Ideally, revenue cycle processes should flow seamlessly from one stage to the next. However, challenges can arise at any point, from the front end to the back end, requiring leaders to be vigilant and strategic in their efforts. Here are some highlighting executive approaches to various revenue cycle challenges: How Healthcare Services Revamped Their Billing […]
Here are some steps to guide you through the process of appealing a denied health insurance claim: 1. Understand the Reason for Denial Review the Denial Letter: Carefully read the denial letter from your insurance company. It should explain why your claim was denied and how you can appeal the decision. Check you’re Policy: Refer […]
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. […]
The official April 2024 update to the HCPCS Level II code set is now available on the Centers for Medicare & Medicaid Services website. April update includes: 62 new codes 2 changes to scope and long description 21 obsolete codes 11 changes to long description 1 change to changes miscellaneous changes Below are some code […]
An end-to-end platform is sought by deep adopters of RCM technology from a single vendor, according to a new Healthcare IT research report. Some providers have adopted technology from only one vendor in order to achieve an end-to-end revenue cycle management (RCM) platform. There are several benefits to working with one vendor, but there are […]
In 2023, multiple entities, such as the Health Insurance Company and health Services Company, declared reductions in prior authorizations. Healthcare Media provided further details on this and additional updates related to prior authorizations in the healthcare sector reported this year. According to a November 13 report from the Medical Group Management Association, 89% of medical […]
Help your medical coders facing difficulties in maintaining coding accuracy by implementing a focused strategy. Medical coders hold a crucial position in healthcare, translating intricate medical data into standardized codes essential for billing, research, and patient treatment. The importance of accurate and high-quality medical coding cannot be overstated, as errors may result in financial setbacks […]
The Advance Beneficiary Notice (ABN), Form CMS-R-131, issued by the Centers for Medicare & Medicaid Services (CMS), holds immense importance for healthcare providers, revenue cycle teams, and Medicare beneficiaries. What is an ABN (Advance Beneficiary Notice)? An ABN, formally extended to Medicare Fee-for-Service (FFS) beneficiaries, precedes outpatient services like labs, imaging, physical therapy, or observation. […]
The final 2024 Medicare Physician Fee Schedule includes a provision that allows health systems to bill Medicare for telehealth services provided by doctors from their homes. This extension of a crucial Medicare reimbursement for health systems using telehealth services lasts until the end of 2024, and it also grants physicians working from home added privacy […]
According to a recent report, 25 states now provide reimbursement for video, store-and-forward, and audio-only telehealth, as well as remote patient monitoring through Medicaid. Although every state and Washington, D.C. include some form of live video-based telehealth in their Medicaid programs, only 25 of them also offer Medicaid reimbursement for live video, store-and-forward telehealth, remote […]