Documentation of medical services is necessary to provide information to assist health care professionals in providing services to patients which are medically necessary. Apart from helping in medical billing and coding, it also reflects the competency and character of the physician. Even though the role played by documentation has always been a supportive one, it’s […]
Electronic Data Interchange (EDI) represents a digital communication channel to deliver data from payers to providers digitally and securely. Most of the providers have a lot of confusion over what it meant by EDI or ERA enrollment. EDI simplifies the process of sending information back and forth between provider and insurance carrier. If you want […]
When you submit a claim to any insurance carrier, it will either get paid, fully or partially, or it might get rejected or it might get denied. Most of the time, providers get confused between claim rejection and claim denial. When a claim is rejected, it generally means details mentioned in the claim are either […]
Providers continue to wonder how we can live in a world where so many RCM processes are handled quickly with technology, yet decisions that affect patient health are slowed by faxes and bureaucracy, even when there is only one clear treatment option. Yes, you are right, we are talking about Prior Authorization (PA) or Pre-Auth. […]
Medical billing which is part of Revenue Cycle Management represents all activities resulting in receiving accurate payment for services rendered to a patient. Medical billing and coding require specialized knowledge and specific skills which can’t be always handled by providers. There are a number of pieces to the puzzle that go from patients visiting your […]
Multiple E&M visits on the same day for the same patient address instances when a physician(s) or other qualified health care professional(s) reports a single code for multiple medical and/or Evaluation and Management (E/M) services for a patient on a single date of service. General E/M Code Procedure: Generally, a single E/M code should be […]
Revenue Cycle Management (RCM) is defined as the process of handling claims, processing payment, and generating revenue for your practice. It includes all functions associated with different steps of medical billing, beginning from the time when a patient makes an appointment and ending after all the claims and payments have been collected and the balance […]
Medical billing and coding translate a patient encounter into the form healthcare facilities use for claims submission and reimbursement. Medical billing and coding are separate processes, but both are necessary for providers to receive reimbursement for healthcare services. Medical Billers and Coders play a crucial role in revenue cycle management as their work starts from […]
Collecting from patients is one of the more challenging tasks of practice management. For the financial sustainability of your practice, you must make a concerted effort to collect co-payments, coinsurance, deductibles, and amounts for services not covered by insurance. You will receive more patient collections if you try and collect at the time of service […]
Telemedicine and telehealth services were growing before the COVID-19 pandemic, and demand has soared during the pandemic as patients and providers alike recognized the efficiencies and convenience of delivering care remotely. However, along with the surge in demand for virtual care comes a higher risk of a malpractice claim for health care professionals. In this […]
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