Understanding Claim Denials in Plastic Surgery

Claim denials in plastic surgery can have several negative consequences for the patient and the plastic surgeon. Apart from financial losses, they could lead to delayed treatments, increased administrative burden, negative impact on patient satisfaction, and overall damage to the plastic surgeon’s reputation. Plastic surgeons must work closely with insurance companies to ensure that claims […]

Tips to Avoid Unbundling Codes

What is Unbundling Codes? Unbundling codes in medical billing refers to the practice of separately billing for individual components of a medical procedure or service, rather than billing for the complete procedure or service as a single entity. This practice can result in higher payments to healthcare providers and higher costs for patients and insurers. […]

Benefits of Outsourcing Accounts Receivable in Medical Billing

Accounts Receivable in Medical Billing Accounts Receivable in medical billing is retrieving of payments due by the insurance and patients to the physician for the delivered services. For the long-term financial sustainability of your practice, it’s crucial to keep accounts receivable under check. Accounts receivable are categorized as the number of days the payment hasn’t been […]

7 Ways to Reduce Revenue Leakage in Medical Billing

Revenue Leakage in Medical Billing ‘Revenue leakage’ refers to situations where a healthcare provider doesn’t receive insurance reimbursement for delivered services. In such billing situations, accounts receivable remain unpaid for too long and eliminate the chances of payment recovery, even partially. Healthcare practices cannot afford to ignore their revenue leakage as it’s directly affecting their […]

Understanding False Claims Act in Healthcare

False Claims Act in Healthcare The False Claims Act (FCA) in healthcare (also called the ‘Lincoln Law’), is a federal law that imposes liability on persons and companies who defraud governmental programs. It is the federal government’s primary litigation tool in combating fraud against the government. The federal False Claims Act makes it illegal to: […]

Covered Destinations for Ambulance Transportation

Basics of Destinations for Ambulance Transportation Ambulance transport is covered to the nearest appropriate facility to obtain necessary diagnostic and/or therapeutic services such as a CT scan or cobalt therapy as well as the return transport. In addition to all other coverage requirements, this transport situation is covered only to the extent of the payment […]

Efficiently Managing Underpayment to Increase Practice Collections

What is Underpayment in Medical Billing? An underpayment in medical billing refers to a billing situation where practices are expecting higher payments for delivered services while insurance carriers have paid a lesser amount for the same services. Usually, denials arise due to incorrect patient information while underpayments stem from incorrect billing prices. Underpayments are tricky […]

Group Practices Remain Competent by Outsourcing Medical Billing

Medical Billing Challenges for Group Practices Group practice owners face an unprecedented number of challenges today, from adding or replacing providers; getting rendering providers enrolled; adopting new technologies; up to receiving an accurate reimbursement for delivered services. Any group practice’s success is reliant on strong Revenue Cycle Management (RCM) team, error-free & timely claim submissions, […]

Avoiding False Claim Billing for your Practice

Understanding False Claims Act As a healthcare practice, you can typically submit claims to Medicare or Medicaid. Your claims are bills for goods you provide and services you conduct for patients. These federal health insurance programs cover the costs associated with your services. The False Claim Act is a federal law that makes it a […]

Importance of A/R Follow-up in Medical Billing

Importance of A/R Follow-up Medical billing is a complicated process that requires special skills in medical billing, coding, denial, and AR management from experienced and well-trained staff. The financial health and success of any medical practice are dependent on maintaining positive cash flow. In order to provide patient care and cover expenses, it’s important that […]

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Medical Billing