Category: Blog

Prior Authorization in Medicare Advantage : Lawmakers Call for Streamlined Process

CMS has proposed a rule to simplify prior authorization in government-sponsored health insurance programs. However, some lawmakers are urging the agency to do more. A bipartisan coalition of 233 representatives and 61 senators have written a letter to CMS requesting that the proposed rules be expanded and that the changes be finalized quickly to enhance […]
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How Adapting Risk Adjustment Coding Can Change Healthcare Landscape?

How Adapting Risk Adjustment Coding Can Change Healthcare Landscape?

Risk adjustment coding plays a vital role in the healthcare sector by capturing and documenting the severity of patient conditions. Its primary purpose is to guarantee precise reimbursement and risk adjustment scores. Given the ever-changing healthcare landscape, it is imperative for healthcare providers and coding professionals to remain adaptable and well-informed about the evolving requirements. […]
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Top Trends That Impacts Medical Billing Space

Top Trends That Impacts Medical Billing Space

Medical coding and medical billing are two distinct yet interrelated tasks in the healthcare industry. Coding is the process of assigning standardized codes to diagnoses and procedures, while billing is the process of submitting claims to insurance companies for reimbursement. One of the biggest challenges in the medical billing space today is the shortage of […]
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4 Strategies to Optimize Billing and Expand Your Customer Base

4 Strategies to Optimize Billing and Expand Your Customer Base

The increasing demand for incontinence products is prompting home medical equipment (HME) providers to reevaluate their existing incontinence programs. With the U.S. witnessing a significant rise in the aging population, marked by 10,000 people turning 65 every day according to the U.N. Population Division, there is a growing market for incontinence products. Studies from Mayo […]
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The High Costs of Delaying AI Adoption in Revenue Cycle Management

The prominent role of AI in healthcare is hard to ignore. In recent years, significant advancements have been witnessed in the field of revenue cycle management (RCM), particularly in coding and billing. The emergence of new technologies incorporating natural language processing, deep learning, and other cutting-edge techniques has revolutionized the process, surpassing the limitations of […]
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Denial Management and Strategies to Reduce Claim Denials

Denial Management and Strategies to Reduce Claim Denials

Denial management is a critical process in the healthcare industry that involves identifying, analyzing, and resolving claim denials. Claim denials occur when healthcare providers’ reimbursement requests are rejected by insurance companies due to various reasons. These denials can have a significant impact on providers’ revenue and overall financial health. In this blog post, we will […]
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Accelerating Revenue: Revealing the Financial Impact of Delayed Medical Billing

Accelerating Revenue: Revealing the Financial Impact of Delayed Medical Billing

The impact of prolonged turnaround times from billers in medical billing is frequently underestimated, yet it has far-reaching consequences for everyone involved. Delays in processing times impose financial burdens on healthcare organizations and patients. By gaining insight into the concealed costs and inefficiencies, we can enhance the process and achieve more favorable financial outcomes. In […]
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How AI Empowers Hospital Bills with Complete Medical Records

How AI Empowers Hospital Bills with Complete Medical Records

According to the CEO of a prominent healthcare IT consulting firm, hospitals face significant financial losses due to billing inaccuracies, estimated to be in the billions annually. However, the implementation of physician-trained artificial intelligence can assist hospitals in recovering millions of dollars by reducing denials and improving revenue recovery processes. The CEO of a prominent […]
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Enhancing Claims Management: Identifying Errors, Maximizing Efficiency, and Streamlining Operations

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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