Medical Billing Blogs

  Most skilled nursing facilities (SNF) face a double quandary because first, they have to operate under increasing financial pressure, and second, there is rising anxiety over staffing and infrastructure. Added to the Balanced Budget Act of 1998 changes the way SNF reimbursements are done. This article will give a comprehensive guide on SNF billing and problems and how to overcome them. Challenges of Billing with Skilled Nursing Facilities For successful reimbursements in SNF claims, one needs to know the consolidated billing requirements. But that’s not all. The billing staff needs to have comprehensive knowledge about the codes and the procedures and facilities covered by Medicare A. Anything that is not covered will lead to claim denial. But the complexity continues as there are some benefits which are not covered by Medicare A are covered by Medicare B. The SNF, in such a case, has to identify the difference and bill it separately to get paid. The payment on a per diem...

  Given the current hectic lifestyle that most individuals lead with little physical activity, Chiropractic centres are receiving a lot of patients each day. As a result, staff and practitioners are overworked, and when they have to take care of the billing process with that workload, it can be a step toward revenue loss. However, that should not be the case. Instead, chiropractic facilities, with an increase in patient numbers, must be making money. But the reality in most practices is different. Because of the ever-changing government rules and health insurance policy updates, staying on top of the changes can be pretty problematic. As per the latest rules, incorrect coding and billing results in revenue loss and, at times, draws attention from the authorities for overbilling, which can be termed abuse or fraud. In all aspects, you want to stay away from such an allegation. But, at the same time, ensure you are getting paid for the services offered to the patients. There are...

  In the last few years, Ambulatory Surgical Centres (ASC) has become one of the fastest-growing medical services. However, the ASC billing and coding is different from the physician, surgeon, or hospital billing. Hence, the billing department of an ASC facility has to be aware of the various guidelines that Medicare often uses compared to the other payers. Furthermore, different payers differ regarding the approved procedures, medical necessity, and other requirements for filling out the forms for reimbursement. The lack of awareness of all these and the regular updates published by CMS every quarter on the lists of surgical procedures covered, the ancillary services covered for establishing payment indicators, and payment rates can be challenging for ASC billing. Added to this, the newly created Category III CPT codes and Level II HCPCS make the billing and coding process difficult, resulting in some common billing errors. For any ASC practice, it is essential to know these ...

  Navigating the insurance claim can be challenging for mental health practitioners, mainly if you are into individual or small facility practice. While most large medical facilities have an entire dedicated department trained in researching, submitting, and following up on the billing and the claims, you might be 'winging it. It is because mental health billing is more complex and complicated than other medical billing. In fact, there is a lack of uniformity in the billing process. In most medical practices, standardized tests and services are performed. However, in mental health, the practitioner has to undertake various procedures to treat a patient. Adding to this, the different approaches in mental therapy make the billing and coding process quite convoluted. Knowing how the different services and procedures is a must to warrant an error-free billing and submission. Failure to understand or follow the correct billing and coding procedure would mean losing out on revenue...

  Artificial Intelligence, commonly termed AI, has made its presence felt across all industries. All the major sectors are leveraging the power of AI to make workflow easy and offer better services to the end-users. The Healthcare industry is no different when it comes to benefiting from AI. However, AI is still not being used in every aspect of the healthcare sector, including mental health facilities. As a result, majority of the industry has started depending on AI to make the work hassle-free. The innovation that AI has can offer great profit and successful practice. Artificial Intelligence can resolve several issues connected to revenue management. As a result, the AI-backed automated technology can be used in multiple areas, whether disease diagnosis, virtual tele-health services, analytics, and EMR integration, to create endless possibilities to improve medical billing and coding.    Using AI in mental health billing works efficiently for mental health professi...