Effective RCM Strategy to Increase Reimbursements

The Healthcare Financial Management Association (HFMA) defines Revenue Cycle Management (RCM) as all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue. Revenue cycle management (RCM) is the financial process related to a patient’s clinical encounter. According to HFMA, a basic role of RCM is to measure how […]

Unique Challenges of Substance Abuse Billing

Medical billing on its own can be a complex process, requiring specific expertise. However, substance abuse billing comes with unique challenges even for certified billing and coding experts. Substance abuse billing is one of the major areas with which drug and alcohol addiction treatment centers struggle resulting in lost revenue and delayed payments. Many drug […]

Effectively Handling Claim Denials

In a perfect world, all submitted claims would be processed correctly the first time. In the world of medical billing, however, we know this is not always the case. Even after cautiously submitting a claim it may get denied. Handling claim denials can be a frustrating, time-consuming, and complicated process. Knowing some basic strategies for […]

Manage Coordination of Benefits (COB) Denials

Centers for Medicare & Medicaid Services (CMS) defines coordination of benefits (COB), as the process which allows plans that provide health and/or prescription coverage for a person with Medicare to determine their respective payment responsibilities. In simpler words, COB determines which insurance carrier is primary, secondary, and so forth. This coordination between insurance carriers exists […]

Increase your Practice Collection by Educating Patients

Current fact suggests, nearly 6 in 10 patients either rarely or never received an estimate of out-of-pocket costs before they received treatment. As per a survey report from TransUnion Healthcare, 75 percent of patients mentioned that they can play better if they receive pre-treatment estimates of out-of-pocket costs well in advance. The healthcare experts agree […]

Collect More Accurately with Eligibility and Benefits Verification

Eligibility and benefits verification is the first and most significant step in the medical billing and coding process. Today’s continually changing and increasingly complex healthcare environment requires, more than ever, close attention to validating coverage, benefits, co-payments, and unpaid deductibles. With the eligibility and benefits verification process in place, you can collect more accurately. Thus, […]

How Can You Fix Expensive Medical Billing Mistakes?

Sometimes, you are so focused on delivering the best patient care, it causes key medical billing mistakes. Whether it’s submitting paper claims, not having EOBs for all claims, not understanding denial reasons, not following up on claims, not reviewing clearinghouse reports, and the list goes on. Unfortunately, failure to follow payer policies and reimbursement guidelines […]

Charging Patient No-Shows

Despite your best efforts to remind patients of their appointments, you’re still likely to encounter one or two patient no-shows every day, approximately 5 percent to 7 percent of total monthly appointments. If the average office visit generates a $25 co-pay and a $90 reimbursement, just two missed appointments per day can cost your practice […]

Removing Front Desk Inefficiencies in a Medical Practice

Inefficiencies in medical practice not only waste time and effort, but also contribute to errors, reduce productivity, affect practice revenue, and frustrate patients, staff, and providers. Despite the potential for serious consequences, many practices fail to address these inefficiencies. Perhaps practice owners don’t have skilled manpower to handle such inefficiencies or they can’t take sufficient […]

Preparing Your Practice for Telehealth Services

Telehealth is gaining popularity daily. The COVID-19 pandemic endorsed the importance of virtual care. Telehealth has received acceptance and more confidence from patients not only for counseling but for other medical services too. If you are not offering telehealth services then you might be missing greater opportunities. Offering telehealth services requires little preparation. Preparing your […]

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