Tag: Medical Coding

medical coding in value-based care

Medical Coding in Value-Based Care: Accuracy for Success

The healthcare landscape is undergoing a significant transformation, shifting from a fee-for-service model to value-based care (VBC). This patient-centric approach emphasizes quality of care, patient outcomes, and cost-effectiveness. For healthcare providers to thrive in this evolving environment, optimizing revenue cycle management is paramount, and at the heart of this lies efficient and accurate medical coding […]
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Hospital Claim Validation

Hospital Claim Validation: A Proactive Strategy to Prevent Denials

Claim denials cast a long shadow over hospital finances, eroding revenue cycles, inflating administrative burdens, and ultimately jeopardizing the institution’s financial stability. While some denials are unavoidable, a powerful and forward-thinking Hospital Claim Validation strategy can dramatically reduce their frequency.  This approach emphasizes embedding accuracy and compliance at every touchpoint of the patient journey and […]
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Robust Denial Managament Solutions

6 Action Items for Your Denials Management Plan

Navigating the complexities of denials management can feel overwhelming for revenue cycle leaders seeking effective solutions. Instead of chasing quick fixes, a structured, methodical approach is essential for building a sustainable and impactful denials management strategy. Implementing a Robust Denials Management Solution is key to achieving this, as it provides the necessary framework for a […]
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CPT Code Update

2025 CPT Code Updates: Key Changes You Can’t Miss

As the healthcare industry continues to evolve, staying informed about 2025 CPT Code Updates is essential for providers, billing professionals, payers, and healthcare administrators. Each year, the American Medical Association (AMA) releases an updated CPT code set to reflect advances in medical knowledge, technology, and clinical practice. The 2025 CPT Code Updates are crucial to […]
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3 Ways to Improve Medical Coding Quality for Accurate Reimbursement

Improve Medical Coding Quality for Accurate Reimbursement

In the complex world of healthcare, accurate medical coding is the linchpin of a healthy revenue cycle. For US-based medical practices, hospitals, and billing companies, efforts to Improve Medical Coding Quality directly translate to timely and accurate reimbursements. Errors in coding can lead to denied claims, compliance issues, and significant financial losses. This blog post […]
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Gender-affirming care coding

Impact of Policy Changes on Gender-Affirming Care Coding

The landscape of healthcare policy in the United States has recently been shaken by an executive order issued by the U.S. President, introducing significant potential shifts, particularly concerning Gender-Affirming Care Coding. This has ignited widespread concerns about insurance coverage, general medical coding practices, and compliance obligations for hospitals and healthcare facilities nationwide. On January 28th, […]
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AI And ML Are Making A Difference In Healthcare

How AI & ML Are Transforming Healthcare RCM

Discussions about artificial intelligence (AI) and machine learning (ML) in healthcare often focus on clinical applications—assisting doctors with diagnoses or personalizing cancer treatments. However, healthcare is a vast industry with equally complex financial and administrative components. AI and ML are revolutionizing these behind-the-scenes processes, improving provider efficiency, reducing costs, and enhancing the patient experience. Enhancing […]
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AI in Revenue Cycle Management

AI in Revenue Cycle Management: Transforming Healthcare Reimbursement

AI in Revenue Cycle Management stands as one of the strongest use cases for artificial intelligence (AI) in healthcare. AI-driven solutions have significantly reduced claim denials and improved overall efficiency by automating complex administrative tasks. These technologies enhance data collection, streamline prior authorizations, and optimize medical coding, leading to faster reimbursement cycles. Healthcare providers are […]
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CPT Code Revisions

CPT Code Revisions for 2025: How to Stay Ahead of Industry Changes

As the healthcare landscape continues to evolve, keeping up with Current Procedural Terminology (CPT) code changes, including essential CPT code revisions, is essential for providers, coders, and revenue cycle management (RCM) professionals. Each year, the American Medical Association (AMA) updates the CPT code set to reflect medical advancements, regulatory requirements, and industry best practices. These […]
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