Medical Billing Blogs

  As a skilled nursing facility (SNF) provider, it’s crucial to stay on top of changing medical billing regulations. Failing to do so can lead to denied claims, delayed payments, and potential legal action. Staying up-to-date with these changes is critical to ensuring accurate and timely billing, avoiding costly mistakes and denials, and maximizing revenue. The healthcare industry is constantly evolving, and it’s essential to stay up-to-date with the latest regulatory changes to ensure accurate billing and avoid costly mistakes. We will discuss the importance of staying up-to-date with changing medical billing regulations for SNFs and how outsourcing Skilled Nursing Facilities billing and coding to a   professional medical billing and coding service provider   like 24/7 Medical Billing Services can help. The Importance of Staying Up-to-Date Staying up-to-date with changing medical billing regulations is critical for SNFs in several ways. First, it helps to ensure complian...

 How is the revenue flow in your health system? If you’ve been handling your DME billing internally with your own team, there may be some potential for improvement. There is no reason to put up with DME medical billing services issues when there is a simple solution. Outsourcing DME Billing Services! After all, third-party DME billing companies are dedicated to everything related to the revenue cycle, but your own DME billers and coders may not be as well trained. Alternatively, the staff of your team may just lack the necessary skills and experience. Did you Know? DME billing tasks may be incredibly time-consuming and costly to administer in-house, which is why many healthcare organizations outsource this function to a third-party  DME billing and coding company . The global outsourced medical billing industry has potential to reach $19.7 billion by 2026, increasing at an 11.8% annual rate. Report by Grand View Research According to the research,...

  According to CMS (Centres for Medical and Medicaid Services), health spending in the United States will exceed 5.7 trillion dollars by 2026.  As the healthcare market is as large as it is depending on public and private insurers, healthcare providers must adhere to tight guidelines in order to remain profitable. Practitioners who want to optimize the procedure and ensure full reimbursement for their services must keep up with current medical billing trends. Even in 2021, when digital change has swept the sector, many medical facilities are grappling with the complexities of medical billing and coding.  Let’s understand how to deal with such complexities: Medical Billing Outsourcing – The Future of Healthcare Providers The strict regulation and coercion of healthcare providers in many countries to embrace digital record-keeping is expected to propel the business. During the predicted period, the sector would benefit from the rapid shift and ambiguity of the legislation a...

  The prices that your medical insurance will reimburse for the services or goods you’ve received are listed on an EOB, which is a report from the insurance company. When your health provider submits a claim for the care you received, the EOB is produced. With the help of your explanation of benefits, it helps you to keep an adequate record of all the health services you received and their associated cost and expenses. Is The Explanation Of Benefits (EOB) The Same As a Bill? No, your EOB is not the same as a bill. Your EOB simply contains the statement of the health care services you received, the cost, and how you are to share the cost with your plan. The EOB cannot be used to clear previous debt or outstanding bills. How Does An Explanation Of Benefits (EOB) Work? When you receive medical care, a healthcare worker will submit a claim to your health insurance agency. You will then get an EOB. You might get a different bill for the sum you might owe later. Your bill will specify wh...

  Undoubtedly, a mental health service provider is required to spend more time organizing better patient care. But numerous regulations and constant changes made by the governing bodies and insurers are rolling out layers of additional requirements. Having a trained and experienced mental health billing partner is always beneficial in such a scenario. There are several ways how they can be helpful such as: 1. Ensure Patient Data Safety  In medical billing, data are sensitive, and keeping them safe is essential. Patients seeking mental health treatment needs data security, and it is of utmost importance that their details remain confidential. You can ensure that the data is protected and HIPAA compliant with an experienced mental health billing partner. 2. Better Claim Processing While the psychiatrist, the nurse, counselor take care of the patient, the mental health billing partner can extract the necessary data from the patient’s treatment plan and other documents before sub...

