Easy Tips for Quick, Accurate and Simplifying the Provider Credentialing Process

Medical Credentialing is a process whereby insurance networks check to make sure that the provider meets the standards set out by the insurance company. In this process, they review a range of documents including medical licenses, malpractice insurance, schooling information, and background checks. Credentialing is performed on an individual state-to-state basis. Whether you are adding […]

Time-Based Billing for CPT Evaluation and Management

Within the guidelines of the CPT code book, CPT has stated; “When counseling and/or coordination of care dominates (more than 50%) the physician/patient and/or family encounter (face-to-face time in the office or other outpatient setting or floor/unit time in the hospital or nursing facility), then time may be considered the key or controlling factor to […]

How to Deal with Patient Responsibility?

As patient responsibility balances climb, practice owners are seeking effective methods of collecting outstanding patient balances and ways to collect more payment at the time of service. Estimating patient responsibility prior to claims adjudication is a tricky business. However, practices can absolutely figure out a payment estimation plan that suits their needs and support the […]

Essential Tips for Handling Cardiology Coding and Billing

Cardiology billing and coding come with multiple procedure rules, complex contractual adjustments, and codes that change regularly. CPT code assignment has the potential to be challenging, particularly when modifiers are used, and staying up to date with new codes, code revisions, and deleted codes takes a significant time investment. Cardiology billing also offers a unique […]

Correct Coding for Pre-operative Clearance

Pre-operative evaluation and testing services may not be covered under Medicare. Primary care physicians are often asked to evaluate a patient prior to surgery at the request of the surgeon. Patients at an advanced age and those with significant medical problems face increased risk for surgical morbidity and mortality, and preoperative evaluation will depend on […]

What is the Insurance Credentialing Process?

Credentialing is a process that the insurance companies use to verify your education, training, and professional experience and to ensure that you meet their internal requirements for serving as an in-network provider on their panel. The goal of the insurance credentialing process is to become in-network and prevent your patients from having claims go towards […]

CAQH and Insurance Credentialing

What is CAQH? Council for Affordable Quality Healthcare, Inc. (initialized as CAQH) is a non-profit organization incorporated in California as a mutual benefit corporation. It is essentially an online portal that stores provider information in a secure, collaboration database. This secured information is granted to health insurance companies during the credentialing process to make acquiring […]

Prominent Ambulatory Surgery Center Medical Billing Functions are Affecting Your Practice Revenue

Compliance guidelines that govern the Ambulatory Surgery Center’s reimbursement are wide-ranging, complex, and ever-changing. Hence, it’s important for ASCs to hire or partner with Ambulatory Surgery Center medical billing and coding management consultants who understand the legal rules placed on ASCs, including specialized coding, accreditation, documentation, and reimbursement care contracts. Here are Prominent Ambulatory Surgery […]

Get positive ROI on every patient through outsourced optometry billing services!

Every moment when you think that your optometry billing and coding prerequisites are under control, new reimbursement and claims submission guidelines, coding alerts, or dedicated staffing roadblocks occur. When you as a practitioner are continuously managing claim denials and rejections, along with eligibility and benefits verifications, plus the claims submission and payment posting, looking into […]

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