Medical Billing Blogs

  2021 proves to be a havoc year for everyone, including the emergency medicine providers. They are being captured in a trap of profitability and revenue crisis right from the advent of 2021. As per the US survey, most emergency medicine   physician   groups usually have an average profit margin of less than 10%. In fact, the current pandemic situation adds more struggle to them by declining their volume. Apart from this, they are also awaiting the new federal legislation framed for patient’s protection from surprise medical bills, also known as “balance bills.” The surprising fact is that the impact of such legislation on emergency medicine reimbursement is still unpredictable. However, The  Centers for Medicare & Medicaid Services (CMS)  has issued the Physician Fee Schedule (PFS) proposed rule, 2021, to impact emergency medicine reimbursement significantly. The following are some highlights from the PFS rule, 2021: 2021 RVUs Increase for ED E/M Services T...

Had difficulty discovered a therapist who takes insurance? You’re not alone. Insurance companies reimburse mental health professionals less than primary or specialty care providers for relative services when in-network care is found. Some intelligent ways to get your Behavioral health claims paid faster? Insurers, care providers, employers, and government policymakers spend significant resources addressing the behavioral health crisis. However, these professionals all face considerable challenges in accomplishing the enormous scope of the behavioral health crisis. Gaps in clinical and experimental information Investigation into understanding behavioral health disorders is still in an emerging phase. Behavioral disorder analyses deal with multiple causalities, and diagnoses have less discrete categorizations, unclear thresholds within the disease, and non-disorder markers. Common comorbidities where users present with various conditions. Less well-defined diagnostic categorization can a...

Emergency room (ER) services are a blessing for medical emergencies that require urgent action, such as an injury or unexpected illness.   Medical billing service providers   understand that coding and billing for emergency care can be a significant challenge without comprehensive charting. However, at most EDs over the nation, there is a chance to improve care, decrease risks, and increase revenue by concentrating on documentation methods. ER documentation describes what was done for the patient to future providers. It covers diagnostic tests, medical decision-making and procedures, discussions with patients and families relevant to care, expert advice, patient follow-up, and many other aspects of the encounter. The  ED report  also serves as proof in the event of a lawsuit. Additionally, ED outlines are evaluated for quality improvement, purposes of research, and utilization/risk management. Therefore, the ED chart should be intact, accurate, concise, and...

To improve responses, communication, and the overall experience, physical therapy clients often choose to outsource their billing operations and revenue cycle management preferably than keep it in-house.  Besides the billing expertise that immediately bolts onto your practice, there are many prominent reasons why private practices hire professionals to take this burden off their shoulders. Even before any in-house billing disappointments begin, analyze these important reasons to  outsource physical therapy billing . 5 Top Notch Reasons to Outsource Physical Therapy Billing Operations: Creation Doesn’t Stop  – Billing doesn’t stop while your biller is out sick or on leave. Unfortunately, for physical therapy systems that rely on a full-time assistant – this is often the case. An outsourced Biller will eternally be “on” and operating for you. Plus, there is built-in clarity – for example, a specialist medical billing firm will automatically supply you with comprehensive rev...

Pathology executes a crucial role in virtually every specialist area of medicine. Pathologists are specialists in human disorders and infections, and their knowledge and studies guide health and medical workers on the best strategies for treating specific ailments. They also work on building technologies and processes to battle illnesses. Much of a pathologist’s time is spent investigating to improve and develop medicine. From emerging treatments against life-threatening infections like cancer to creating alternative remedies for common illnesses, a pathologists’ time is valuable. Unhappily, like with most other healthcare professions, pathologists often strive to receive full reimbursement for the assistance they provide. Medical billing is a complicated process, but it is necessary to gain successful returns from clients. By  outsourcing medical billing  to expert  pathology medical billing services , you can rest comfortably knowing you will receive full payment immedi...

It’s not rocket science to prove that dermatology is one of the most complex medical specialties as it is a multi-faceted specialization. For example, dermatological procedures can range from simplistic cosmetic surgeries to more complicated skin grafting that must be reflected in the medical billing. Therefore, this is what makes medical billing a complicated process for dermatological practice. Moreover, dermatologists usually handle more patients than physicians in other specialties. Hence, to address the large volume of the patient, the medical billing and coding should be as accurate as possible so that you receive proper reimbursement. This article will get more insight into  dermatological billing and coding  challenges and how you can streamline your dermatological billing processes to make them more efficient and quicker. Different coding systems Coding systems are essential for both the physicians and the insurance payers as they indicate the procedure performed bas...

Are you facing difficulties in staying current with the shifting DME billing landscape? And, is that taking a toll on your medical practice? Well, staying up to date with compliances can be a daunting task but is essential at the same time. It requires a professional to carry out complex processes to file claims on time regularly while keeping errors at bay. Improper DME Medical Billing can hugely affect your revenue system which is a crucial part of your business. Moreover, the dynamic regulatory compliances from HIPAA no doubt make the billing system more efficient but also pose myriad challenges in DME billing. Keeping up with the changing norms is a good way of avoiding billing errors and ensuring maximum reimbursements. Durable Medical Equipment (DME) is an important part of the patient’s treatment, but these DME devices can only be issued upon a physician’s recommendation. This leads to a slew of paperwork and formalities which can quickly turn into a disaster if not dealt with ...

  What is Medical Billing? When it comes to settling payments from insurance companies, medical practitioners, hospitals, and healthcare facilities face a lot of hassles. For the patients, the bill is settled once they provide the details of their insurance at the front desk of the healthcare facility. However, the hospital or healthcare center receives the reimbursements only when the claim is settled by the insurance companies. Medical billing  refers to the process of filing and following up on claims with health insurance companies / providers in order to receive payments for the healthcare services rendered to patients by the practices / physicians. Medical billing serves as an effective channel between medical service providers and insurance companies. Need of Medical Billing Services With time, as the medical practice scales to new heights and grows, medical practitioners, doctors, and healthcare providers would need to delegate the medical billing task by hiring an in-...