Reducing E/M Services Claim Denials

E/M Services Denial Reasons As per the Centers for Medicare & Medicaid Services (CMS) data, approximately 15 percent of evaluation and management (E/M) services are improperly paid and accounted for almost 9.3 percent of the overall Medicare fee-for-service improper payment. Some of the common denial reasons are ‘similar services from multiple providers in the same […]


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Surprise Medical Billing for Anesthesiologists

Basics of Surprise Medical Billing Out-of-network billing, or ‘surprise medical billing,’ occurs when a patient receives a bill for the difference between the out-of-network provider’s fee and the amount covered by the patient’s health insurance, after co-pays and deductibles. These bills can be unanticipated by patients, who often assume that facility-based providers, including anesthesiologists, are […]


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Increased Importance of Telehealth in Small Practices

Increased Importance of Telehealth Small practices tried their best to survive during the COVID-19 pandemic and telehealth helped them a lot to survive in these challenging times. During the COVID-19 pandemic, the use of telemedicine has only grown in importance. Experts predict that by 2025, the size of the telehealth market will reach $17.2 billion. […]


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Providing Non-Essential Services Using Virtual Care

In March of 2020, the CDC asked physicians to provide non-essential care with virtual care in order to reduce the risk of COVID-19 exposure. But now post-pandemic landscape, many physicians have adopted virtual solutions in order to provide quality care for marginally healthy groups. Virtual care gives physicians risk-free, reliable ways to offer non-essential care […]


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Benchmarking Financial Performance of Radiology Practices

Benchmarking involves comparing business statistics to historical data or to the same type of data gathered across a wider spectrum. This is only one statistic, or metric, that can be used to evaluate a practice’s performance. In addition to physician productivity, practices often measure their quality of service and financial performance against internal goals or […]


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Highly Neglected Revenue Cycle Processes

For most providers, the revenue cycle process means submitting claims and wait for payer reimbursements. These providers are under the impression that if they submit the claim, it will get paid but that’s not the case. Revenue cycle management includes really crucial processes like provider credentialing and contracting, Benefits verifications, prior authorizations, and out-of-network billing […]


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What provider should know about transition to Medicaid Managed Care?

Managed Care plays important role in the delivery of healthcare and it is used to describe a health insurance plan or health care system that coordinates the provision, quality, and cost of care for its enrolled members. Traditionally States have utilized a fee-for-service (FFS) payment system to cover enrollees but now states are also making […]


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How Providers can improve telehealth for COVID-19?

Healthcare providers implemented telehealth for COVID-19 pandemic widely in the US. According to 2019 Health Center Program Data, 43% of health centers were capable of providing telemedicine (it is a part of telehealth), compared with 95% of the health centers that reported using telehealth during the COVID-19 pandemic. While the largest increase in the use […]


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