Modifier 58 vs Modifier 78: 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 key differences […]
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 […]
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 […]
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 […]
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 space today is the shortage of […]
Compliance is a word no one really wants to talk about. It’s boring, you know you NEED a compliance program, but you feel that you’re pretty good with billing and coding, and heck – you’re a smaller group and you think no one is looking over their shoulder at your practice. The government has better […]
Physicians need to keep their billing and coding right to ensure seamless reimbursements from payers. Similarly, they should stay updated with the latest coding changes to keep their revenue cycle intact. In addition, running a successful medical practice is a daunting task as the providers need to stay updated with the industry guidelines. The year […]
It’s a New Year, and welcome, 2023! When I still practiced clinically, I once got a job as an emergency physician at a brand-new hospital. I was really excited, because I recognized the opportunity for our department to develop our own best-practice culture. I was hoping the staff would gel in an environment of cooperation, […]
Due to technological innovation, the healthcare sector faces greater transformation. Adopting new technologies and implementing virtual care brought significant change in Medical Billing. The year 2022 ends with a substantial rise in the adoption of payment systems and the implementation of new technologies in the Medical billing process. In addition, the integration of advanced Medical […]
Another study confirms that medical billing costs in the US significantly exceed those in similar countries, but researchers now know why: coding drives up US administrative spending. Complex coding structures in the US are driving up medical billing costs in the US, making it one of the most expensive countries to get paid, according to […]