Tag: Medical Billing Outsourcing


Medical Billing Companies Have Positive Outlook On Industry

A new report analyses the state of outsourced medical billing and uncovers areas of opportunity. KEY TAKEAWAYS Sixty five percent of respondents say they have a positive outlook on the industry, while 9% have a negative outlook. Automation is key for billing companies to grow and attract providers, who want to outsource billing to save […]
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Medical Billing Outsourcing Global Market Report 2023

Medical billing outsourcing services are services in which a healthcare provider hires a medical billing service provider outside their practice to do all the billing. The main types of services in medical billing outsourcing are the front end and back end. The front-end is in charge of the patient experience, while the back-end is in […]
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Outsourcing RCM Services can Lead to Better Outcomes

A report highlights pandemic-related impacts of the past year on revenue cycle challenges. As the labor shortage continues to hamper healthcare organizations, outsourcing has become a common strategy to mitigate costs. Nearly one-third of hospital and health system leaders (63%) have pursued at least one outsourcing solution, with revenue cycle functions at the top of […]
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Medicare Suspends Prior Authorization Requirements for Some DME

Prior authorization is no longer required for certain DME when it risks the health of the patient. The Centers for Medicare & Medicaid Services (CMS) has suspended the prior authorization requirements for certain durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) when waiting for prior authorization would delay healthcare and risk the life or health […]
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Medical Coding Uncertain Lesion Excisions With Certainty

  What to do when the pathology doesn’t correlate to the service provided. The rules for cutaneous (skin) excision coding are straightforward: When the pathology for a lesion is benign, code for excision of benign lesion, 11400-11446; and when the pathology for a lesion is malignant, code for excision of malignant lesion, 11600-11646. But in […]
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The Challenges of Billing Observation Correctly

Observation, outpatient outlier payments, and the Inpatient-only List: Getting it right is not always easy. On this week’s Monitor Mondays we had a robust discussion about Condition Code 44. And on June 9, I will be presenting a webinar on the nebulous concept of “outpatient” service in a bed. Both of these have one thing […]
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How to correctly document and bill for patient e-visits

Q: The providers in our clinic want to start billing e-visits.Can they bill for all the communication between the provider and patient through our online portal? A: As you venture into billing e-visits, on-line visits, digital visits – however you’d like to refer to them – let’s review the required elements for these types of […]
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Take the Complexity Out of Behavioral Health Coding

The secret to ensuring both proper payment and compliance is in the details. Why is mental health coding so complex? Laurie Bouzarelos, MHA, CPC, asked and answered that question in her presentation “Coding and Billing for Psychiatry and Outpatient Mental Health Providers” at AAPC’s virtual HEALTHCON 2022, March 27-30. Bouzarelos manages to take much of […]
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Preventive Medicine Versus E&M Codes

Choosing a proper office visit code can become confusing unless one understands the rules separating preventive medicine and evaluation and management (E&M) coding. Problem-oriented E&M services, office, and other outpatient visit codes 99202-99215 (along with hospital, observation, and consultative encounters) are for patients who present with signs, symptoms, conditions, diagnoses and/or problems that need to […]
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