The Healthcare Insurance Portability and Accountability Act (HIPAA) plays a critical role in healthcare organizations and the main objective of (HIPAA) is to improve the efficiency and effectiveness of the health care system. HIPAA regulations were mainstream in 2020 due to COVID-19 testing, status, transmission, and care. HIPAA the act was signed into law in 1996 […]
Current Procedural Terminology codes are a set of codes published and maintained by the American Medical Association (AMA) for chiropractors and chiropractic billing specialists. Mistakes such as incorrect chiropractic CPT codes can lead to claim rejections and delays in payments and put your practice at risk for failure. Hence to avoid errors you should consider […]
The recent COVID-19 pandemic has accelerated claim denials from payers. According to a recent analysis, the average rate of claim denial is increasing by 23 percent in 2020 compared to four years ago. Faults related to missing or invalid claim data, which included unspecified billing issues, missing or invalid explanation of benefits, and service not […]
It is found that nearly 70% of Independent Physicians specialize in a certain aspect of healthcare and that the specialized nature of their practice within the local healthcare community enables them to remain independent. However, reimbursement of physicians working for a hospital or health system is significantly higher than that paid to independent physicians. According […]
Physicians/providers are revenue-generating members of hospitals or healthcare organizations. Credentialing enables practitioners to become employable as they can treat patients. Today as health systems are growing continuously, and more and more providers need to being credentialed with insurance carriers to realize exponential revenue growth. But first, we need to understand what is credentialing? The process […]
To overcome the financial impact of pandemic, providers need to measure and focus on an efficient RCM process to get success in 2021. COVID-19 pandemic has a severe impact on the healthcare industry, caused healthcare providers to depend on efficient RCM process to maintain financial stability in 2021 and henceforth. What is RCM Process? Revenue […]
Replacing Code 0249T CPT Category III code 0249T, ligation, hemorrhoidal vascular bundle(s), including ultrasound guidance, has been deleted and converted to CPT Category I code 46948, hemorrhoidectomy, internal, by Code for Transanal Hemorrhoidal Dearterialization (THD), 2 or more hemorrhoid columns/groups, including ultrasound guidance, with mucopexy, when performed. The new code, CPT 46948, more accurately describes […]
Basics of Worker’s Compensation Worker’s compensation, commonly known as worker’s comp, is a type of insurance that covers the treatment of injuries occurring on the job. Employers typically purchase commercial worker’s comp policies directly, although some states administer these policies. Medical billers must therefore remain aware of the worker’s comp policies for their state, including […]
Providers seeing a 2 percent payment decrease on their Remittance Advice (RA) is due to a mandatory sequestration payment reduction. Claim adjustment reason code (CARC) 253 is used to report the sequestration reduction. The code will appear as a CO 253 on the RA ‘Sequestration-reduction in federal payment’ as the reason. For the Medicare Fee-for-Service […]
Insurance will deny the claim with denial code CO 29 – the time limit for filing has expired, whenever the claims submitted after the time frame. The time limit is calculated from the date service provided. Each insurance carrier has its own guidelines for filing claims in a timely fashion. Some are as short as […]
Connect with us by filling out this form. Let’s tailor a
solution that fits your needs perfectly.
