Category: Blog

Claim Denial Codes

Claim Denial Codes: Reduce Denials & Boost Healthcare Revenue

Claim denial rates are a significant challenge for healthcare providers, with substantial variations based on payer type, location, and specific insurance companies. To understand these variations, it’s crucial to analyze the specific claim denial codes issued by each payer. While the industry standard for claim denials hovers between 5% and 10%, certain payers, notably those […]
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reduce payment turnaround time

Reduce Payment Turnaround Time: Best Practices for Faster Reimbursement

For any medical practice, the timely reimbursement of claims is essential to maintaining a healthy cash flow and sustaining operations. The moment your practice submits a claim to the payer, the countdown begins until you receive the actual payment. Delays in reimbursement can strain your revenue cycle, affect financial stability, and even impact patient care. […]
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AI in Revenue Cycle Management

AI in Revenue Cycle Management: Transforming Healthcare Reimbursement

AI in Revenue Cycle Management stands as one of the strongest use cases for artificial intelligence (AI) in healthcare. AI-driven solutions have significantly reduced claim denials and improved overall efficiency by automating complex administrative tasks. These technologies enhance data collection, streamline prior authorizations, and optimize medical coding, leading to faster reimbursement cycles. Healthcare providers are […]
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AI-powered medical billing solutions

Transform Your Revenue Cycle with AI-Powered Medical Billing

Errors, delays, and denials can significantly impact a practice’s revenue cycle, leading to financial strain and operational inefficiencies. Artificial Intelligence (AI) offers a powerful solution to streamline and optimize medical billing processes, specifically through AI-powered medical billing solutions. At Allzone MS, we understand the challenges healthcare providers face and are committed to leveraging AI to […]
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ICD-10 Pain Coding

Pain Coding ICD-10: G89 Codes & Guidelines | Medical Coding

Continuing our exploration of commonly misunderstood areas in medical coding, today, we focus on pain coding, specifically addressing ICD-10 Pain Coding. Pain is one of the most frequent reasons patients seek medical attention. As published by the National Institutes of Health (NIH), pain is the leading complaint that drives individuals to healthcare providers. Most people […]
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HCPCS G-Codes

AUC Program & HCPCS G-Codes: Ensuring Compliance in Medicare Billing

The Centers for Medicare & Medicaid Services (CMS) initiated the educational and operations testing phase of the Appropriate Use Criteria (AUC) program. During this period, Medicare Administrative Contractors (MACs) began accepting AUC-related modifiers and HCPCS G-Codes on claims for advanced diagnostic imaging services provided to Medicare Part B patients. Understanding AUC Program Requirements Under the […]
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AI-driven prior authorization denials

AI-Driven Prior Authorization Denials: Physicians Warn of Patient Harm & Burnout

A growing number of physicians are voicing concerns about the increasing role of artificial intelligence (AI) in health insurers’ prior authorization processes. The American Medical Association’s (AMA) latest 2024 AMA Prior Authorization Physician Survey highlights that many warn AI-driven prior authorization denials are exacerbating patient harm and physician burnout. The survey, which included 1,000 practicing […]
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FESS coding

FESS Coding: CPT, ICD-10 & Billing Guidelines

Functional Endoscopic Sinus Surgery (FESS) is a minimally invasive procedure performed endoscopically on the nasal and sinus cavities. It is primarily used to relieve symptoms of chronic sinusitis, such as congestion, drainage, post-nasal drip, headaches, and facial pain. FESS coding can be complex due to the multiple CPT codes associated with the procedure. Reviewing sinus […]
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MIPS performance disparities

MIPS Performance Disparities: How Individual Radiologists Are Impacted

A recent study published in the Journal of the American College of Radiology reveals stark MIPS performance disparities, with individual radiologists facing significant disadvantages compared to those participating in group reporting or Advanced Payment Models (APMs) within the Centers for Medicare & Medicaid Services (CMS) Merit-Based Incentive Payment System (MIPS). The research, analyzing data from […]
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Statistical extrapolation in healthcare audits

Statistical Extrapolation: Navigating Multimillion-Dollar Healthcare Audits

Imagine the chilling realization that a review of a mere 100 patient claims could trigger a demand for multimillion-dollar repayments from your healthcare organization. This is not a hypothetical scenario; it’s a stark reality faced by healthcare providers nationwide, driven by the potent auditing technique known as statistical extrapolation in healthcare audits. While the underlying […]
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