Claim denials cast a long shadow over hospital finances, eroding revenue cycles, inflating administrative burdens, and ultimately jeopardizing the institution’s financial stability. While some denials are unavoidable, a powerful and forward-thinking Hospital Claim Validation strategy can dramatically reduce their frequency. This approach emphasizes embedding accuracy and compliance at every touchpoint of the patient journey and […]
This post dives into the top E/M coding tips that will empower your team to accurately capture the level of service provided, optimize revenue, and navigate the intricate landscape of compliance with confidence. 1. Embrace the 2021/2023 E/M Guidelines for Office/Outpatient Visits (99202-99215): The significant changes introduced in 2021 and further refined in 2023 for […]
Turning submitted medical claims into actual payments is a crucial phase for any healthcare practice. The time it takes to receive these payments directly impacts your financial health and operational efficiency. To maintain a healthy revenue cycle, it’s essential to reduce AR turnaround time and aim to clear your Accounts Receivable (AR) within a 30-day […]
Claim denials remain one of the biggest challenges healthcare providers face when it comes to maintaining consistent revenue and smooth operations. While some common causes like incomplete documentation and incorrect patient information are well-known, there are still many lesser-known or overlooked reasons medical claims get denied. In this article, we’ll explore five more reasons why […]
Outpatient care has become a cornerstone of modern healthcare, thanks to technological advancements, patient preferences, and cost-effective treatment models. As outpatient services expand, so do the administrative and financial complexities behind the scenes. Revenue Cycle Management (RCM) for outpatient care is no small feat — it involves managing patient scheduling, insurance verification, coding, billing, and […]
Navigating the complexities of denials management can feel overwhelming for revenue cycle leaders seeking effective solutions. Instead of chasing quick fixes, a structured, methodical approach is essential for building a sustainable and impactful denials management strategy. Implementing a Robust Denials Management Solution is key to achieving this, as it provides the necessary framework for a […]
In the intricate ecosystem of healthcare, where patient well-being and financial viability intertwine, accurate medical coding stands as a cornerstone. Physicians, while primarily focused on patient care, bear the ultimate responsibility for the documentation that underpins the billing process. To ensure accuracy and compliance, Medical Coding Audits for Physicians are essential in identifying potential errors […]
Artificial intelligence (AI) is one of the most talked-about innovations in healthcare finance—and for good reason. While it brings excitement about streamlined operations, particularly in areas like AI in denial management, and better outcomes, it also sparks questions about its impact on providers, staff, and daily workflows. At AAPC, we’ve been actively exploring how AI […]
The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) is intensifying its oversight of Medicare expenditures and billing practices through focused audits across three crucial domains, a move that can be summarized as OIG Intensifies Medicare Audits. These reviews are strategically designed to fortify Medicare’s fiscal soundness and guarantee the […]
Each year, updates to CPT codes are introduced to reflect advancements in medical procedures and technologies, impacting billing and coding across multiple specialties. Effective January 1, these annual updates encompass new, revised, and deleted codes, along with updated coding guidelines. For 2025 CPT Code Updates, there are 270 new codes, 112 revised codes, and 49 […]










