Tag: Healthcare Claims

RCM automation

Maximizing A/R Efficiency with RCM Automation

A well-managed A/R process ensures timely cash flow, reduces administrative burdens, and maintains the stability of a healthcare practice. However, many healthcare practices still struggle with outdated, manual A/R management processes that can lead to inefficiencies, errors, and delayed payments. In recent years, Revenue Cycle Management (RCM) automation has emerged as a game-changer in addressing […]
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Medical billing and interoperability

Medical billing and interoperability

Interoperability role in medical billing: A growing number of physicians practice in an interconnected world, which means that medical practices and hospitals need to seamlessly share information in order to be able to provide good health management and ensure that patients are treated safely and effectively. Health care interoperability is an important concept that has […]
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8 Successful Tactics for Reducing Denied Claims 2024

8 Successful Tactics for Reducing Denied Claims 2024

Roughly 65% of rejected claims aren’t reprocessed for resubmission (Zindl, 2021). As one of the healthcare industry’s numerous challenges, the upward trend of denied claims persists, with many left unaddressed. This has repercussions for both providers and patients alike. When denied claims remain unsubmitted, providers face substantial losses. Beyond revenue, these rejections strain staffing resources. […]
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Top Advantages of Automated Medical Claim Processing

Top Advantages of Automated Medical Claim Processing

With the arise of indirect health practices such as telehealth, it is becoming increasingly indispensable to play with bill payments and claims orderly. The medical billing cycle is a complex system encompassing procedures such as medical recordkeeping and patient data processing. Medical claim processing is the keystone for healthcare insurance companies since it needs data […]
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A Surgeon General Touts Possible Changes in Prior Authorizations

A Surgeon General Touts Possible Changes in Prior Authorizations

Federal healthcare leaders say they are committed to helping physicians, patients, and health insurance companies by improving the prior authorization process for medical care. On Jan. 17, Center for Medicare & Medicaid Services Administrator and U.S. Surgeon General Vice Admiral, held a listening session with health care stakeholders. That was followed by a conference call […]
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Introduction to the WHO’s ICD-11

Introduction to the WHO’s ICD-11

Cluster coding is a new feature for coding professionals. The World Health Organization (WHO) began developing the International Classification of Diseases, Eleventh Version (ICD-11), in 2007, and first released a preliminary version for evaluation and testing in 2016 – ironically, just one year after the U.S. finally adopted a clinical modification of the WHO’s ICD-10 […]
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