Category: Blog

OIG Intensifies Medicare Audits

OIG Intensifies Medicare Audits: Vascular Interventions, HRAs

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 […]
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2025 CPT Code Updates: Key Changes in Billing and Coding Practices

2025 CPT Code Updates: Key Changes in Billing and Coding Practices

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 […]
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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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