Medical Billing Blog: All Articles Mentioned by Melissa Clark

Archive of All Articles Mentioned by Melissa Clark

This is the archive containing links to all articles mentioned by our CEO Melissa Clark in the blog.

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

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

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

Published By: Melissa's Mentions | No Comments

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

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Tips for Recouping Lost Revenue From COVID-19 Pandemic

Craig Adkins of AdvancedMD gives HealthIT Answers some tips of how to recoup some of the revenue lost during the pandemic in this article mention. “The past few months of the pandemic have brought many challenges to physician practices, especially small, independent providers operating outside the domains of COVID-19 treatment. While mandatory shutdowns and quarantines have slowed the spread of the virus, the economic impact has been substantial. Fewer outpatient visits—and even fewer procedures—over the past several months have led to serious financial hardship for many providers. Practices that will stay afloat during this challenging time are doing so strategically. In some cases, practices planned for a “rainy day” and

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EHR Training and Experience Lead to Decreased EHR Use by Residents

Are you satisfied with your EHR? Do you spend 40% of your day in your EHR? Research shows that some physicians do..   “Physicians at large community hospitals spend nearly four hours during work hours, or roughly 40 percent of their day, on the EHR, according to a study published in the Public Library of Science (PLOS ONE). Additionally, researchers found a significant decrease in resident EHR use with increased training and experience, although the overall amount of time spent on the EHR remained high. “Studies exploring EHR use emphasized extensive time as one of the significant drawbacks to EHR,” wrote the study authors. “It has been reported that physicians

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Navigating Pre-authorization and Prior Authorization in Medical Billing

Navigating the intricacies of pre-authorization and prior authorization in medical billing can be a daunting task for both healthcare providers and patients. This comprehensive guide aims to demystify these processes, shedding light on their importance, differences, and the steps involved, as well as providing tips for seamless navigation. Understanding Pre-authorization and Prior Authorization Pre-authorization and prior authorization are terms often used interchangeably in the context of healthcare billing, yet they bear subtle distinctions. Both processes involve obtaining approval from a health insurance company before a patient receives specific services, treatments, or medications. This approval is crucial to ensure the proposed healthcare service is covered under the patient’s insurance plan and

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

Week 2 of the Change Healthcare Cyber Attack

The cyber attack on Change Healthcare, reported to have begun on February 21, 2024, has been attributed to the Blackcat ransomware gang, also known as ALPHV. This incident has caused significant disruptions across the healthcare sector, affecting pharmacies and healthcare providers throughout the United States. The cybercriminal group is known for its “double extortion” tactic, where they encrypt the victim’s files and also steal sensitive data, demanding a ransom for both the decryption key and the non-release of the stolen data. In this case, there’s a possibility of a data breach, although it hasn’t been officially confirmed by Change Healthcare at this stage​​. Mandiant, Alphabet’s cybersecurity unit, is spearheading the

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

The Role of Training in Revenue Cycle Performance Improvement

The role of training and education in revenue cycle performance improvement is both critical and transformative, affecting healthcare organizations across the globe. In a landscape where financial viability directly influences the ability to provide quality care, the optimization of the revenue cycle becomes a paramount objective. This comprehensive exploration will dissect the importance of training and education in enhancing revenue cycle operations, including the impact on compliance, employee efficiency, patient satisfaction, and overall financial health. Understanding Revenue Cycle Management Revenue Cycle Management (RCM) encompasses all the financial processes involved in managing the administrative and clinical functions associated with claims processing, payment, and revenue generation. This includes patient registration, insurance and

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Empowering Patients: The Role of Advocacy in Healthcare Billing

Medical billing can be a labyrinthine process, often leaving patients feeling overwhelmed and confused. From deciphering complex codes to negotiating with insurance companies, the journey through medical billing can be as challenging as the medical treatment itself. However, in this maze of paperwork and jargon, patient advocacy emerges as a guiding light, helping individuals understand and navigate their medical bills with confidence and clarity. Understanding the Complexity Medical billing is notorious for its complexity. It involves a myriad of stakeholders, including healthcare providers, insurance companies, and government agencies. Each entity has its own set of rules, codes, and procedures, making the billing process intricate and opaque for patients. One of

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Tips for Negotiating Payer Contracts to Maximize Reimbursement

Negotiating payer contracts is a crucial aspect of managing a healthcare practice or facility, as it directly impacts the reimbursement rates for services provided. Remember that successful negotiation involves understanding the needs of both parties and finding a mutually beneficial agreement. Regularly review and reassess your contracts to ensure they remain competitive and align with the evolving needs of your practice. Here are some tips to help you negotiate payer contracts effectively and maximize reimbursement: Research and Analysis: Understand the current market rates and reimbursement standards for your specialty and region. Analyze your practice’s financial performance and identify areas where improvements in reimbursement rates are needed. Data Collection: Gather comprehensive

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