Tag: Healthcare Reimbursement

Unlocking the Secrets of Denied Claims: Insights, Solutions, and Strategies

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. […]
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Survey: High Initial Claim Denials Impact Healthcare Providers

Survey: High Initial Claim Denials Impact Healthcare Providers

The Rising Denial Rates in Healthcare Claims Processing Initial Claim Denials: In a new survey conducted by healthcare Company an increased percentage of initial claims are denied by private payers, including pre-approvals for medical claims. Hospitals, health systems, and post-acute care providers may have a difficult time getting paid for medical services. The survey respondents […]
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Differences: Preventive vs. Office Visits in Medical Coding & Billing

Differences: Preventive vs. Office Visits in Medical Coding & Billing

Preventive Services Vs Office Visits: It is important to note that Medicare does not cover preventive services in the same manner as commercial payers. Therefore, it is important to know the patient’s policy and insurance coverage. Table A shows a breakdown of the coverage parameters. Understanding the distinction between Preventive Services Vs Office Visits is […]
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Clinicians Struggle with Medical Coding Amid Patient Care Responsibilities

Clinicians Struggle with Medical Coding Amid Patient Care Responsibilities

Presently, healthcare professionals face growing administrative demands alongside their patient-focused duties. A pivotal challenge among these is medical coding, essential for various reasons. It ensures adherence to billing standards impacting reimbursements, meets quality metrics established by healthcare entities and insurers, and guarantees precision in diagnoses recorded for billing purposes. Yet, the task of accurate coding […]
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Medicare’s Telehealth Reimbursement Waiver Extended to 2024

Medicare’s Telehealth Reimbursement Waiver Extended to 2024

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 […]
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The Importance of Accurate Medical Coding in Healthcare Reimbursement

The Importance of Accurate Medical Coding in Healthcare Reimbursement

In the intricate realm of healthcare, where patient well-being is paramount, the financial dimension often receives less attention. Yet, it’s imperative to recognize that healthcare encompasses not only patient treatment but also ensuring fair compensation for healthcare providers. Precise medical coding is a cornerstone of this endeavor. This piece delves into the profound importance of […]
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AMA Unveils 2024 CPT Codes

AMA Unveils 2024 CPT Codes

The revised code set now features descriptions of procedures and services in Spanish for the first time. The American Medical Association’s 2024 Current Procedural Terminology (CPT) code set, revealed today, encompasses various noteworthy features. These include consolidated codes for reporting ongoing COVID-19 immunizations, provisional codes for upcoming monovalent vaccines, and codes for Respiratory Syncytial Virus […]
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How Revenue Cycle Management Improves Healthcare in 2023

How Revenue Cycle Management Improves Healthcare in 2023

Discover how healthcare providers can accelerate cash flow, minimize denials, reduce operational costs, and enhance patient satisfaction through streamlined Revenue Cycle Management (RCM). RCM is a strategic approach to overseeing all financial aspects of a patient’s journey, from initial appointment scheduling to final bill payment. This article highlights the critical role RCM plays in maximizing […]
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