Category: Blog

Enhancing Claims Management

Enhancing Claims Management: Identifying Errors, Maximizing Efficiency, and Streamlining Operations

Claims management serves as a valuable tool for insurance firms, enabling them to identify the root causes of claim errors, measure areas for improvement, and explore new opportunities to continuously enhance their operations. However, the ever-increasing complexity of claims administration poses a formidable challenge for insurance businesses, hindering their ability to uncover fresh prospects and […]
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ICD-10-PCS Codes and Guidelines

Latest ICD-10-PCS Codes and Guidelines for FY 2024

The latest ICD-10-PCS codes and guidelines for the fiscal year 2024 have been unveiled by the Centers for Medicare & Medicaid Services (CMS). With a net growth of 73 codes, the total count of inpatient procedure codes has reached 78,603. Notably, the New Technology Section has experienced the largest surge, introducing 40 new codes. The […]
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Medical Coder's Challenges

The Top Challenges Faced by Medical Coders Today

Medical coding is a crucial aspect of the healthcare industry. It involves the transformation of medical diagnoses, procedures, and services into universal codes that can be easily understood and processed by healthcare providers and insurance companies. Despite its importance, medical coding is not without its challenges. Here are some of the top challenges faced by medical coders […]
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The Impact and Challenges of Medicare Advantage (MA) for Payers and Providers

The Impact and Challenges of Medicare Advantage for Payers and Providers

Medicare Advantage (MA) is becoming more appealing to payers due to its numerous benefits, but providers are struggling to adjust to its effects. Payers are increasingly recognizing the advantages of MA, especially in terms of profitability. According to a study conducted by the Kaiser Family Foundation (KFF), MA insurers disclosed an average gross margin of […]
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RCM Strategies

Strategies for Maximizing Revenue Cycle for Financial Success

Based on a recent survey conducted by MGMA, it was found that 40 percent of medical practices were unsuccessful in attaining their revenue objectives in 2021. The survey participants emphasized various significant obstacles, including insufficient staffing, escalating expenses, and delayed payments from payers. To tackle this widespread revenue shortfall, healthcare providers are urged to prioritize […]
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Tips to Avoid Billing Errors in Radiology Practices

Have you ever received a medical bill that left you perplexed, questioning how the expenses added up and left you scratching your head? If that’s the case, you’re certainly not alone. Billing for radiology can be intricate and confusing, involving numerous codes and procedures. Unfortunately, errors in medical billing are all too frequent, resulting in […]
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EM Coding Guidelines

Comparing 2023 CPT® E/M with Documentation Guidelines

The 1995 and 1997 Documentation Guidelines and the 2023 CPT® E/M Services Guidelines are not drastically different when compared side by side. Some hospitals and coding and billing entities may believe that the new 2023 CPT® evaluation and management (E/M) services guidelines and code changes simplify the coding, billing, and auditing processes. However, it is […]
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Top 6 Medical Billing Changes

The Top 6 Changes in Medical Billing for 2023

The healthcare industry is constantly evolving, and medical billing is no exception. With the ever-changing landscape of healthcare, it’s important to stay up-to-date on the latest changes in medical billing and how they relate to medical billing companies and medical billing services. The Top 6 changes in Medical Billing 1. Implementation of ICD-11 The International […]
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