This year with the new cardiology Billing and guidelines, cardiologists are in a tight spot. Furthermore; CMS lowers the reimbursement as part of its multiple procedure payment reductions for imaging services. This will lead to a reduction of 22% on the technical modules of the lower-priced services. It is imperative to have the right coding […]
What is Pre Authorization? Most of the carriers request to obtain prior authorization from them before the service/surgery. Prior authorization for health care services is required for certain services. If authorization is not obtained prior to performing the service, the insurer may not reimburse for the procedure. Most services requiring prior authorizations are surgical procedures […]
With the rollout of ICD-10; billing, coding, documentation, compliance, and auditing have become the buzzword in the healthcare industry. All these are going to have a massive impact on your practice’s revenue cycle. Hence; to meet the compliance standards and to combat the challenges of the documentation, billing, and coding hiring an outsourcing billing service […]
HCC coding also known as Hierarchical Condition Category coding is the important key element that decides the reimbursement benefits for a Medicare Advantage Plan that uses ICD diagnostic codes as the primary indicators of the member’s health status. Correct coding for the Medicare advantage plan will ensure clean claims for the physician practices. MBC is […]
The clearinghouse you work with has a huge impact on your business. The more efficiently your clearinghouse processes and returns your information, the faster you will get paid, and the more payments you will collect. Billing is at the core of your revenue cycle. Therefore, choosing the right clearinghouse for medical practice is an important […]
Most physicians strive to work ethically, provide high-quality medical care to their patients, and submit proper claims for payment. Trust is at the core of the physician-patient relationship. The Federal Government also places enormous trust in physicians. Medicare and other Federal health care programs rely on physicians’ medical judgment to treat patients with appropriate, medically […]
The CMS has developed the Healthcare Common Procedure Coding System (HCPCS) for reporting medical procedures and services. Some of the most commonly used HCPCS Level II Codes, J-codes are used for non-orally administered medication, chemotherapy, and immunosuppressive drugs, and inhalation solutions as well as some orally administered drugs. Submitting Claims with J-codes: HIPAA required that […]
When outstanding patient balances grow out of control, your practice may feel there’s no option but to place them in the hands of a collection agency. Putting debt professionals in charge is the best way to get your payment… right? Not always. Physicians and practice managers often resort too quickly to the services of a […]
Physicians in general surgery are facing an uphill task of medical billing keeping in check the different needs of the facilities and keeping a tab on the effective revenue cycle management to look for frequent denials and which of the claims need more efficient coding. The channel of insurance payment has been one of the […]
The revenue cycle process and its management have continuously progressed over the last few years to keep up with the changes occurring in the healthcare industry. 2020 is no exception. When we talk about healthcare units and hospitals, the primary thought that comes to one’s mind is the patient care experience as it relates to […]
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