For millions of Americans relying on Medicare, the specter of high out-of-pocket healthcare costs looms large. Unexpected illnesses, chronic conditions, and even routine medical needs can quickly erode savings and create significant financial strain. The idea of a Medicare out-of-pocket spending cap has long been a topic of discussion, promising a shield against catastrophic expenses. […]
Allergen immunotherapy remains a cornerstone of treatment for many patients suffering from allergic conditions, offering long-term relief and potentially altering the course of disease. For allergy and immunology practices, CPT code 95165, which covers the professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, is a vital component of their […]
In the fast-paced and ever-evolving world of healthcare, medical billing services play a critical role in ensuring a provider’s financial health. Yet, despite its importance, medical billing is still surrounded by several misconceptions that lead to inefficiencies, revenue loss, and administrative burnout. Whether you’re a physician, clinic manager, or revenue cycle professional, falling for these […]
That sinking feeling when an unexpected, sky-high medical bill lands in your mailbox – it’s a universal experience for many. Welcome to the world of “surprise medical billing,” a frustrating byproduct of our complex healthcare system. Thankfully, new federal protections are in place to shield consumers. But what happens when a surprise bill still sneaks […]
Electronic Health Records (EHRs) have revolutionized healthcare documentation, promising efficiency, improved patient care, and streamlined billing. However, in recent years, many healthcare providers have voiced a significant concern: EHR documentation focused on billing has become too prevalent, often at the expense of clinical care. This shift toward reimbursement-centric documentation has led to clinician burnout, reduced […]
In the complex world of insurance and healthcare claims, the concept of “zero-paid claims” can feel like a phantom menace. You’ve submitted a claim, received an Explanation of Benefits (EOB) or remittance advice, and to your dismay, the payment is… zero. While a zero payment might seem innocuous, it can, in certain scenarios, be interpreted […]
In the intricate dance of healthcare administration, few processes have historically caused as much friction as prior authorization. The traditional, often manual, methods of obtaining approval for medical services and medications have long been a source of frustration for both physicians and patients. Lengthy wait times, administrative burdens, and potential delays in necessary care have […]
Artificial intelligence (AI) is one of the most talked-about innovations in healthcare finance—and for good reason. While it brings excitement about streamlined operations, particularly in areas like AI in denial management, and better outcomes, it also sparks questions about its impact on providers, staff, and daily workflows. At AAPC, we’ve been actively exploring how AI […]
In today’s competitive healthcare environment, delivering an exceptional ASC patient experience is crucial for differentiating your ambulatory surgery center (ASC) and fostering sustainable growth. This experience hinges on treating patients with care, respect, and competence throughout every interaction – from staff engagement to procedural efficiency and technological integration. This article focuses specifically on enhancing the […]
In the fast-paced world of US healthcare, efficiency and accuracy are paramount. For healthcare providers, a robust Revenue Cycle Management (RCM) system is the backbone of financial health. However, as technology evolves and patient expectations rise, outdated RCM systems can become significant bottlenecks, leading to revenue loss, compliance issues, and increased administrative burdens. So, how […]