Category: Blog

Lab claim denial management

Strategies for Laboratory Claim Denial Management

Laboratories often grapple with claim denials stemming from ambiguous payer policies, inconsistent information from payer representatives, coding complexities, and network status uncertainties. To mitigate these challenges and improve financial outcomes, a strategic approach to laboratory claim denial management is essential. By implementing a robust data analysis and trending strategy, laboratories can significantly improve their denial […]
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AI Prior Authorization Denials: Highlights Physician Concerns and Patient Harm

A recent survey conducted by the American Medical Association (AMA) has revealed significant concerns among physicians regarding the use of artificial intelligence (AI) in healthcare, particularly related to AI prior authorization denials. The survey, which included 1,000 practicing primary care physicians and specialists in the United States, highlights the increasing challenges that AI poses to […]
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ASC patient experience

Boosting ASC Patient Experience through Efficient Front Desk Procedures

In today’s competitive healthcare environment, delivering an exceptional ASC patient experience is crucial for differentiating your ambulatory surgery center (ASC) and fostering sustainable growth. This experience hinges on treating patients with care, respect, and competence throughout every interaction – from staff engagement to procedural efficiency and technological integration. This article focuses specifically on enhancing the […]
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HIPAA-compliant EHR with AI

HIPAA-Compliant EHR with AI & Automation: Secure, Efficient Healthcare

A HIPAA-compliant EHR with AI and automation not only ensures regulatory compliance but also leverages advanced technologies to enhance security, improve efficiency, and streamline healthcare workflows In an era where data breaches and cyber threats are at an all-time high, the need for a secure electronic health record (EHR) system has never been more critical. […]
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medical claim denial management

Enhancing Denial Management Strategies for Medical Practice

Claim denials pose a substantial threat to the financial health of medical practices. Effective medical claim denial management is crucial for protecting revenue, streamlining operations, and maintaining positive payer relationships. This comprehensive guide outlines a strategic approach to reducing denials, managing appeals, and safeguarding your practice’s financial stability, with a strong focus on effective medical […]
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RCM Technology Upgrade

Is Your RCM Technology Lagging? Time for an Upgrade

 In the fast-paced world of US healthcare, efficiency and accuracy are paramount. For healthcare providers, a robust Revenue Cycle Management (RCM) system is the backbone of financial health. However, as technology evolves and patient expectations rise, outdated RCM systems can become significant bottlenecks, leading to revenue loss, compliance issues, and increased administrative burdens. So, how […]
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3 Ways to Improve Medical Coding Quality for Accurate Reimbursement

Improve Medical Coding Quality for Accurate Reimbursement

In the complex world of healthcare, accurate medical coding is the linchpin of a healthy revenue cycle. For US-based medical practices, hospitals, and billing companies, efforts to Improve Medical Coding Quality directly translate to timely and accurate reimbursements. Errors in coding can lead to denied claims, compliance issues, and significant financial losses. This blog post […]
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Open-Source AI Medical Diagnostics

Open-Source AI Medical Diagnostics: Matches GPT-4 in Study

A groundbreaking study from Harvard Medical School has revealed that an Open-Source AI Medical Diagnostics model performed on par with GPT-4—one of the leading proprietary AI models—in diagnosing complex medical cases. Published in JAMA Health Forum, the findings suggest that physicians may soon have more options for integrating AI into clinical decision-making while maintaining greater […]
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Mechanical Ventilation Coding

Avoiding Overpayments Through Accurate Mechanical Ventilation Coding

 The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently conducted a review of Medicare Severity Diagnosis Related Groups (MS-DRGs) that required more than 96 consecutive hours of mechanical ventilation. The audit focused on compliance with Medicare payment requirements and accurate Mechanical Ventilation Coding and code assignment. A total of […]
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