Medical Billing Services

Providers face multiple healthcare fraud and abuse laws at the local, state, and federal levels. Fraud and abuse cases in the healthcare industry cost billions of dollars a year. Healthcare fraud and abuse situations include submitting false claims; billing for medically unnecessary services; billing and coding errors; billing for services that were provided by unlicensed […]

The first element of the revenue cycle starts with patient registration. From the minute a new patient begins the registration process, it’s crucial that you are asking for and receiving correct information. If any information is omitted, given incorrectly, or entered incorrectly by the front desk then it will lead to incomplete and/or incorrect claim […]

Healthcare service providers sometimes waive patient financial responsibility i.e., Copays and Deductibles as an accommodation to the patient, professional courtesy, and employee benefits. However, waiving co-pays and deductibles may violate fraud and abuse laws and payer contracts. For a payer, waiving co-pays and deductibles creates two problems. First, payers require co-pays to discourage overutilization and […]

Anti-Markup Rule The Anti-Markup Rule prohibits a billing physician or other supplier from marking up either the Technical Component (TC) or Professional Component (PC) of a diagnostic test ordered by the billing physician or other supplier (or ordered by a party related to such physician or other suppliers through common ownership or control) unless the […]

Requirements Related to Surprise Billing Biden-Harris Administration, through the U.S. Departments of Health and Human Services (HHS), Labor, and Treasury, and the Office of Personnel Management, issued ‘Requirements Related to Surprise Billing; Part I, ‘an interim final rule that will restrict excessive out of pocket costs to consumers from surprise billing and balance billing. Surprise […]

Medical billing is the most important yet underestimated part of your healthcare organization’s revenue cycle. However, there are a few things that are commonly believed about them that just aren’t true! These myths range from considering medical billing as a data entry process to misconceptions about outsourcing. We wanted to clear up some of the […]

One of the biggest challenges for healthcare providers is boosting patient responsibility collection. Due to lower monthly premiums, more individuals are choosing plans with higher deductibles and more out-of-pocket expenses for services. This increase in patient portion for medical services is a major challenge for healthcare revenue cycle management. As more patients are opting for […]