Medical Billing Blogs

  Medical billing for mental health services is more complicated than in other areas of healthcare due to the types of services, time, scope, and restraints placed on mental health treatments. For instance, if a patient visits a doctor for a routine check-up, they will almost certainly go through a standard series of tests and exams. This typically includes measuring the patient's height and weight, taking their blood pressure, listening to their heart, and possibly drawing blood. These exams, for the most part, are standardized across all patients, take the same amount of time, and differ only slightly from patient to patient. Similarly, when providers bill routine check-ups to health insurers, the billing is standardized, repetitive, and frequently bundled into a single overall charge. However, the same cannot be said for mental health treatments. That’s why you must have a well-organized mental health billing process as a provider of mental health services that allows you ...

  Neurology medical billing can be demanding and time-consuming, frequently leading to roadblocks. For example, more than half of neurologists report being overwhelmed by updates to neurology medical billing procedures and making changes in response to new patient requests. Because there is widespread misunderstanding about insurance obligations, challenging a neurology medical bill is common. Furthermore, these patients are frequently from low-income families and may have a history of neurology medical bill problems. While neurology billing companies can significantly increase payment amounts and speed, neurologists should be aware of common billing pitfalls.   Here are some of the most significant neurology medical billing challenges that neurologists face today- Filing Multiple Claims & Coding Errors Depending on your neurology services, you could be required to file thousands of claims per week. Because some neurology billers lack the technology to process mult...

  Prior authorization is an essential element of medical billing and coding, particularly when claims are to be settled by an insurance company. It is the process of obtaining insurance carrier approval to treat specific services. Getting approval from the payer ahead of time increases the likelihood of a smooth claims settlement. The procedure involves obtaining an authorization number, which providers must include on the claim during submission. While it may appear simple, the process of prior authorization is fraught with complications. Providers must be aware of pre-authorization guidelines and payer coverage and provide the specific diagnosis on reports. Let’s see what all you need to know about the prior authorizations- Problems with Prior Authorization Even though insurers approve most requests, the process can be time-consuming and involves the administrative hassle of endless paperwork, repeated phone calls, and mounting claim piles. This can disrupt or delay a patie...

  The contracts between insurance payers and pharmaceutical manufacturers are here to stay in the medical world. In the last few years, these value-based contracts have been growing. Not only that, these are bringing in higher payment rates in the process of improving the outcome for the patients. They are also supplanting the traditional contracts in which rebates on the payments were based on volume and the formulary. What Is Payer Contracting & Drug Pricing? Theoretically, the 'at-risk' or value-based agreements are developed for positive development. The pharmaceutical companies in such a scenario uphold the performance of the drugs with these contracts. The process allows the medical facilities to offer the best service and results to the patients. However, the reality has been a bit different. These contracts have been based on un-advanced volumetric math, making them a value-based idea but not fully functional. It is because manufacturers are still working on ...

  Did you know? Electronic Health Records (EHR) is maintained in customized software, and medical practitioners prescribe them. Therefore, EHR software is highly recommended in every medical practice, and the best ones need to be installed for the effective running of the facility. In fact, EHR software is crucial for both outpatients and inpatients, especially in DME. But opting for any EHR software in DME is not recommended. Since there is much EHR software available in the market in DME, it needs to be approved by the insurance company of the patient. EHR software has become essential in DME practice because it helps maintain compliance and keep the information on track at every step. It thus helps in smoothening the DME medical billing services. A DME practice requires the best EHR software to ensure that every claim is paid. In addition, robust EHR software streamlines revenue cycle management, which boosts the overall revenue and ROI of the facility while improving work e...

  Any medical practice requires continuous cash flow to ensure the smooth running of the facility. Therefore, the need of the hour for any medical facility is to have an effective revenue cycle management to have an effective practice and provide the best services to the patients. A part of managing the revenue cycle is to maintain the records and keep them up-to-date, manage the physicians' compensation, ensure correct billing and coding for reimbursements and invest in the new technology for a seamless flow of revenue. Undoubtedly, effective revenue cycle management is crucial to decreasing the time period of Account Receivables (A/R) and increasing efficiency. Therefore, understanding your practice's business model and optimizing the A/R will help you to support and improve your cash flow while consolidating the working capital. A part of such process must include optimizing the AR and collecting the revenue from the aging AR. Let’s have a deep dive into the top five str...