After years of longing for an update, the U.S. healthcare system is finally undergoing the crucial modernization it desperately needs. Dedicated IT professionals within healthcare organizations are now diligently developing enhanced electronic health records (EHRs) that promise increased efficiency and effectiveness. This transformative process entails integrating EHRs with state-of-the-art patient-access technologies. Consequently, various healthcare practitioners, […]
In the healthcare industry, accounts receivable (AR) days are a critical metric that measures how long it takes for a healthcare provider to get paid for the services they provide. Long AR days can have a significant impact on a healthcare provider’s cash flow, making it difficult to operate and grow their business. There are […]
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 […]
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. […]
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 […]
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 […]
On Friday, June 16, the Centers for Disease Control and Prevention (CDC) unveiled the ICD-10-CM codes for the upcoming fiscal year 2024 (FY 2024). This latest release introduces 395 new additions, removes 25 codes, and includes 13 revised codes. The removals are a result of the expansion of diagnosis codes. In total, there will be […]
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 […]
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 […]
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 […]










