In the newest update on the road to preventing surprise medical billing, the current Administration has issued what is known as “Requirements Related to Surprised Billing; Part 1”. As we mentioned in an earlier post, surprise medical billing happens when patients unknowingly receive out-of-network services which result in unexpected bills. The [...]
Once you submit a claim, what happens next? In the Revenue Management Cycle, after submitting a claim, it goes to the insurance payor, or a clearinghouse in some cases, and get processed. Once insurance receives the claim, they may take 30-45 days to process it. The time it takes for insurance [...]
Last week we provided an overview of what ICD-10 codes are. This week we will talk about CPT codes. CPT, or Current Procedural Terminology codes, are used to identify procedures performed by physicians and healthcare providers. Developed in 1966 by the American Medical Association (AMA), these codes are used by healthcare [...]
ICD. Three letters that you may have encountered in medical coding and billing. What exactly does it mean and what do you need to know about it for your practice? This blog post is dedicated to answering these questions. ICD stands for International Classification of Diseases. According to the World Health [...]
Is your healthcare practice having issues with billing and collections? Are you unclear about why claims are getting denied or why you’re not collecting as much or as quickly as you were expecting? Just like a human body system needs all parts functioning to run smoothly, the revenue cycle needs all [...]
What is Credentialing? Credentialing is ultimately the process of collecting and verifying medical professionals’ qualifications. It is a compilation of evidence of a physician’s license, education, experience, etc. This process is a way for others to assess that the medical provider is indeed competent. One party that needs to verify a [...]
The No Surprises Act is passed and set to take effect January 1, 2022. As a result, based on different states’ regulations, there may be changes to the way medical billing is done. For one thing, your healthcare practice must start being more careful about providing information related to the network [...]
Opening and operating a medical practice, whether it is a clinic or hospital, is not an easy task. This past year has further cemented the importance of healthcare practices and the need that patients have. Maybe your practice has been open for many years, or perhaps it has just opened. Whichever [...]
Not all claims are paid in full or some are denied completely, and there could be many reasons for this. Ensure that you understand the reason behind each payment and work to resolve any issues. First, if there is a denial, it will show up on the Explanation of Benefits (EOB). [...]
