Prior Authorization and It’s Impact on Practice Collection

Prior authorization is a check run by some insurance companies or third-party payers before they will agree to cover certain prescribed medications or medical procedures. There are a number of reasons that insurance providers require prior authorization, including age, medical necessity, the availability of a generic alternative, or checking for drug interactions. A failed authorization […]

Impact of High-Deductible Health Plans (HDHP) on Medical Practices

High-Deductible Health Plans (HDHP) have become increasingly popular since the Medicare Modernization Act of 2003 authorized portable, tax-advantaged health savings accounts (HSAs) designed to be coupled with these plans. Supports of HDHP advocate that, these plans as an effective mechanism for controlling health care costs by creating cost-conscious health care consumers who will look for […]

How to Manage Incoming Calls at Your Medical Practice?

Medical Practice complains about the volume of incoming telephone calls and how much time their employees spend handling them. Why is your Medical Practice getting so many calls? It is the only way patients can make or change appointments. Patients call the office for refill authorization. Patients were distracted during their visits and are calling […]

Wound Care Billing Guidelines 2019

Not only is wound coding and documentation is a daunting task, but also attracts intense inspection from auditors, with severe financial penalties for mistakes. And it’s only gotten more challenging with the new ICD-10 changes. What is included in the wound care billing guidelines 2019? An infected surgical wound, T81.4xxA, is among those 51 codes […]

What Are The Differences – an Interventional Cardiologist and Invasive, Non-Interventional Cardiologists?

A healthy heart is essential to lead a healthy and happy lifestyle. There are a lot of things that can go wrong with your heart, and sometimes the symptoms that something is wrong are not always obvious. A cardiologist is a health practitioner who specializes in diagnosing problems with the heart and surrounding arteries. What […]

Prepare Your Cardiology Practice With Key Cardiology Coding Guidelines

With the rollout of ICD-10; billing, coding, documentation, compliance, and auditing have become the buzzword in the healthcare industry. All these are going to have a massive impact on your practice’s revenue cycle. Hence; to meet the compliance standards and to combat the challenges of the documentation, billing, and coding hiring an outsourcing billing service […]

Procedure for Claim Submission with J-codes

J-codes used in Procedure for Claim Submission - HCPCS Level II Codes

The CMS has developed the Healthcare Common Procedure Coding System (HCPCS) for reporting medical procedures and services. Some of the most commonly used HCPCS Level II Codes, J-codes are used for non-orally administered medication, chemotherapy, and immunosuppressive drugs, and inhalation solutions as well as some orally administered drugs. Submitting Claims with J-codes: HIPAA required that […]

Murphy signed Out-of-Network Healthcare Billing Law in New Jersey

Governor Phil Murphy on August 30th, 2018 signed a bill that ended the decade-long battle to address the issue of the cost and impact of expensive medical bills for residents in the state. In a statement, Gov. Murphy said, “Today, we are closing the loophole and reigning in excessive out-of-network costs to prevent residents from […]

Claim Reimbursement as per various Health Care Plans

There are a number of ways in which health insurance carriers provide coverage. Health Care plans insurance coverage can be quite complex, as it involves the coordination between a healthcare provider, the health insurance provider, and the actual person receiving care. Some of the methods of coverage include managed care, indemnity policies, and high-deductible plans. […]

Implementation of intensive care unit strategy for oncology

Cancer patients admitted to an emergency or intensive care unit (ICU) have some critical requirement of basic care needs because of their unknown illness; time-point in the treatment plan and treatment-related deadliness resulting in organ damage, hemodynamic infection, or blood contamination. Over the past two decades, therapeutic advances have reshaped not just the medical approach […]

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