Medical coding and billing errors are a persistent headache for healthcare providers, costing them time, money, and reputation. Studies show that a staggering percentage of medical bills contain errors, leading to denied claims, delayed payments, and frustrated patients. Focus on Prevention: Top coding and billing Errors to Avoid Non-Covered Charges: Verify insurance coverage before rendering […]
Prior Authorization Challenges are a growing hurdle for medical practices dealing with Medicare Advantage plans. Recent investigations reveal concerning trends: improper denials and a lack of transparency from some insurers. This can significantly delay or even block essential care for patients. The Problem with Prior Authorizations Improper Denials: A government investigation found that Medicare Advantage […]
The article explores common billing mistakes and offers tips for four healthcare services that can cause payment headaches for physicians. 1. Annual Wellness Visits vs. Physicals: Understanding Medicare Requirements Differentiating between Annual Wellness Visits (AWV) and Initial Preventive Physical Exams (IPPE) is crucial for accurate billing. Both are covered by Medicare for preventive care, but […]
The good news for coders is that the 2024 ICD-10-CM update allows for more specific coding of chronic migraine with aura, improving accuracy and potentially helping patients access treatment. Diagnosing Migraine: A Complex Puzzle While the International Headache Society defines chronic migraine, pinpointing the exact type can be challenging. Migraines come in various forms, and […]
Ideally, revenue cycle processes should flow seamlessly from one stage to the next. However, challenges can arise at any point, from the front end to the back end, requiring leaders to be vigilant and strategic in their efforts. Here are some highlighting executive approaches to various revenue cycle challenges: How Healthcare Services Revamped Their Billing […]
Navigating the complexities of telehealth coding is crucial for ensuring that services are properly reimbursed. This guide provides essential information and tips for coding telehealth services accurately, helping physicians avoid denials and recoupments. 1. Telephone Services: Use Cases: Suitable for straightforward problems like simple rashes, asymptomatic coughs, and medication refills. Requires a minimum of five […]
When your medical practice submits a claim to a payer, the countdown begins until you receive the payment. Ensuring timely payment is crucial for your business, as delays can have costly consequences. Ideally, you should aim to clear accounts receivable within 30 days. To effectively reduce accounts receivable, it’s essential to implement efficient billing processes, […]
The world of medical billing and accounts receivable (AR) can feel like a labyrinth for healthcare providers. Lost in a maze of codes, claims, and denials, it’s easy to see revenue slip through the cracks. But fear not! Here’s our guide to mastering AR and ensuring your practice thrives. Medical Billing & Accounts Receivable Medical […]
Streamline Prior authorizations can be a real pain, but with a few adjustments, you can make the process smoother and save yourself and your patients some stress. Here are 5 tips to streamline prior authorizations: Know Your Triggers: Become familiar with medications and procedures that frequently require prior authorization. Identify alternative options, like generics, that […]
The Crucial Role of Medical Coding Compliance in a Value-Based World: Telling the Patient’s Story for Better Billing and Quality Care. Medical Coders: The Unsung Storytellers of Healthcare Medical coders play a critical role in hospitals, but their importance often goes unnoticed. They’re the storytellers behind the scenes, analyzing patient records, selecting billing codes, and […]










