Tag: Medical billing and coding

medical claims processing

The Power of Business Process Automation in Medical Claims Processing

Medical claims processing has traditionally been a labor-intensive and error-prone task, involving manual data entry, verification, and adjudication. However, the advent of Business Process Automation (BPA) has revolutionized this process, making it more efficient, accurate, and cost-effective. Beyond the Basics: Advanced BPA Features While the core functionality of BPA in medical claims processing involves automating […]
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Prevent Coding and Billing Errors

Preventing coding and billing errors can reduce claims denials

Accurate medical coding and billing are essential components of a healthcare practice’s financial health. When codes for procedures and diagnoses are recorded correctly, providers can receive timely reimbursements for the services they deliver. However, Prevent coding and billing errors can lead to claim denials, delays in payments, and increased administrative burden This blog post will […]
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physician practice RCM

RCM in Physician Practices: Key Steps Revealed by AMA

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 […]
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Medical coding Audits

Medical Coding Audits: Trends and Guide for Providers

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 […]
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modifier 58 vs modifier 78

Modifier 58 Versus 78 – Which Should You Use?

Modifier 58 vs Modifier 78: Key Takeaway: Modifier 58: Same underlying condition, planned or unplanned additional procedure. Modifier 78: New problem caused by the initial surgery (complication) requiring a return to the OR. Medical Coders often struggle to differentiate between modifier 58 (staged/related procedure) and modifier 78 (unplanned return to OR). Let’s break down the […]
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How AI is streamlining medical billing and coding processes

Coding and medical billing with AI: Billing and coding processes in the healthcare industry are notoriously complex. The manual entry of data, the interpretation of physician notes, and maintaining compliance with ever-changing regulations all contribute to a system that is ripe for inefficiency and error. Healthcare providers and patients can save time, money, and frustration […]
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low-dollar accounts receivable

Embracing Low-Dollar AR with Three Strategic Pillars

 Low-dollar accounts receivable for 3 Tips: This can be done effectively, efficiently, and profitably by following the three pillars of low- dollar AR below. Leveraging Offshore Resources for Enhanced Revenue Cycle Management Data doesn’t just tell a story, it can also provide a roadmap for managing low-dollar balances. Use data to identify accounts with the […]
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Benefits Of Coding In Optimizing Resource Allocation

From Claims to Care: How Coding Optimizes Resource Allocation

It is important for ensuring that the proper resources reach the right patients throughout the complicated healthcare system. However, piles of paperwork and complicated medical codes make it difficult to verify that the proper resources are delivered to the right patients when they are needed. Coding may be a great tool for cutting through the […]
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Top Trends That Impacts Medical Billing Space in 2023

Challenges in the Medical Billing Space 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 […]
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