Surgical Package Coding Guidelines

Most medical and surgical procedures include pre-procedure, intra-procedure, and post-procedure work. When multiple procedures are performed at the same patient encounter, there is often an overlap of the pre-procedure and post-procedure work. Payment methodologies for surgical procedures account for the overlap of the pre-procedure and post-procedure work. The component elements of the pre-procedure and post-procedure […]

Be Compliant with Accurate OB/GYN Coding Guidelines

Many times physicians tends to code a regular set of procedure codes without a proper understanding of coding guidelines. It’s always advisable to take the guidance of certified coders who have a deep understanding of payer-specific and medical specialty-specific coding guidelines. Otherwise consistent inaccurate medical coding might result into an external payer audit. It’s specifically […]

Significance of Claim Scrubbing in Medical Billing

What Is Claim Scrubbing? Claim scrubbing is a method of reviewing claims before a medical practice submits them to an insurance carrier. Claim scrubbing removes all the errors that might lead to claim denials. In the claim scrubbing process, the billing team checks the correctness of the Current Procedural Terminology (CPT) codes in your claims. This […]

5 Newly Added Sometimes Therapy Codes

The Centers for Medicare & Medicaid Services (CMS) in its ‘year 2022 annual update to the therapy code’ document introduced 5 newly added ‘sometimes therapy’ codes. CMS considers these 5 CPT codes to be remote therapeutic monitoring (RTM) services that physical therapists (PTs), occupational therapists (OTs), and speech-language pathologists can provide, when appropriate. CMS designated […]

Grow Your Practice with Telehealth Services

Patients Love Telehealth Healthcare providers and patients used to see medical care as something best done in-person. But the COVID-19 pandemic changed everything including a massive transition to virtual care. According to McKinsey Consumer Health Insights Survey, patients still prefer the convenience of digital engagement and virtual care options. This patient preference is an opportunity […]

Top 5 Online Tactics to Gain More Patients

Need of Online Presence In the current era of digitalization where mobile phones are no longer used only for calling, your patients are using every possible online channel to find information about your practice. Earlier, healthcare practices used to get incoming calls or voicemails filled with questions about the practice. Now patients might have the […]

Additional Tips for Negotiating Payer Contracts

Many physicians struggle with fee-for-service payer contract negotiations because asking for higher payments can feel like a pointless effort. Negotiating a successful payer contract is possible for those willing to craft a thoughtful, data-driven argument for why they deserve more money. Physicians think it will be really stressful or may not yield any results. Negotiating […]

Efficiently Managing Underpayment to Increase Practice Collections

What is Underpayment in Medical Billing? An underpayment in medical billing refers to a billing situation where practices are expecting higher payments for delivered services while insurance carriers have paid a lesser amount for the same services. Usually, denials arise due to incorrect patient information while underpayments stem from incorrect billing prices. Underpayments are tricky […]

Improving Your Practice’s Front Desk Collections

Timely collection of patient payments is equally important as collecting insurance reimbursements. In the past few years as more and more patients are adopting High Deductible Health Plans (HDHPs), patient responsibility has increased exponentially. The most reliable source of patient collections is when they are in the office. So, up-front collection of patient payments at […]

Differentiating Between Medical Necessity and Medical Decision Making

Differentiating Between Medical Necessity and Medical Decision Making Medical coders and physicians often confuse between terms medical necessity and medical decision making and this confusion might lead to an inaccurate selection of Evaluation and Management (E/M) codes. It’s important to understand both concepts and clear the confusion as it could result in denied payments. Any […]

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