Medical Billing Blogs

According to CMS (Centres for Medical and Medicaid Services), health involving in the United States will exceed 5.7 trillion dollars by 2026. Undoubtedly, the healthcare industry is as large as it is depending on public and private insurers; providers must adhere to strict guidelines in order to remain profitable. Keeping up with current psychiatry medical billing trends is crucial for psychiatrists who want to optimize the process and be fully reimbursed for their mental health services. Even in 2023, when digital change has swept the sector, many mental health providers are grappling with the complexities of psychiatry billing and coding . In this blog, we’ll look at the most recent psychiatry medical billing trends as well as insights that help mental health providers deal with day-to-day issues. Challenges faced by Mental Health Providers On the surface, the underlying challenges for mental health providers in 2023 are more competition and fewer patients. New psychiatry billing pa...

  Many patients have vision plans as well as medical insurance plans. It can be challenging to select which one to bill, especially when patients want to be involved and are concerned about how much they will have to pay. Patients may even request that you charge their vision plan rather than their medical insurance. By following some strategies, you can make coordination between medical and vision plan billing more efficient and effective. While it is standard billing practice to choose which plan (vision or medical) to bill depending on the patient’s major complaint and diagnosis, this is only sometimes possible. Before the appointment visit, it is necessary to confirm both vision policies and medical insurance. Let’s take a look at how to make coordination between medical and  vision plan billing  easy: Medical vs. Vision Insurance Plans With the pending current healthcare reforms, the discrepancy between vision insurance plans and medical insurance plans has placed op...

  Though outsourcing is not a new notion,   outsourcing medical billing and coding services   can be a difficult option. This is due to the fact that medical billing and coding work hand in hand, and unless your service provider is an expert at detecting the relevant codes, the bills may come out incorrectly, resulting in large-scale losses. On the other side, when done right, providers consider outsourcing medical billing may be a painless procedure that allows you to focus on your main healthcare goals. Some of the primary reasons for outsourcing medical billing and coding are as follows: Revenue  Growth: By outsourcing medical billing and coding, healthcare organizations can save time and money on salaries, office equipment, and purchasing, upgrading, and maintaining billing software. Reduced administrative costs, quicker claim submission, and improved reimbursements will end up resulting in increased revenues for the hospitals. More Time for Patients: When medica...

  Undoubtedly, every medical practice requires medical billing and coding. Of course, there will be a cost associated with the medical billing process. You can either hire full-time staff to handle billing in-house. On the other hand, you can outsource a medical billing company to manage your whole revenue cycle management (RCM) for a fee. Practice’s must decide which option makes the most sense, both practically and financially. Though you need enough personnel to complete the billing and coding task on time, you must also keep within your budget—without overbooking your staff members. Let’s discuss FTE Model v/s The Traditional Medical Billing Model which one proves to be more appropriate for your healthcare practice: Are you thinking about outsourcing your medical billing and coding? Which pricing plan is best for your practice? You have two possibilities for charging pricing from your  outsource medical billing and coding company , i.e., either stick to your traditional mo...

  Mastering the art of Substance Use Dis-Order (SUD) billing is crucial for healthcare providers offering substance use disorder treatment. To help you streamline your billing operations and ensure accurate reimbursement, we have created this ultimate guide. Here, we will take you through a step-by-step approach, providing in-depth insights and practical tips. Additionally, we will guide you in finding a trusted Substance Use Dis-Order (SUD) billing service provider that aligns with your specific requirements. Step 1: Eligibility Verification and Insurance Coverage Analysis The foundation of successful Substance Use Dis-Order (SUD) billing lies in verifying patient eligibility and thoroughly understanding their insurance coverage. We’ll explore effective methods to verify insurance details, review policy limitations, and identify pre-authorization requirements. By partnering with a specialized Substance Use Dis-Order (SUD) billing service provider, you can expedite the eligibility ...

  Behavioral health practices face unique challenges when it comes to billing. Complex insurance policies, mental health parity laws, and coding for a wide range of services make accurate claims processing essential. Billing errors can negatively impact revenue, patient satisfaction, and even lead to legal issues. This is where accurate claims processing comes into play. At 24/7 Medical Billing Services, we specialize in   behavioral health billing   and understand the importance of accurate claims processing. Here are some key points to consider for boosting your behavioral health revenue with accurate claims processing. The Importance of Accurate Claims Processing Accurate claims processing is crucial for any medical practice, but it is especially important for behavioral health practices. Billing errors can lead to denials, delays in reimbursements, and even legal issues. In addition, patients may lose trust in the practice if they receive unexpected bills or if their ...

Community Behavioral Health Centers (CBHCs) play a vital role in providing mental health and substance use disorder services to low-income and underserved communities. However, recent reports suggest that some CBHCs engage in questionable billing practices, putting them and their patients at risk of legal troubles and financial harm. As a leading medical billing service provider, 24/7 Medical Billing Services has seen first-hand how these practices can negatively impact CBHCs’ bottom line and reputation. Some of the most common questionable billing practices by community behavioral health centers: Upcoding: Upcoding is the practice of billing for a more expensive service than the one provided. CBHCs may upcode by listing more intensive services than were actually performed, in order to receive a higher payment rate. For example,  CBHCs billing  for an hour-long therapy session when only 30 minutes were provided. This practice is fraudulent and illegal. Not only can it lead to ...

DME claims are no longer paid with little to no further evidence required. In recent years, Medicare and other private insurance companies have increasingly demanded thorough paperwork for each submitted claim. Obtaining and filing extra documentation is critical for DME providers as many of these documents will be required to be shown during an audit. In fact, it is advantageous to have systems in place that make use of DME Billing documentation checklist. These procedures ensure that you collect the necessary documentation for each order. Simultaneously, an effective filing system can help ensure that your claims are paid on time and are audit ready. Therefore, medical billing is a complicated process that most DME providers must manage in addition to providing medical equipment. If the provider is to be compensated, the following specific specified standards must be completed: Accurate patient registration Patient registration does not have to be a face-to-face engagement for DME p...

  Every substance abuse treatment facility’s purpose is to assist patients in recovering from substance use disorders. These practices, unfortunately, must also deal with the difficulties of Medical Billing for Your Substance Use Disorder (SUD).   Substance abuse billing   presents particular issues, causing physicians to spend valuable time chasing payments rather than providing good quality care. Getting paid swiftly is essential for every business, especially in the medical field. Unfortunately, the wait between receiving services and receiving payment can often be months. You need to be aware of some medical billing suggestions for your SUD practice to help you speed up the process and boost your cash flow. These medical billing tips will help you expedite your interactions with insurance and patients, allowing you to get reimbursement for your services more promptly. Tips to Ensure Accurate SUD Medical Billing Your medical practice’s success relies heavily on an effi...