New Updates in HIPAA Regulations for 2021

The Healthcare Insurance Portability and Accountability Act (HIPAA) plays a critical role in healthcare organizations and the main objective of (HIPAA) is to improve the efficiency and effectiveness of the health care system. HIPAA regulations were mainstream in 2020 due to COVID-19 testing, status, transmission, and care. HIPAA the act was signed into law in 1996 […]


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Recovering patient volume amidst covid-19

Covid-19 affects the healthcare industry especially medical practices that experienced a negative financial impact directly or indirectly. For example- according to the Medical Group Management Association, there is a 60% decrease in patient volume since the beginning of COVID-19. Lockdown in the US forced patients to stay indoors due to which many patients delayed or canceled […]


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What is third-party medical billing?

It turns out that third-party medical billing can be extremely beneficial for medical practices because medical billing can take up a lot of valuable time. Moreover, it is difficult to find and train people to handle billing and coding complexities. Plus, if claims are processed slowly or incorrectly, they can negatively impact your practice’s revenue. […]


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Chiropractic billing tips in 2021

Current Procedural Terminology codes are a set of codes published and maintained by the American Medical Association (AMA) for chiropractors and chiropractic billing specialists. Mistakes such as incorrect chiropractic CPT codes can lead to claim rejections and delays in payments and put your practice at risk for failure. Hence to avoid errors you should consider […]


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How to reduce hospital claim denial rates in 2021?

The recent COVID-19 pandemic has accelerated claim denials from payers. According to a recent analysis, the average rate of claim denial is increasing by 23 percent in 2020 compared to four years ago. Faults related to missing or invalid claim data, which included unspecified billing issues, missing or invalid explanation of benefits, and service not […]


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Significant reimbursement gap between independent physician and hospital physician

It is found that nearly 70% of Independent Physicians specialize in a certain aspect of healthcare and that the specialized nature of their practice within the local healthcare community enables them to remain independent. However, reimbursement of physicians working for a hospital or health system is significantly higher than that paid to independent physicians. According […]


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What is the next generation ACO model?

Hospitals form an integral part of an ACO (i.e. Accountable Care Organizations), and hospitalists serve critical roles within their hospitals. Hence, they are very much interested in the impact of ACOs on their practices as ACO’s goals are a long list of hospital goals. In a patient-centered organization, the patient and providers are true partners […]


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Central Billing Offices – A myth of the past

In today’s environment reimbursement continues to decline coupled with increased regulatory oversight hence it is necessary for physicians, patients, and the healthcare industry to be efficient. Hence Central Billing Office (CBO) is the answer as it improves efficiencies in billing, payment posting as well as enables enhanced customer service and seamless patient experience. Now let’s understand […]


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Should I outsource my medical billing in 2021?

To run independent medical billing practice becomes more complicated with every passing year. There are new regulations, coding updates (e.g. 2021 changes to E/M Coding), revisions in payer rules, and performance measures that can significantly impact your reimbursement. You need oversight of RCM experts to your revenue cycle, healthcare organizations cannot put their cash flow […]


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Things to know about Cardiology Billing and Coding

Cardiology billing and coding are complex for several reasons. This specialty experiences regular amendments of key procedure rules, complex contractual adjustments, and codes, and that is the reason while using the modifiers requires attention. However, we know the complexities of this specialty and with many happy clients, we have focussed in providing correct cardiology billing […]


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