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 […]
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 […]
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 […]
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 […]
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 […]
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 […]
Are you thinking that revenue flow is interrupted due to high accounts receivable? Of course, you need to boost A/R productivity for the Success of Revenue Cycle but you aren’t the only healthcare professional to face revenue loss but you can make a difference particularly during the pandemic. Insurance companies are obliged to pay healthcare […]
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 […]
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 […]
Denial Code CO 50 means that the payer refused to pay the claim because they did not deem the service or procedure as medically necessary. It is a very popular denial code and the sixth most frequent reason for Medicare claim denials. According to a CMS, It is observed that 30% of claims are either […]
Connect with us by filling out this form. Let’s tailor a
solution that fits your needs perfectly.
