Challenges of Running Solo Practice If you are a solo healthcare provider or own a small medical practice, you might sometime feel the pressure of having to do everything on your own and struggling to provide optimal patient care. Running a healthcare practice offers unique challenges like administrative and insurance tasks, government and insurance regulations, […]
Outsourcing is the Need of the Hour Nowadays, most of the practices feel comfortable passing the burden of billing and coding onto medical billing partners. Billing companies have medical specialty-wise billing and coding experts who streamline the revenue cycle process for healthcare practice. But not all medical billing companies are the same, some of them […]
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, […]
Basics of Preventive Care Preventive care helps detect or prevent serious diseases and medical problems before they can become major. Annual check-ups, immunizations, and flu shots, as well as certain tests and screenings, are a few examples of preventive care. This may also be called routine care. While coding, you need to understand the difference […]
Medicare Part A covers skilled nursing and rehabilitation care in a Skilled Nursing Facility (SNF) under certain conditions for a limited time. Coverage for care in SNFs is measured in ‘benefit periods’ or sometimes ‘spell of illness. In each benefit period, Medicare Part A covers up to 20 days in full. After that, Medicare Part […]
Increased Scope of Telemedicine Telemedicine and telehealth describe the use of telecommunication tools including the Internet, video, and email to exchange information in the context of health care between patients, providers, consultants, and content for the purpose of education, evaluation, decision-making, and treatment. Prior to the COVID-19 pandemic, telemedicine applications had evolved to broadly cover […]
Basics of Wound Care Active wound care procedures are performed to remove devitalized and/or necrotic tissue to promote healing. Debridement is the removal of foreign material and/or devitalized or contaminated tissue from or adjacent to a traumatic or infected wound until surrounding healthy tissue is exposed. These services are billed when an extensive cleaning of a […]
E/M Services Claim 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 claim denial reasons are ‘similar services from multiple providers in […]
Challenges in Securing Reimbursements For any practice owner, submitting error-free claims and securing accurate insurance reimbursements is the most important and at the same time most challenging task. Things even get worse due to sloppy billing and coding mistakes practices. As per CMS (Centers for Medicare & Medicaid Services), Medicare, claims worth $6.25 billion in […]
A recent survey of U.S. healthcare organizations highlighted declining reimbursements as a top industry challenge. The COVID-19 pandemic changed payer billing guidelines, and reimbursement policies made receiving accurate reimbursement tougher. Reimbursement complications often lead to documentation and coding inaccuracies leading to increased claim denials. The healthcare reimbursement process requires complicated steps and, at each turn, […]
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