Tag Archives: revenue cycle management

Received Payer Request for Medical Records? Keep Calm and Take These Steps

If a letter were to arrive at your organization in an innocuous-appearing envelope, you may be afraid to open it. It’s unsettling for a payer to request medical records for claims that have already been paid. It is becoming more … Continue reading

Posted in Medical billing and coding services | Tagged , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Understand Payment Rates and Basics of ASC Billing

An Ambulatory Surgical Center (ASC) is defined by CMS as a facility with the sole purpose of providing outpatient surgical services to patients. ASC is a facility that, very simply, specializes in outpatient procedures. Procedures done at an ASC are … Continue reading

Posted in Ambulatory Surgical Centers | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

What is MIPS and How it Affects My Practice?

What is MIPS? On November 1, 2018, CMS released revisions to payment policies under the Medicare Part B physician fee schedule for the Quality Payment Program (QPP) for the calendar year 2019. In accordance with one of the most bipartisan … Continue reading

Posted in Medical billing and coding services | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Understand Basics of Optometry E/M Coding

Typically, eye care practitioners don’t use the E/M codes for what most optometrists consider a general eye examination. They are more typically used for patient encounters where the patient presents with a medical complaint or a continuation of medical case … Continue reading

Posted in Optometry Billing and Coding Services | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Common Denials for SNF and How to Avoid Them?

Denial 1: Certification or Recertification Statement (Missing/ Lacked Information) From 2012-2014 the percentage rate of improper payments to SNF almost doubled all stemming from failure to obtain certification or recertification. General Guidelines: The Certification Statement must include that the individual requires skilled … Continue reading

Posted in Skilled Nursing Facilities Billing | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Top 3 Radiology Claims Denials and How to Avoid Them?

The goal of a well-managed radiology billing operation is to submit claims for services promptly and receive reimbursement as quickly as possible. Timely submission and prompt payment enhance the practice’s cash flow and keep the overall cost of billing at … Continue reading

Posted in Radiology Billing | Tagged , , , , , , , , , , , , , , , , , , , , | Leave a comment

Easy Tips for Quick, Accurate and Simplifying the Provider Credentialing Process

Medical Credentialing is a process whereby insurance networks check to make sure that the provider meets the standards set out by the insurance company. In this process, they review a range of documents including medical licenses, malpractice insurance, schooling information, … Continue reading

Posted in Medical billing and coding services | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment