Medical Billing is the backbone of your practice which embraces the bottom-line of your business. Efficiency is the cornerstone for any Medical Billing Process, without which your Practice may seem unmanageable. However, with Patient care as the prime function, efficiency in Medical Billing can be challenging to be achieved. A physician’s core focus is fully tied up with the daily… Read more »
Medical practices and physicians are more focused on patient care, and patient satisfaction and thereby improve and develop their business. With these priorities consuming most of their daily chores, Medical Billing and claims processing can take a second seat or lag down with quality issues obliging the physicians or medical practices to turn towards Medical Billing Outsourcing. Nevertheless, Outsourcing Medical… Read more »
2020 has been a challenging year for the Global healthcare sector, which resulted in sweeping changes affecting healthcare and Medical billing outright. With these challenges and changes anticipated to carry over, Medical Billing in 2024 as predicted will see a lot of updates, advancements, revised medical billing and coding guidelines, compliances, and regulations. Read further to educate yourself with the… Read more »
Medical Billing Companies are third party service providers striving towards achieving the financial goals of any Medical Practice or medical group while the physician renders his complete attention on patient care and satisfaction. While handling Medical Billing In-house may seem successful on the surface; apparently diving deep down into the process level and looking into the numbers can say a… Read more »
While both In-house billing and outsourced billing have their own pros and cons, studies and testimonials have proved Outsourcing Medical Billing Process to be more beneficial and the best choice for any setup. Read through the article to understand why Outsourcing Medical Billing is the better option in comparison to In-House Billing. Medical Billing can be a Complicated and Arduous… Read more »
Digital and technological innovations have transformed the healthcare care -sector and Revenue Cycle Management in Medical Billing significantly over the past few years. As the saying goes “Necessity is the mother of inventions” the Novel Corona Viral attack and the global pandemic situation has necessitated the need for technological advancement, Process Automation and integration of artificial intelligence to cope up… Read more »
Medical Practices and Physicians are always engaged with patients and patient care; Physicians and staffs in the healthcare facilities are always busy already wearing multiple hats and handling various necessities for the patient. It can be difficult for them to take the time out to handle Medical Billing which requires undivided attention, leading to a lot of dips and lags… Read more »
In any scope of work, there is always room for improvement. Revenue Cycle Management is the backbone of the healthcare industry and has continuous room for improvement with the ever-changing revision of Medical procedures, technological developments, and Insurance policies. The unceasing changes and updates in the healthcare industry and the revenue cycle management process require Providers, Medical staff, medical billers, and coders… Read more »
The U.S. healthcare industry and Revenue Cycle Management (RCM) sector is fast evolving with huge technological advancements necessitating constant changes and introducing new trends into process efficacy. These upgrades and developments are more into effect after the COVID pandemic as a result of certain process implications and with the best efforts towards adaption to the ongoing requirements. Let us discuss… Read more »
Medical billing is a tricky job that accounts for intense labor, huge investment, and valuable time. The new healthcare reforms that revolutionized the US healthcare industry in recent times have complicated medical billing operations. Because of this reason, healthcare organizations and independent practitioners face a hard time tackling billing operations while focusing on patient care. The best solution would be… Read more »
Medical billing and coding is a cycle of efforts towards getting the medical claims reimbursed with full payment and ensuring the physician or the medical practice has received their due payments within the standard turn-around time (TAT). Every scope in Medical billing has a timeline or TAT and failing which will affect the overall timely filing limit (TFL) of the… Read more »
While outsourcing Medical Billing services is not a new concept, practices and hospitals are still in a delicate situation when deciding to outsource their billing process. The major cause of indecision is the worry of putting their billing service into wrong hands and the daunting task of identifying the right billing partner, fear of losing control over your business, additional… Read more »
Most of physicians and Medical Practice have agreed, Medical Billing Outsourcing as beneficial in comparison to In-house billing. While the benefits Outsourcing is long-established resulting in an increased number of physicians and Medical Practice shifting from in-house billing to Outsourcing, there are a lot of areas to check and validate while choosing a suitable Medical Billing Partner. Let us look… Read more »
Healthcare Revenue Cycle Management Operations includes Medical Billing, Denial Management and patient payment collections, etc. Through revenue cycle management, physicians can achieve faster and accurate reimbursement. But in recent years, healthcare revenue cycle management is a difficult task due to various reasons such as Let us discuss a few techniques to improve the revenue cycle operations in 2025 briefly. Provide… Read more »
Medical Records Management: Importance & Benefits of Outsourcing Medical records are essential documents that contain a patient’s medical history and current health status. Reviewing these records before any treatment ensures quality healthcare services. However, tracking and maintaining medical records can be challenging for physicians and medical practices. According to U.S. federal law, medical records must be maintained for at least… Read more »
Keeping the Medical Practice revenue flow intact and evergreen requires constant effort from physicians and Medical practices. Overcoming financial lags owing to claim denials and keeping up with the ongoing changes and regular updates are prerequisites for any practice to ensure the monthly collections and claim reimbursements are intact. There are various reasons why a claim can get denied and… Read more »
Whether you are a new Provider or an established healthcare practice, providing extra care to the medical claim processing sector is the only way to improve cash flow. Although patient care is the key focus of Physicians, many are new to the industry and lack the experience to handle medical billing. Well, it doesn’t mean that experienced Providers are well-versed… Read more »
The diagnosis Code ICD -10 CM (International Classification of Diseases 10th Revision Clinical Modification) is the crucial part of Medical Coding which can affect the financial aspect of the claim if not documented appropriately. Assigning accurate codes requires the physician to provide complete and accurate clinical documentation of the procedure, however with the regular update of Medical Codes and the… Read more »
While practices strive towards efficient and qualitative medical billing and coding to enhance claims first-pass rate and monthly collections; conversely claim denials, rejections and low payments are inevitable. Medical Practices lose a tremendous amount of revenue by not working on denials and ignoring unpaid claims. These missed revenues can be earned by reworking and appealing with the payer, the process… Read more »
Preventing healthcare fraud and abuse is essential to maintain the integrity of the healthcare system, protect patients and Protected Health Information (PHI), and ensure that resources are used efficiently and appropriately. Healthcare fraud refers to intentional deception or misrepresentation with the aim of gaining unauthorized benefits or payments, while healthcare abuse involves practices that are inconsistent with accepted medical, fiscal,… Read more »
Every physician and medical practice suffer with unpaid claims and payment rejections for the service rendered. While it is obvious that the physician and the medical practice are entitled to get the payment for the services rendered which cannot be denied practically. However going by the insurance policy and the coverage and benefits applicable to the policy member, the insurance… Read more »
Medical billing can be a complex and time-consuming process, and physicians often face several unexpected challenges in the Medical billing process affecting the entire Revenue Cycle Management. Listed below are some common challenges faced by Physician in medical billing: Lack of understanding of billing codes and regulations: Medical billing involves a significant number of codes and regulations that can be… Read more »
Claim denials and Denial Management are the most challenging area in Healthcare and Medical Billing. Every physician, medical practice, and the medical group is striving towards achieving quality Medical Billing and Coding with conscious efforts towards keeping claim denials at bay. However, billing and coding errors seem to be unavoidable owing to various reasons, making efficient Denial Management process the… Read more »
Improving medical billing and coding processes can significantly enhance claim rates and revenue for healthcare providers, which is the primary goal for any business. Here are some suggestions to help physicians and Medical Practices achieve enhanced financial returns: Accurate Documentation and Coding: Ensure that all patient encounters are accurately documented and coded with the appropriate diagnosis and procedure codes. Proper… Read more »
US healthcare facilities and companies sign up contracts with a wide range of insurance companies every year. All payers have different policies, standards, parameters and regulations to follow. Therefore, keeping track of all contracts is an enormous task, especially when the US healthcare industry is observing so many new reforms like the ICD-10 Code Set Implementation. To streamline the contract… Read more »
Medical Billing Denials are the most common concern of every practice. Claims denials and rejections are inexorable however they can be controlled to a greater extent with necessary steps and obligatory checks. Let us discuss in detail the causes of claims denials and some tips to avoid them. Most common reasons for Medical Billing Denials: A claim can be denied… Read more »
Medical billing claim denials affect physician practice and cash flow. By reducing the claim denials rate, you can enhance your practice profitability and reduce administrative costs. To overcome the issue of a claim denial, it is important to understand the common reasons for claim denial. Let us discuss the most common reasons for medical billing claim denials. Incorrect Patient Identifier… Read more »
The Merit-based Incentive Payment System (MIPS) is a program developed by the Centers for Medicare and Medicaid Services (CMS) in the United States. It aims to provide incentives to physicians for quality and value-based care. While each specialty-based physician may have specific challenges in participating in MIPS due to their unique workflow, there are several strategies they can employ to… Read more »
Timely retrieval of Medical Records is fundamental to successful Revenue Cycle Management (RCM) and also to plan patient procedures based on the previous health history. The availability of proper Medical Reports or documents is crucial to perform effective Medical Billing and Coding. Being negligent in Medical Records Management not only impede in patient treatment but also affects claim reimbursement and… Read more »
Getting due payment or reimbursement without any shortfalls is a primary focus for any Physician or Medical Practice. However real-time scenarios can give a different picture with reasons such as low paid, rejections, denials and payment delays. While getting 100% timely payment for all claims processed might seem impractical, working towards achieving maximum reimbursement within the turnaround time (TAT) and… Read more »
Managing Physician Practice has never been a cakewalk more over the novel changes owing to recent global COVID and pandemic attack has worsened the situations which have left the physician lookout for alternative supports for efficiency in Practice Management. Here are some Top Physician Management tips for Streamlining your Practice Process Advancement and Streamlining: Analyze your current Physician Practice Management… Read more »
Healthcare Contract Management majorly deals with management of contracts between payor and providers. Complexities involve with the ever-changing policies, regulations, compliance and insurance charges to be monitored and tracked for efficiency and quality. It can get difficult for physicians and medical practices to keep a track of the contractual agreement and focus on patient care and achieve maximum reimbursement. With… Read more »
Physicians and Medical Practices are striving towards efficient and enhanced Denial Management to achieve their financial goals. To curb claim denial completely seem to be an inevitable challenge, however, keeping claims denials under standard quality percentage can reduce revenue loss and effort spent on clearing them. Read below to know the Tips and Tricks for Better Healthcare Denial Management. Denial… Read more »
Goal of any Physician or Medical Practice is to increase business by a regular flow of patient appointments with new and existing patient visits. Patient retention is the most critical part when compared to generating new appointments and marketing. There are many factors that play a major role on retaining patients who are the core asset of any practice. Patient… Read more »
Surprise bills are the most common concern of affordability for many In-Network and Out of Network (OON) patients. These bills are least expected and financially unmanageable as most of the times patients are unware that they had got service from an Out of Network provider until they get their Medical bills. Such unanticipated Medical Bills when patients are getting treated… Read more »
Insurance carriers have various checks and parameters that contemplate towards 100% reimbursement. Payments for Physician services are considered taking into account of each and every process and task involved right from patient visits, consulting, prescribing medications, treatments and procedures, and even the after care services. Hence it is essential for any provider to document every process in detail. Missed or… Read more »
While patient care can be the primary focus for any physician or practice, it is also quintessential to ensure the other areas such as support staff, administration, financial management, medical billing and coding are equally attended and addressed to acquire targeted results continuously. Physician Practice Management is an indispensable component for any Medical Practice irrespective of their size and bandwidth… Read more »
Mobile Charge Capture is a software platform designed – to improve the efficiency of physicians by effective management of billing time and communication billing and coding outside the office setting. The software captures charges and patient data right at the point of patient contact along within a secure HIPAA compliant messaging. Charge capture is accessible on a mobile device –… Read more »