Increasing wound care reimbursements can be challenging, as it involves multiple stakeholders such as insurance companies, healthcare providers, and policymakers. However, there are several strategies that can be used to address these challenges, including: 1. Partnering with Wound Care Specialists Partnering with wound care specialists can be a great way to increase practice revenue, as […]
What is Unbundling Codes? Unbundling codes in medical billing refers to the practice of separately billing for individual components of a medical procedure or service, rather than billing for the complete procedure or service as a single entity. This practice can result in higher payments to healthcare providers and higher costs for patients and insurers. […]
Accounts Receivable in Medical Billing Accounts Receivable in medical billing is retrieving of payments due by the insurance and patients to the physician for the delivered services. For the long-term financial sustainability of your practice, it’s crucial to keep accounts receivable under check. Accounts receivable are categorized as the number of days the payment hasn’t been […]
Revenue Leakage in Medical Billing ‘Revenue leakage’ refers to situations where a healthcare provider doesn’t receive insurance reimbursement for delivered services. In such billing situations, accounts receivable remain unpaid for too long and eliminate the chances of payment recovery, even partially. Healthcare practices cannot afford to ignore their revenue leakage as it’s directly affecting their […]
Medical coding is a key process of revenue cycle management. Whether you are facing a high rate of denials and not achieving best-in-class A/R outcomes or not receiving timely insurance reimbursements, the impact of low-quality coding shows very quickly on your practice collections. Medical coding not only produces clean claims but also helps identify issues […]
Significance of Insurance Claim Submission Running a successful healthcare practice is much more challenging than delivering high-quality patient care services. Whether you are running a solo practice, a laboratory, a hospital, or a dental clinic, there are several things you need to get right, including insurance billing. Receiving accurate insurance reimbursements is considered the backbone […]
Introduction to Radiation Oncology Model The Radiation Oncology Model aims to improve the quality of care for cancer patients receiving radiotherapy (RT) and move toward a simplified and predictable payment system. The RO Model tests whether prospective, site-neutral, modality agnostic, episode-based payments to physician group practices (PGPs), hospital outpatient departments (HOPD), and freestanding radiation therapy […]
Medical provider credentialing is a process through which healthcare facilities and insurance companies access and confirm the qualification of a provider. The process is vital as it helps maintain high standards in healthcare. Since credentialing tells us whether a provider has the necessary training or expertise to practice healing arts, it is paramount for everyone […]
2023 Medicare Physician Fee Schedule Proposed Rule Recently, the Centers for Medicare & Medicaid Services (CMS) released the CY 2023 revisions to payment policies under the Medicare Physician Fee Schedule (MPFS) and other changes to the proposed rule for Medicare part B payment policies (CMS-1770-P). In this article, we shared the impact of the 2023 […]
False Claims Act in Healthcare The False Claims Act (FCA) in healthcare (also called the ‘Lincoln Law’), is a federal law that imposes liability on persons and companies who defraud governmental programs. It is the federal government’s primary litigation tool in combating fraud against the government. The federal False Claims Act makes it illegal to: […]
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