The Revenue Cycle Management (RCM) process is at the heart of any healthcare organization, encompassing all administrative and clinical functions that contribute to capturing, managing, and collecting revenues. Increasing efficiency, reducing costs, and improving patient care are essential in the rapidly evolving healthcare landscape. RCM will be reshaped by several key RCM trends and technological […]
Medical billing is at the forefront of a transformational industry in healthcare. Medical billing trends 2024 promise to make this a pivotal year for medical billing due to rapid technological advancements, regulatory changes, and evolving patient expectations. Providing insights that can help healthcare providers, billing professionals, and administrators navigate these changes effectively, this newsletter explores […]
Generative AI is revolutionizing healthcare: Recent breakthroughs have seen these models excel in medical exams, complex diagnoses, and even pandemic response strategies. Advanced language models like GPT-4, Google’s Bard, and specialized healthcare models are now capable of handling intricate tasks that can dramatically improve clinical decision-making and administrative efficiency. The immense potential of Generative AI […]
A domestic medical billing audit is an operation that inspects and estimates the value and dependability of clinical documentation and the overall medical billing process. This technique closely examines health records upheld by the practice and evaluates medical billing data presented to the payers to make sure that the practice picks out, observes, and rectifies […]
The healthcare industry has traditionally been a black box when it comes to pricing. Patients, providers, and payers alike have often struggled to understand the complex web of costs associated with medical services. However, a seismic shift is underway. The advent of price transparency regulations and the evolving role of Revenue Cycle Management (RCM) are […]
A proposal to track prior authorization using CPT codes was pulled back for revision after a surprising finding. An urologist, advocated for the plan to compensate physicians for time spent on prior authorization requirements. He also hoped it would streamline the process and improve patient care. However, the American Medical Association (AMA) informed urologist that […]
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 […]
The revenue cycle management process (RCM) must be optimized for financial stability and growth in today’s competitive healthcare landscape. As a result of a smooth RCM process, revenue leakage is minimized and profitability is maximized. With this newsletter, leading medical billing experts share their insights on how to streamline and optimize Revenue Cycle Management. The […]
Medical ICD-10-CM coding accuracy is crucial for efficient healthcare reimbursement. Even minor errors can lead to claim denials, delays, and lost revenue. Here are the top 10 medical coding mistakes to avoid: Accuracy is Key: 1. Don’t Skip the Details: ICD-10-CM codes often require specific details in the fourth and fifth digits. Using truncated codes […]
Medical coding is the backbone of administrative and clinical processes in healthcare. This landscape is characterized by the International Classification of Diseases, 10th Edition (ICD-10), which provides a standardized system to classify diseases, injuries, and medical procedures. While ICD-10 offers robust benefits in terms of specificity and data granularity, healthcare professional’s worldwide face significant challenges […]