Medical Billing Blog: Section - Medical Coding

Archive of all Articles in the Medical Coding Section

This is the archive containing links to all articles written in the Medical Coding section of our blog.

Click any of the article links below to read the entire article or browse another section to the right to read articles on another subject.

The growing importance of patient collections

Patient collections have grown in importance in the healthcare industry for several reasons. Here are some key factors contributing to the increased emphasis on patient collections: Rise in High-Deductible Health Plans (HDHPs): The prevalence of high-deductible health plans has increased, shifting a larger portion of healthcare costs onto patients. As a result, providers need to focus on collecting payments directly from patients to cover these higher deductibles. Increased Patient Financial Responsibility: Patients now bear a greater financial responsibility for their healthcare expenses. This includes co-payments, coinsurance, and deductibles. Effective patient collections are crucial for healthcare providers to recover these out-of-pocket costs. Changing Reimbursement Models: The shift from fee-for-service to value-based

Published By: Melissa Clark, CCS-P | No Comments

What is physician insurance credentialing?

Physician insurance credentialing, also known as provider credentialing or insurance credentialing, is the process by which healthcare providers, including physicians, nurse practitioners, and other healthcare professionals, become approved participants in insurance networks or panels. Being credentialed with insurance companies is essential for healthcare providers to receive reimbursement for services rendered to patients covered by those insurers.   Here’s an overview of the process: Application Submission: Healthcare providers submit a credentialing application to insurance companies or third-party payers. This application typically includes detailed information about the provider’s education, training, work history, licensure, certifications, malpractice history, and more. Verification of Credentials: Insurance companies or credentialing organizations verify the information provided by the

Published By: Melissa Clark, CCS-P | No Comments

5 Most Important Aspects of Medical Billing: Melissa’s Mention

Here is an excerpt from an interesting article that has been mentioned by Melissa:   “Medical billing is a process where you pay your provider for their services. When we say you, we mean that this is the process where your insurance carrier and you pay the service provider or hospital you were in for deductible charges. Now when you know this let’s put ourselves in the position of a medical institution, clinic, or practice that has to bill for their work. Believe it or not, sometimes it is very hard to do this and these businesses have their work cut out for them when it comes to charging their

Published By: Melissa Clark, CCS-P | No Comments

ICD-11: What it is, When it is Coming and How it Will Differ from ICD-10

ICD (International Classification of Diseases) is a universally accepted ranking system used by the WHO (World Health Organization) for categorizing physical and mental illnesses. ICD-11 is the eleventh edition of this categorization system. For about two decades, there have been no development or publishing of an update or revision to the ICD. The official presentation of ICD-11 at the World Health Assembly took place in May 2019 following its release on June 18, 2018. Member states are expected to adopt it as the official reporting system starting on January 1, 2022. However, it is still unknown when the U.S. Healthcare system will be ready to adopt it for use. ICD-11

Published By: Melissa Clark, CCS-P | No Comments

The Importance of A/R and Outstanding Medical Claims

Accounts receivable (A/R) management is an integral part of the medical billing process and it is crucial for the financial stability and success of healthcare facilities and medical practitioners. Accounts receivable is referred to as the sum of money owed to the medical practitioner or healthcare provider for the service provided, but not yet paid. The medical services that are rendered by physicians, nursing homes, therapists, laboratory technicians, and hospitals are continuously increasing. An efficient insurance model assists a medical practice in recovering overdue payments from insurance carriers easily and on time. This is when a diligent A/R employee, or department is important, they assist the healthcare provider in being

Published By: Melissa Clark, CCS-P | No Comments