

In healthcare, claim denials pose a significant challenge to a provider’s revenue cycle. Each year, over $4.5 trillion in claims are submitted to insurance carriers in the U.S. alone. Despite this volume, healthcare providers continue to see an alarming rise in denied claims. In 2022, 42% of respondents reported an increase in denials, but by […]
Reduce AR Days

Reduce AR Days and Improve Reimbursements with Cash Flow Cure

Accounts Receivable (AR) days directly impact cash flow and overall financial health. The longer a claim sits in AR, the more challenging it becomes to collect revenue, leading to cash flow disruptions, operational inefficiencies, and reduced profitability. Therefore, it’s crucial for businesses to actively work to reduce AR days and improve their financial performance. With […]
Urology Billing and Coding

Urology Billing & Coding Errors and How to Prevent Them

Urology practices face unique challenges when it comes to billing and coding. The complexity of urological procedures, coupled with ever-changing coding guidelines, can lead to costly errors, claim denials, and revenue loss. Accurate and efficient billing is crucial for the financial health of any urology practice. This blog post will delve into common urology billing […]
Manual Claims Denial Management

Why Manual Denial Management is Hurting Your Revenue

Healthcare providers face mounting financial pressures due to rising operational costs, evolving regulatory requirements, and shrinking reimbursement rates. One of the most critical areas affecting revenue cycle efficiency is claims denial management. Despite advancements in technology, many healthcare organizations still rely on manual claims denial management, leading to inefficiencies, revenue leakage, and administrative burdens. This […]
Therapy Services Codes

Therapy Services Codes: A Complete Guide to CPT & HCPCS Codes

Therapy services play a vital role in healthcare, helping patients recover from injuries, manage chronic conditions, and improve overall well-being. To ensure accurate billing and reimbursement, healthcare providers must use the correct therapy services codes. These codes, primarily based on the Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), help standardize claims […]
Top Medical Billing Trends

Medical billing trends in 2025

The medical billing landscape is evolving rapidly, driven by advancements in technology, regulatory updates, and shifting patient expectations. Staying informed about Top Medical Billing Trends is crucial. As we enter 2025, healthcare providers and medical billing companies must stay ahead of the curve to ensure compliance, maximize revenue, and improve patient satisfaction. This newsletter will […]
Wound Repair Coding

Mastering Wound Repair Coding: A Guide to CPT Codes

Accurate coding of dermatological procedures requires a deep understanding of skin anatomy and the ability to extract key details from clinical documentation. Over the past two months, we’ve covered Wound repair coding guidelines for skin tag removal, shaving, and lesion excision. Now, in this final installment, we focus on wound repair (closure) procedures using CPT® […]
cpt chronicles- Medical coding

CPT Chronicles: The Future of Medical Coding

Medical coding is at the heart of healthcare administration, ensuring accuracy, compliance, and efficiency in the complex world of medical billing and reimbursement. With the rapid advancement of technology, regulatory changes, and an evolving healthcare landscape, medical coding is undergoing a transformative shift. As part of this shift, professionals are turning to resources like ‘CPT […]
medical necessity documentation

Medical Necessity Documentation: A Guide to Reducing Claim Denials

Claim denials are a significant headache for healthcare providers, impacting revenue and administrative efficiency. While denials can stem from various issues, a large majority are rooted in documentation errors, particularly those related to demonstrating medical necessity. Defining Medical Necessity: The American Medical Association (AMA) defines medical necessity as healthcare services or products provided to a […]
Denial Management Process

3 Proactive Strategies for Improving Denial Management

In the ever-evolving field of medical billing, denied claims remain a significant obstacle for healthcare providers. Studies reveal that over 10% of claims face initial rejection by insurers, leading to revenue losses, administrative strain, and frustration for all stakeholders. To mitigate these challenges and ensure financial stability, an effective denial management process is essential. However, […]