Tag: RCM

Denial Prevention vs. Denial Facilitation

Denial Prevention vs. Facilitation: Optimize Healthcare Revenue

In the healthcare revenue cycle, denials are inevitable — but how you manage them makes all the difference. A common discussion in this space centers around Denial Prevention vs. Denial Facilitation, two strategies that, while they may sound similar, have distinct purposes and outcomes. Understanding and effectively applying both can drastically improve your practice’s cash […]
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Reproductive Healthcare Data Privacy

Understanding the HIPAA Reproductive Healthcare Data Privacy Final Rule

The final rule issued by the Biden administration aimed to bolster the privacy of reproductive healthcare data under HIPAA, a significant move following the Supreme Court’s overturning. Health and Human Services (HHS) officials hoped this rule would alleviate the “chilling effect” on individuals seeking or providing legal reproductive healthcare, stemming from both legal challenges and […]
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medical necessity documentation

Medical Necessity Documentation: A Guide to Reducing Claim Denials

Claim denials are a significant headache for healthcare providers, impacting revenue and administrative efficiency. While denials can stem from various issues, a large majority are rooted in documentation errors, particularly those related to demonstrating medical necessity. Defining Medical Necessity: The American Medical Association (AMA) defines medical necessity as healthcare services or products provided to a […]
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CAR-T therapy coding

A Deep Dive into CAR-T Therapy Coding and Billing for Medicare

Stay updated with the latest guidelines for reporting products and procedures related to Chimeric Antigen Receptor (CAR) T-cell therapy to ensure accurate CAR-T therapy coding and billing for Medicare patients. Overview of CAR-T Therapy CAR-T is a cutting-edge cell-based gene therapy that modifies a patient’s own T lymphocytes (T-cells) in a lab to express chimeric […]
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How Cryptocurrency is Revolutionizing Medical Billing with Technology

How Cryptocurrency is Revolutionizing Medical Billing with Technology

Cryptocurrency benefits medical billing by revolutionizing the industry. It offers a decentralized digital currency that serves as a medium of exchange, similar to traditional money. This innovative approach facilitates secure digital transactions, making counterfeiting nearly impossible due to the robust cryptography employed.  Another key advantage is that cryptocurrency operates outside government authority, eliminating taxes or […]
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Automated Insurance Eligibility Checks: Improving AR Days

Automated Insurance Eligibility Checks: Improving AR Days

Table of Contents Understanding the Impact of Denials and AR Days The Role of Automated Insurance Eligibility Checks Benefits of Automated Insurance Eligibility Checks Implementing Automated Insurance Eligibility Checks Insurance Eligibility Verification Service: A Critical Step for Healthcare Practices One significant challenge that healthcare providers face is the high rate of insurance claim denials and […]
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Benefits of Outsourcing rcm

The benefits of outsourcing RCM functions

Here’s a rewritten version of the provided text, aiming for a more concise and impactful delivery: Navigating the complexities of today’s healthcare revenue cycle management (RCM) presents a significant challenge for providers. A key advantage of Revenue Cycle Management outsourcing lies in its ability to alleviate these substantial administrative burdens, which often escalate with evolving […]
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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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Value-Based Care: Navigating Challenges and Opportunities in Revenue Cycle Management

Value-Based Care: Navigating Challenges and Opportunities in Revenue Cycle Management

RCM and Value-Based Care Challenges and Opportunities: Healthcare is a dynamic field constantly evolving to improve patient and staff experiences. As the industry transforms, it’s crucial to understand both the potential benefits and drawbacks of these changes. One area experiencing significant evolution is Revenue Cycle Management (RCM). The shift towards value-based care models is a […]
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