The American Medical Association (AMA) on 16th August 2021 announced that the Current Procedural Terminology (CPT®) code set is ready for the rollout of third doses of the Pfizer and Moderna COVID-19 vaccines. The CPT Editorial Panel has expedited approval of a new administration code that is unique to a third dose of the current […]
During the COVID-19 public health emergency, reimbursements for telehealth continue to evolve. The federal government, state Medicaid programs, and private insurers have expanded coverage for virtual health care services. More Medicare Fee-for-Service (FFS) services are billable as telehealth during the COVID-19 public health emergency. In this blog, we shared telehealth billing guidelines for medical billing […]
Increased Patient Financial Responsibility In the current healthcare climate, more and more patients are opting for high-deductible healthcare plans resulting in increased patient financial responsibility. Due to high deductible healthcare plans patients has to make large out-of-pocket payments to receive treatment. Few years before physician facilities, and hospitals were not that dependent on patient portions […]
By its very nature, oncology is one of the more stressful fields of medicine. Physicians are involved in scenarios dealing with life-threatening diseases and complex treatments every day. That means any other work apart from patient care will add stress. This includes administration and execution of oncology medical billing. Annual changes in medical coding, payer-specific billing […]
What is Eligibility and Benefits Verification? To receive payments for the services rendered, healthcare providers need to verify each patient’s eligibility and benefits before the patient’s visit. According to RemitData, two of the top five claim denial reasons for the year 2013 were insurance coverage related. With more patients choosing high deductible plans, this figure […]
Provider Credentialing Provider credentialing is the process by which an insurance company formally assesses a provider’s qualifications and competency-based on demonstrated competence. Before a provider or organization can bill an insurance company, the provider must first be credentialed by the insurance company. This can be a time-consuming process, and often takes up to six months […]
According to the denial rates report published in February 2021, out of total claims submitted worth $3 trillion, claims worth $262 billion were denied. You will be surprised to know that more than 90% of these denials are preventable. And the worst part is, more than half of these denials were never appealed or resubmitted […]
With patients bearing more financial responsibility for their healthcare, outpatient settings are becoming more appealing—driving demand for optimized Ambulatory Surgical Center Collections. A research report from Bain & Co. estimates that procedures in these centers will increase from 23 million in 2018 to 27 million in 2021. As per the same report, out of all […]
CPT manual section ‘Special Ophthalmological Services’ describes diagnostic tests that go beyond eye exams. These tests may be reported in addition to the general ophthalmological services or evaluation and management services. Diagnostic tests are usually reimbursed separately by most payers. Documentation of diagnostic tests should clearly mention why the physician ordered a diagnostic test and […]
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 […]
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