  As a behavioral health provider, you face unique challenges when it comes to medical billing. The complexity of billing for mental health services, coupled with the constantly changing regulations and requirements, can be overwhelming. In fact, according to a study by the  American Medical Association , administrative tasks such as medical billing can take up to 30% of a healthcare provider’s time. This is where outsourcing medical billing services can be an ideal solution for behavioral health providers. Behavioral Health Billing Services Consider these data and facts: Increased Revenue : Outsourcing medical billing services can result in increased revenue for behavioral health providers. According to a survey by the Medical Group Management Association, practices that outsource their billing services have a collection rate of 95%, compared to 79% for practices that handle billing in-house. Reduced Administrative Burden: By outsourcing medical billing, behavioral health pro...

 The study of moods, hormones, and mentality that influence a person’s actions and how it impacts their day-to-day existence is known as behavioral health. Due to the nature of the care delivered to patients and the financing made available for the therapy,  behavioral and mental health billing services  is challenging. The present opioid usage pandemic, which includes both heroin and prescription painkillers, has a big influence on the United States healthcare industry. Traditionally, mental health care and overall health care services have been provided independently from those for the avoidance and treatment of substance abuse and substance use disorders. Patients are treated by psychologists and psychiatrists in a variety of ways, including counseling, medication, mindfulness, etc. Depending on the clients or patients and the ailment, these treatments can take a variety of times.  A patient with incapacitating behavioral problems needs further psycho...

Managing hospital billing services can be a challenging task for healthcare providers. It requires extensive knowledge and expertise in handling medical claims, following up with insurance providers, and ensuring timely reimbursement. In addition, the ever-changing regulations and coding standards can add to the complexity of hospital billing. Outsource hospital billing services can be an effective solution for healthcare providers to manage their billing operations efficiently. In this ultimate guide, we will explore the benefits of outsourcing hospital billing services and how to choose the right hospital billing company. Benefits of Outsourcing Hospital Billing Services Focus on Patient Care: Outsourcing hospital billing services can free up healthcare providers’ time and resources to focus on patient care. With a  reliable hospital billing provider , healthcare providers can streamline their billing operations and reduce the administrative burden. Improved Revenue Cycle: An exp...

  Hospital billing and coding is a complex and time-consuming task. Many people working at the hospital ensure everything is well organized and systematic. Everything is a challenge, from the patient billing process to the reimbursement process. In fact, coding serves many functions, ranging from retrieving to reporting information based on diagnosis and procedure. One of the most critical medical billing and coding considerations is whether the patient is an inpatient or an outpatient. To understand the distinction between outpatient and inpatient coding, it is necessary to first comprehend these two terms in depth. Inpatient Coding Vs. Outpatient Coding Meaning The term “inpatient” refers to a patient formally admitted to the hospital on the doctor’s orders. A hospital, rehab facility, nursing home, or long-term care facility may be where the patient is admitted for an extended stay. Staying in the hospital for the night does not automatically make a patient an inpatient. The ter...

  Did you know? 206 community mental health centers (CMHC) received an estimated $218.6 million in 2010 for delivering partial hospitalization program (PHP) services to roughly 25,000 Medicare beneficiaries with mental and behavioral disorders. Certain investigations have discovered flaws in Medicare payments to CMHCs for PHPs. Furthermore, a few of the practices were convicted of fraudulently charging Medicare roughly $200 million for medically unnecessary PHP procedures from 2002 to 2010.  That’s why it is always recommended to know about the billing for community behavioral health clinics in detail to avoid fraud and low reimbursements. Or, you can also avail of community behavioral health services to enhance your revenue.  Let’s have a look at a few of the crucial aspects of community behavioral health clinics billing and coding:  Overview: Certified Community Behavioral Health Clinic (CCBHC) is a community-based behavioral health care paradigm that st...

  Medical billing modifiers are commonly misused in different medical practices, including the providers of surgeries. Did you realize you could be required to repay money paid to you by insurance or third-party payers if you misused a modifier? When you misuse a service billing modifier on a claim, it can be a costly mistake. That’s why it is essential to understand the basics of using modifiers to maximize reimbursement while avoiding claim denials and possible audits. An Overview of Modifiers   in Surgical Billing Services As per AMA and the CMS, a modifier is a means of reporting or indicating that a service or process has been done and altered by some specific situation but has not changed in definition.  It may also provide additional information about services done more than once or services that have occurred unusually. When not all of the services in a bundle are done, modifiers can be used to indicate this. Types of Modifiers Level I Modifiers: Level I modifiers...