Medical Billing Blog with Medical Billing & Coding Info & Articles
Our blog contains news and articles relating to numerous healthcare sectors including revenue cycle management, medical billing, medical coding, ICD, HIPAA, practice management functions and more.
Assessing the Financial Health of Your Practice: Key Metrics for Billing Success
Assessing the financial health of a medical practice is crucial for its success and sustainability. Key metrics play a vital role in evaluating the billing success of a practice. Regularly assessing these key metrics and adapting strategies accordingly can contribute to the long-term financial success and sustainability of your medical practice. Additionally, seeking professional advice from healthcare financial consultants or advisors can provide valuable insights and guidance in optimizing billing processes and financial management. Here are some key metrics that can help in assessing the financial health of your medical practice: Revenue Cycle Management (RCM) Metrics: Days in Accounts Receivable (DAR): This metric measures the average number of days it …
Optimizing front desk procedures for improved billing accuracy
Optimizing your front desk procedures is crucial for improving billing accuracy in a healthcare setting. The front desk serves as the initial point of contact for patients and plays a significant role in ensuring that billing information is collected accurately and efficiently. Here are key strategies for optimizing front desk procedures to enhance billing accuracy: Patient Registration: Accurate patient registration is the foundation of billing accuracy. Front desk staff should collect comprehensive patient information, including demographics, insurance details, and contact information. Implement electronic registration systems to minimize data entry errors and streamline the registration process. Insurance Verification: Verify insurance coverage for each patient during the registration process. Confirm eligibility, coverage …
20 Very Important Aspects of Medical Billing
These 20 aspects collectively contribute to the effective and efficient management of your medical billing process, optimizing reimbursement and minimizing the risk of claim denials. Patient Information: Accurate collection and maintenance of patient demographics, contact details, and insurance information. Insurance Verification: Thoroughly confirming insurance coverage, including eligibility, benefits, and any pre-authorization requirements. Medical Coding: Precise assignment of codes (ICD-10, CPT, HCPCS) to document diagnoses and procedures accurately. Charge Entry: Entering coded information into the billing system to generate claims for submission. Claim Submission: Timely submission of claims to insurance companies, adhering to specific guidelines and deadlines. Claim Rejections and Denials Management: Proactive resolution of rejected or denied claims, identifying reasons …
What are some obstacles to efficient healthcare revenue cycle management?
Efficient healthcare revenue cycle management (RCM) involves various processes, from patient registration and insurance verification to claims processing and reimbursement. Several obstacles can impact the efficiency of healthcare RCM. Addressing these obstacles requires a comprehensive approach, including the use of technology, continuous staff training, regular audits, and staying informed about regulatory changes in the healthcare industry. Common challenges to achieving effective RCM: Incomplete or Inaccurate Patient Information: Inaccurate or incomplete patient data during registration can lead to billing errors, claim denials, and delayed payments. Insurance Verification Issues: Difficulty in verifying insurance coverage and benefits can result in claim denials or delays in reimbursement. Coding Errors: Incorrect medical coding can lead …
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 …
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 …
Can you save money by outsourcing your medical billing?
Outsourcing your billing can potentially save you money, but it depends on various factors such as the size of your practice, efficiency of the billing process, and the cost structure of outsourcing services. Here are some ways outsourcing medical billing can save you money: Reduced Overhead Costs: Outsourcing eliminates the need to hire and train in-house billing staff, which can reduce costs related to salaries, benefits, office space, and equipment. Efficiency and Accuracy: Professional billing companies specialize in this area and often have dedicated teams using advanced software to handle billing tasks accurately and efficiently. This can reduce errors and rejections, leading to quicker reimbursements and fewer denied claims. Focus …
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 …
Data can unlock capacity in the O.R. & drive better decision-making: Melissa’s Mention
“Optimizing operating room performance is a tough nut to crack for hospitals because true OR capacity is often uncaptured and underutilized due to rigid scheduling protocols. During a workshop sponsored by LeanTaaS at the Becker’s Hospital Review 9th Annual CEO + CFO Roundtable in November, Sanjeev Agrawal, president and COO of LeanTaaS, and Matt Ruby, director of business operations, surgical services at Northwestern Memorial Hospital in Chicago, discussed challenges and available solutions related to efficient OR utilization. Four key takeaways: 1. Unused OR capacity leads to unrealized return on investment. The OR represents the economic backbone of hospitals but is often underutilized because of the rigidity of block scheduling and …
Telehealth and Its Impact on Healthcare Delivery
Technology has influenced many facets of life, and healthcare is not an exemption. Over the last few years, several digital healthcare startups have sprung up, and this has simplified the process of healthcare delivery to remote places and people who find it difficult to commute. Modern life has undergone tremendous transformation because of the internet and progressive software. This useful tool has changed the way we communicate and keep in touch with family and friends, how we consummate financial transactions, and how goods and services are negotiated and purchased. There are so many telehealth tools that you can choose from if you are keen on receiving quality healthcare …
