Defining Clean Claim A clean claim is a submitted claim without any errors or other issues, including incomplete documentation that causes claim rejections or denials. As per the definition of a clean claim first part is correct to claim information and while the second part is not missing any information. In this blog, we shared […]
When a healthcare provider wishes to appeal a denied Medicare claim (Fee-for-Service), Medicare offers five levels in the Part A and Part B appeals process. Five-level areas: First Level: MAC Redetermination, Level Two: Qualified Independent Contractor (QIC) Reconsideration, Level Three: Office of Medicare Hearings and Appeals (OMHA) Disposition, Level Four: Medicare Appeals Council (Council) Review, […]
Urgent care billing and coding is more challenging than other primary care medical billing and coding. Various payer reimbursement policies, frequent coding changes, and high deductible health plans increase difficulties for urgent care billing. According to the American Academy of Urgent Care Medicine, as many as 100 new urgent care clinics open every year but […]
American Academy of Pain Medicine estimates that over 100 million people suffer from acute or chronic pain, which equates to 20.4% or 1 in 5 adults. This number is far more than the number of patients affected by heart disease, diabetes, and cancer combined. While there’s such growth in pain management care, some of the […]
Accounts receivable management plays a key role in having stable financial health for your practice. Accounts receivable is nothing but the amount owe to you by insurance companies and patients. As the number of days increases to collect this amount, the chances of collecting this amount also decrease. Accounts receivable are classified in a number […]
Most practice owners are hesitant to outsource their medical billing and coding functions. Practice owners are familiar with basic medical billing and coding functions and try to do everything on their own. They will code themselves, use modifiers and will submit the claim, and will for insurance reimbursements. They will use online knowledge available for […]
Orthopedic practice owners are struggling to maintain the financial stability of their practice. There are many reasons for this struggle as expenses aren’t declining while reimbursement from payers isn’t increasing. As per a recent orthopedic billing survey, more than 30% of orthopedic surgery claims are incorrectly submitted. Such a high portion of rejected and denied […]
Radiology medical billing has its own set of challenges. Unlike the rest of medical billing specialties, radiology billing has two components i.e., the professional component and the technical component. While billing for radiology, when a radiologist uses a radiology apparatus, dyes & machines, it must bill it under technical elements, whereas diagnostic results must be […]
Running a chiropractic practice is no easy task. Chiropractic treatments usually take longer and require frequent visitations, as a result of which focusing on the other related tasks becomes quite difficult. Medical billing and coding regulations are always changing in the chiropractic and pain management arena. The amount of administrative work involved in the daily […]
Rising operational costs, changed payer policies, decreasing reimbursement, and increased compliances adversely affect the financial health of the family practice. In addition, operational inefficiencies and waste cut even deeper into profits and income. A certain amount of each factor is inherent in any family practice. In this blog, we shared ways your family practice might […]
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