Revenue cycle technology comes in various forms, tailored to the specific needs of healthcare providers, yet these indispensable tools have become vital for ensuring seamless operations within the revenue cycle. The healthcare revenue cycle represents a vast and intricate operation that encompasses a range of activities, from patient registration and insurance verification to denials management […]
In 2019, the Office of the Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) found that one in every eight prior authorization requests was denied by Medicaid managed care organizations. Dive Brief: A recent report by the HHS’ Office of the Inspector General suggests that due to high rates of […]
Medical billing can be a complicated landscape with costly and alarming risks. From minor transcription errors to major coding misunderstandings, inaccuracies in this field may lead to lost income or legal complications for your healthcare organization. While some medical billing problems stem from simple oversights, others result from systemic challenges. However, all of these issues […]
Here are five common mistakes you should avoid to prevent revenue loss 1. Inappropriate medical Coding: Frequently, medical coding for evaluation/management services tends to be excessively aggressive or overly passive, leading to coding errors. These mistakes are primarily due to the misinterpretation of E/M coding guidelines and the fast-paced nature of the clinical environment. Aggressive […]
As healthcare providers, ensuring that your accounts receivable (A/R) is properly managed is crucial to the financial health of your practice. However, managing healthcare A/R can be a daunting task, especially when it comes to follow-up on denied claims. In this ultimate guide, we’ll provide you with best practices to effectively manage your healthcare A/R […]
On July 13, 2023, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule seeking public feedback on proposed policy changes for Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues. These changes are set to take effect on or after January 1, 2024. The proposed rule for […]
The 2024 Medicare Physician Fee Schedule proposal includes a reduction of 3.4% to the conversion factor that determines Medicare payment rates. This reduction will widen the gap between practice expenses and reimbursement. If the proposal is approved, the new conversion rate will be $32.7476. Here are some other key highlights of the CMS proposal: The […]
Collaboration among a diverse team that blends clinical expertise and technical proficiency is essential in today’s dynamic healthcare environment to overcome administrative and diagnostic challenges. This multidisciplinary approach facilitates the creation of healthcare technology solutions that benefit all stakeholders, including payers, providers, and patients. By adopting a more personalized approach, treatment outcomes can be optimized […]
Telemedicine or telehealth, which refers to providing care via electronic communication when patients and providers are in separate locations, has been available for decades. However, the COVID-19 pandemic has accelerated the adoption of telehealth due to the urgent need to deliver care in new ways. Before the pandemic, telehealth faced challenges such as limited reimbursement, […]
The President administration has announced its intention to restrict the sale of “junk” insurance policies, including short-term plans that may not provide adequate coverage for individuals who are in-between jobs and require temporary health care coverage. These policies have been known to deny basic coverage to policyholders. On Friday, President announced a set of fresh […]










