The Centers for Medicare and Medicaid Services (CMS) has released a summary of each HCPCS Level II code application decision. The document is twenty-eight pages long and the link can be found in the Resources section. There are 23 items included in the HCPCS Level II Code Q2 2024 Drug and Biological decisions. Twenty new […]
Physician RCM: This guide dives into key areas physician private practices can target to strengthen their revenue cycle management (RCM), as outlined by the American Medical Association (AMA) in recent News. By optimizing these eight steps, practices can ensure timely and accurate reimbursement for services provided. 1. Patient Registration: Accuracy First The foundation of a […]
Medical ICD-10-CM coding accuracy is crucial for efficient healthcare reimbursement. Even minor errors can lead to claim denials, delays, and lost revenue. Here are the top 10 medical coding mistakes to avoid: Accuracy is Key: 1. Don’t Skip the Details: ICD-10-CM codes often require specific details in the fourth and fifth digits. Using truncated codes […]
Medical coding and billing errors are a persistent headache for healthcare providers, costing them time, money, and reputation. Studies show that a staggering percentage of medical bills contain errors, leading to denied claims, delayed payments, and frustrated patients. Focus on Prevention: Top coding and billing Errors to Avoid Non-Covered Charges: Verify insurance coverage before rendering […]
Embrace the Denial Management Makeover and discover how to improve cash flow, streamline billing, and finally conquer denied claims. There are few things worse than denies for any healthcare provider. They disrupt patient care, but they also add to their financial burden. Denied claims mean lost revenue, impacting your cash flow and making it hard […]
The landscape of medical coding audits is constantly evolving. Staying informed about these trends and implementing best practices can significantly reduce stress and ensure a smooth audit experience. The Shifting Landscape of Medical Coding Audits Traditionally, medical coding audits felt like a lottery. Providers faced the uncertainty of random reviews, often scrambling to address issues […]
Modifier 25 healthcare billing in continues to be a source of frustration for healthcare providers. Health plans seem to view it as a tool to reduce payments, making it a strategic point of contention. For those unfamiliar, this modifier is added to an evaluation and management (E&M) service code on a claim. It signifies a […]
In medical coding, CPT modifier are vital for accurate reimbursement of healthcare services. These special codes, attached to primary procedure codes, provide additional details about the complexity or extent of a service. However, using modifiers incorrectly can lead to claim denials and lost revenue. This blog post shares six key tips to help you get […]
The Prime Minister’s recent voluntary national survey shed light on the Denied claims. The survey, conducted between October and December 2023, found that nearly 15% of all Medicare Advantage, Medicaid, Commercial and Managed Medicaid claims were denied. Between 45% and 60% of rejected cases were overturned, although the expensive appeals process sometimes meant multiple appeals. […]
It is imperative that medical billing be as efficient as possible in today’s fast-paced healthcare environment in order to achieve financial stability and maintain a thriving practice. We must admit, however, that monotonous tasks and constant change can quickly lead to burnout. The purpose of this newsletter is to provide you with five key strategies […]