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Revenue Cycle Management (RCM)
Basics of Value Based Contract (VBC)
Defining Value-Based Contract (VBC) A value-based contract (VBC) is a written contractual arrangement between parties in which the payment for health care goods and services is tied to predetermined, mutually agreed upon terms that are based on clinical circumstances, patient outcomes, and other specified measures of the appropriateness and effectiveness…
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Radiology Billing Services
5 Inefficiencies in Radiology Billing and Coding
Most radiology practices are currently feeling the pinch of deep reduction in imaging revenue and decreased volume. Based on an analysis of the change in imaging volume from Yale’s academic multi-specialty radiology practice, the group saw a 70 percent dip in outpatient imaging since the start of the COVID-19 crisis,…
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Mental Health Billing Services
Billing Codes for Psychiatric Collaborative Care Management
What is Collaborative Care Management (CoCM)? Psychiatric Collaborative Care Management (CoCM) typically is provided by a primary care team consisting of a primary care physician and a care manager who work in collaboration with a psychiatric consultant, such as a psychiatrist. Care is directed by the primary care team and…
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Revenue Cycle Management (RCM)
3 Signs that Show Need of Outsourcing Revenue Cycle Functions
Healthcare providers are under increasing pressure as more and more patients are shifting to value-based care. Providers are already under pressure as they have to deal with declining reimbursements, higher risks, and tighter margins while improving patient care. Due to this, hospitals and physician practices of all sizes are being…
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Claims Denials
Analyzing Claim Denial Trends for 2020
Hospitals are receiving more claim denials from payers, with the average rate increasing by 23 percent in 2020 compared to 2016, according to a research report conducted by Change Healthcare. The analysis includes 102 million hospital transactions valued at $407 billion in total charges across more than 1,500 U.S. hospitals.…
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Medical Coding
Improving Medical Coding Quality
Even though medical coding plays a crucial part in revenue cycle management, it is the most neglected process of medical billing. As per the study report, documentation and medical coding are considered to be the weakest processes of the revenue cycle in 2019. Accurate medical coding will ensure the claims…
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Medical Billing Services
Diagnosis Coding Guidelines for Aftercare
Aftercare visit codes cover situations when the initial treatment of a disease has been performed and the patient requires continued care during the healing or recovery phase, or for the long-term consequences of the disease. Post-op care is different from aftercare. Post-op care falls into this category of care when…
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