Medical Billing Blogs

  Before providing any medical services, healthcare providers must first verify a patient’s eligibility and benefits. This procedure ensures that the provider is paid for the services given and that the patient receives the right level of care with no financial surprises. With the ever-changing world of insurance plans, keeping up with the newest rules and regulations can be difficult, making   eligibility and benefits verification    a critical element in the revenue cycle management process. Let’s unravel the mystery of verification of benefits (VOB): Why is there a need for Unraveling the Mystery? It is critical for medical practices to do comprehensive eligibility and benefits verification to ensure that patients receive the right quality of care and that they receive correct compensation for services rendered. Here are some of the reasons why eligibility and benefit verification is critical in medical practices: Avoid Claim Rejections: It is one of the most seve...

Today’s healthcare system is continuously evolving, not only in terms of patient requirements and new treatment advancements but also in the often-unnoticed realm of   medical insurance coding and billing . While much of healthcare occurs between the doctor and the patient, much remains to be done after the patient leaves the doctor’s office or hospital. The continual changes in norms and laws might be complex for those who manage this behind the scenes. However, the medical billing and revenue cycle management process is critical for healthcare providers because it allows them to get reimbursement for the treatment they offer to patients and, hence, keep their doors open. But how can we simplify the complex medical reimbursements? Here are a few of the tips to be followed for  healthcare billing and coding : Establish a process Establishing a step-by-step procedure is critical for any  claim-collecting process . A printed form with a checklist comprising all procedures, ...

  In the realm of healthcare administration, the synergy between technology and medical billing has emerged as a catalyst for transformative change. At 24/7 Medical Billing Services, we recognize the pivotal role technology plays in enhancing efficiency. Join us on an exploration of the dynamic partnership between technology and medical billing, and how this alliance can reshape healthcare practices. The Convergence of Technology and Medical Billing: In a world driven by data and connectivity, the fusion of technology and medical billing services brings forth a new era of precision and speed. From automated coding to electronic claims submission, technology is revolutionizing every aspect of the billing process. Advantages of Tech-Integrated Medical Billing: Swift Data Management: Electronic Health Records (EHRs)  streamline patient data access, minimizing errors and boosting collaboration between healthcare providers and billing professionals. Automated Coding Excellence: AI-...

  Mental and behavioral health billing is a challenging endeavor to nail down.  The reason for this complication is that charges for different services vary, as do the credentials of the professional delivering the therapy.  Before we know it, the practice or RCM staff may face a never-ending pile of   behavioral health billing   specialists   to manage with limited resources and time. Let’s streamline Streamlining the behavioral health billing best practices for success. Another area that presents a concern is the issue of correctly processing pre-authorization. Due to the differences in the types of treatments and procedures associated with mental and behavioral health facilities, pre-authorization for these facilities is separate from that for other specializations. This makes it difficult for RCM workers to unbundle and improve the claims submission process. Billing consistency in mental and behavioral health facilities differs from that of other medica...

  Delaware- 24/7 Medical Billing Services, a recognized leader in healthcare revenue cycle management, proudly unveils a groundbreaking paradigm in the optimization of Durable Medical Equipment (DME) billing. Infused with a profound understanding of the intricate healthcare reimbursement landscape, the company introduces a meticulously detailed and data-driven approach that promises to reshape the trajectory of reimbursements for healthcare providers. In the intricate landscape of modern healthcare, optimizing DME billing is paramount to sustaining the financial health of medical practices. 24/7 Medical Billing Services, driven by their unwavering commitment to empowering healthcare providers, presents a comprehensive spectrum of data-driven strategies that have been forged from extensive industry insights and robust analyses. These strategies are aimed at streamlining billing workflows, mitigating administrative complexities, and accelerating the often-protracted reimbursement lif...

  Introduction: This case study presents the success story of streamlining  Durable Medical Equipment (DME) billing processes  for a leading Home Medical Equipment Supplier. The name of the supplier will remain undisclosed to ensure confidentiality. This study highlights the real challenges faced by the supplier and the effective solutions provided by 24/7 Medical Billing Services to optimize their billing operations. Client Background: The Home Medical Equipment Supplier is a prominent provider of essential medical equipment, catering to patients with diverse mobility and healthcare needs. Their comprehensive range of DME includes wheelchairs, hospital beds, oxygen equipment, and more. Despite their commitment to delivering quality service, the supplier encountered complex billing processes that impeded revenue growth and operational efficiency. Real-Time Challenges: Inaccurate Documentation and Claims: The supplier faced a significant challenge with documentation and cl...

  Did you know the medical billing outsourcing market is massive and rapidly expanding? According to Grand View Research, it is predicted to reach 25.3 billion USD by 2028, with a CAGR of 12.3%. Discover the top trends that are shaping the future of medical billing services and healthcare industry. Front-end services dominated the worldwide  medical billing outsourcing  industry last year. However, the middle-end services industry is predicted to develop at the fastest compound annual rate of 12.4 percent this year through 2026. Hospitals dominated the global billing outsourcing market last year (highest market share), which is anticipated to continue through 2026. To achieve all these goals, errors in insurance validation, patient registration, and claim submission must be eliminated, as well as payment denials must be managed. It also necessitates the follow-up of the trends shaping the future of medical billing services, regardless of size. Let us look at some of ...

Using non-physician practitioners (nurse practitioners, physician assistants, clinical nurse specialists, and so on) to boost productivity in a medical practice is an effective strategy to do so. However, covered services delivered by non-physician practitioners (NPPs )   are reimbursed at a lower rate (85% of the fee schedule amount) under Medicare rules. The “incident-to” billing for services rules provide an exception, enabling 100 percent reimbursement for non-physician treatments that meet the guidelines outlined in Chapter 15, Section 60 of the   Medicare Benefit Policy Manual . The term “incident to” a physician’s professional services denotes that the services or supplies are provided as an integral, although incidental, element of the physician’s professional assistance during the diagnosis or treatment of an accident or sickness. However, the ability to use “incident to” charging is subject to several constraints and limits. Let’s have a look at such complexities: Co...

  Introduction: This case study delves into the real challenges faced by a reputable Behavioral Health Clinic in Ohio and the effective solutions provided by 24/7 Medical Billing Services to optimize their  mental health billing process . The name of the client remains undisclosed to ensure confidentiality. Client Background: The Behavioral Health Clinic is a vital support system for mental health care in Ohio, known for its compassionate team of professionals offering counseling, therapy, and psychiatric services. Despite their dedication, they encountered significant hurdles in efficiently managing their billing procedures. Real-Time Challenges : Billing Errors and Revenue Loss: The clinic experienced billing errors that led to a noticeable revenue loss month on month. These errors included incorrect coding, missing information, and data entry mistakes, which contributed to delayed payments and revenue loss. Insurance Verification Errors: Insurance verification was prone to ...