Medical Billing Blogs

  Payment posting is essential to any solo practitioner’s or healthcare organization’s revenue cycle management. It entails posting and deposit functions and reconciling posting activities and deposits. The payment posting process impacts many other aspects of the healthcare organization, including efficiency, patient satisfaction, and overall financial performance. Payment posting also offers insight into a practice’s daily revenue stream and enables practices to identify and correct potential issues quickly. It is essential for your practice to be apt to see daily insurance payments from EOBs, patient payments, insurance checks from   ERAs , and other information. In addition, having an efficient ERA/EOB payment posting system provides a clear picture of your day-to-day financial situation. Let’s have a deep understanding of payment posting services: Types of Payment Posting Payment posting in medical billing  is done in two ways, depending on the level of insurance cov...

The No Surprises Act, which is included in the Consolidated Appropriations Act of 2021, is intended to protect clients from unexpected medical bills . The No Surprises Act’s Good Faith Estimates Billing provision is intended to provide clients with an estimate of how much they will be billed for the medical care they will receive prior to their appointment. How long will it take to provide the Good Faith Estimate? The Good Faith Estimate must be provided within the following time frame: If you scheduled service at least 03 days in advance, the Good Faith Estimate needs to be offered no later than 01 business day after the scheduling date, If you scheduled service at least ten days in advance, the Good Faith Estimate needs to be offered no later than 03 business days after the scheduling date, In other cases, the Good Faith Estimate must be offered 03 business days after the requested date. But what about the updated Good Faith Estimate? Is there any update required? If the scope of the...

  Wound care is a specialty with stringent rules and regulations. It is necessary to follow Medicare billing guidelines for skin substitutes. The specialty electronic medical record (EMR) information is critical for demonstrating that the practice follows clinical, financial, and operational guidelines. When a patient calls to schedule a service, the documentation process begins. Are you fed up with the complicated Billing and Coding for Skin Substitute Grafts? Do you require a list of important Medicare billing guidelines for skin substitutes? If you answered yes, keep reading. The Medicare billing guidelines for skin substitutes provided below cover various aspects of medical billing during the grafting. Let's go over the key points of Medicare's skin substitute guidelines: Deleted Skin Graft Codes (Product-based Codes) The American Medical Association (AMA) deleted and replaced the "product-based" allograft and xenograft codes with a series of new codes inv...

  Pre-authorization or prior-authorization is a legal requirement to make certain that the insurance payer pays for the treatments and medications specified on the medical claim form. The insurance payer is free to refuse payment of a patient’s medical service as part of the health care insurance plan without authorization. Prior authorization for prescription drugs is intended to ensure that patients have access to safe, effective, and affordable prescription drugs. Companies that provide medical billing services collaborate closely with physicians to ensure a more efficient process for approving prior authorization requests. If a patient is prescribed a medication that necessitates prior approval for medical necessity and such approval is not obtained, the patient may be forced to pay the full cost. What kinds of drugs need prior authorization? The following drugs may necessitate a prior authorization request: Having dangerous side effects Harmful when combin...