Category: Blog

The Top Challenges Faced by Medical Coders Today

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 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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Strategies for Maximizing Revenue Cycle for Financial Success

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

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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Comparing 2023 CPT E_M with Documentation 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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The Top 6 Changes in Medical Billing

The Top 6 Changes in Medical Billing

Table of Contents The Top 6 Changes in Medical Billing Implementation of ICD-11 Increased Use of Telehealth Services Changes in Reimbursement Rates Increased Focus on Patient-Centered Care Greater Emphasis on Data Security Focus on Price Transparency The healthcare industry is constantly evolving, and medical billing is no exception. With the ever-changing landscape of healthcare, it’s […]
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Unveiling the Advantages of Claim Scrubbing

Unveiling the Advantages of Claim Scrubbing

Claim scrubbing enables the potential for increased accuracy in claims, enhanced client relationships, and improved patient interactions. Claim scrubbing is the process of identifying and rectifying coding errors in medical claims prior to their submission to insurance providers. Whether conducted manually or through automated systems, claim scrubbers validate medical claims before they are sent to […]
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Automating Claims Processing in the Healthcare Industry

Automating Claims Processing in the Healthcare Industry

By utilizing automation, it is feasible to improve the upstream and downstream adjudication process through data validation and routing. The healthcare industry can benefit from automation in almost all administrative functions, but it can significantly improve the auto-adjudication rate. In an ever-changing industry, possessing technical expertise is of utmost importance. The healthcare sector is increasingly […]
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