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 […]

Basics of EDI Enrollment with Medicare FFS

What is EDI Enrollment? For a provider is trying to enroll with Medicare FFS, they must first establish an Electronic Data Interchange (EDI) agreement with Medicare. EDI is the process of using nationally established standards to exchange electronic information between business entities. The Department of Health and Human Services (HHS) adopted certain electronic standards for […]

Is Outsourcing Billing, the Right Option for Me?

Medical billing which is part of Revenue Cycle Management represents all activities resulting in receiving accurate payment for services rendered to a patient. Medical billing and coding require specialized knowledge and specific skills which can’t be always handled by providers. There are a number of pieces to the puzzle that go from patients visiting your […]

Improving Bottom Line of Your RCM

Revenue Cycle Management (RCM) is defined as the process of handling claims, processing payment, and generating revenue for your practice. It includes all functions associated with different steps of medical billing, beginning from the time when a patient makes an appointment and ending after all the claims and payments have been collected and the balance […]

Role of Medical Billers and Coders in RCM

Medical billing and coding translate a patient encounter into the form healthcare facilities use for claims submission and reimbursement. Medical billing and coding are separate processes, but both are necessary for providers to receive reimbursement for healthcare services. Medical Billers and Coders play a crucial role in revenue cycle management as their work starts from […]

Effective RCM Strategies to Collect Maximum Patient Responsibility

Patients’ financial responsibility is on the rise as more patients are choosing high-deductible health plans (HDHP). Increasing patient responsibility is an ongoing trend that does not seem to be slowing down in the near future. Providers report many challenges with responding to growing patient financial responsibility. Given the increased payment responsibility, being able to determine […]

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 […]

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 […]

Effective RCM Strategy to Increase Reimbursements

The Healthcare Financial Management Association (HFMA) defines Revenue Cycle Management (RCM) as all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue. Revenue cycle management (RCM) is the financial process related to a patient’s clinical encounter. According to HFMA, a basic role of RCM is to measure how […]

Increase your Practice Collection by Educating Patients

Current fact suggests, nearly 6 in 10 patients either rarely or never received an estimate of out-of-pocket costs before they received treatment. As per a survey report from TransUnion Healthcare, 75 percent of patients mentioned that they can play better if they receive pre-treatment estimates of out-of-pocket costs well in advance. The healthcare experts agree […]

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