How to Improve Back-office Revenue Cycle Functions?

Back-office revenue cycle functions include claim submission, payment posting, denials handling & resolution, accounts receivable follow-up, and others. All these functions must be taken care of by billing experts to ensure accurate practice collection. Providers have to spend a lot of time on these back-office functions due to high employee turnover, billing and coding updates, changes […]

Boosting Patient Responsibility Collection

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 […]

Guidelines to Submit a Clean Claim

Defining Clean Claim A clean claim is a submitted claim without any errors or other issues, including incomplete documentation that causes claim rejections or denials. As per the definition of a clean claim first part is correct to claim information and while the second part is not missing any information. In this blog, we shared […]

How to File a Medicare Appeal?

When a healthcare provider wishes to appeal a denied Medicare claim (Fee-for-Service), Medicare offers five levels in the Part A and Part B appeals process. Five-level areas: First Level: MAC Redetermination, Level Two: Qualified Independent Contractor (QIC) Reconsideration, Level Three: Office of Medicare Hearings and Appeals (OMHA) Disposition, Level Four: Medicare Appeals Council (Council) Review, […]

Urgent Care Billing Challenges Amongst COVID-19 Pandemic

Urgent care billing and coding is more challenging than other primary care medical billing and coding. Various payer reimbursement policies, frequent coding changes, and high deductible health plans increase difficulties for urgent care billing. According to the American Academy of Urgent Care Medicine, as many as 100 new urgent care clinics open every year but […]

Improving Your Pain Management Collection

American Academy of Pain Medicine estimates that over 100 million people suffer from acute or chronic pain, which equates to 20.4% or 1 in 5 adults. This number is far more than the number of patients affected by heart disease, diabetes, and cancer combined. While there’s such growth in pain management care, some of the […]

Systematically Reduce Your Accounts Receivable

Accounts receivable management plays a key role in having stable financial health for your practice. Accounts receivable is nothing but the amount owe to you by insurance companies and patients. As the number of days increases to collect this amount, the chances of collecting this amount also decrease. Accounts receivable are classified in a number […]

Why You Should Outsource to a Medical Billing Company?

Most practice owners are hesitant to outsource their medical billing and coding functions. Practice owners are familiar with basic medical billing and coding functions and try to do everything on their own. They will code themselves, use modifiers and will submit the claim, and will for insurance reimbursements. They will use online knowledge available for […]

Improve Orthopedic Collection Process

Orthopedic practice owners are struggling to maintain the financial stability of their practice. There are many reasons for this struggle as expenses aren’t declining while reimbursement from payers isn’t increasing. As per a recent orthopedic billing survey, more than 30% of orthopedic surgery claims are incorrectly submitted. Such a high portion of rejected and denied […]

Challenges to Radiology Medical Billing

Radiology medical billing has its own set of challenges. Unlike the rest of medical billing specialties, radiology billing has two components i.e., the professional component and the technical component. While billing for radiology, when a radiologist uses a radiology apparatus, dyes & machines, it must bill it under technical elements, whereas diagnostic results must be […]

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