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.
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 …
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 …
Defining the Role of a Medical Billing Clearing House
The importance of a clearing house in the medical world cannot be overemphasized. Also called Third Party Administrators (TPAs), clearing houses make healthcare payment seamless by serving as a link between the hospital, patient, and insurance provider. The role of the clearing house is to interact with the billing system of a hospital, clinic or physician’s office to evaluate medical claims. It sets up necessary documents for patients with claims before forwarding them to the insurer. Typically, a clearing house has strong ties with various insurance providers. Clearing houses aren’t restricted to just collecting documents and ensuring proper documentation for the claim/claims of patients, they are also saddled with the …
HIPAA and Professional Sports Figures: Let’s Get the Record Straight: Melissa’s Mention
Matt Fisher clears up some confusion related to HIPAA and individuals on Health IT Answers. “The spotlight continues to shine brightly on HIPAA, especially as an excuse, when it comes to professional athletes responding to questions around COVID vaccine status. The most recent string of erroneous responses started strongly over the summer when NFL training camps kicked into gear. As players returned and the league indicated its intentions for health safety, questions were often posed to players to find where they all stood. Before diving into a bit from my perspective, I encourage readers to check out a similar article by Charles Curtis on ForTheWin with USA Today where I …
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 …
