Medical Billing Blog with Medical Billing & Coding Info & Articles

Welcome to the Medical Billing and Coding Blog

Welcome to the medical billing blog containing news and articles relating to medical billing, medical coding, ICD, HIPAA and practice management functions.

2004-2024 Celebrating 20 Years of Healthcare RCM Articles

The Blog Currently Contains 1,265+ Healthcare Articles

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

Published By: Melissa Clark, CCS-P on January 19, 2024

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

Published By: Kary Chasteen, CPC on January 17, 2024

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 on January 15, 2024

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 on January 8, 2024

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

Published By: Melissa Clark, CCS-P on January 4, 2024