Medical Billing Blogs

  As awareness of the crucial role of nutrition in managing and preventing various medical conditions continues to rise, more individuals seek the expertise of medical nutritional therapists to address their unique dietary requirements. Thereby, the growing need for Medical Nutritional Therapy (MNT) in the USA has brought to light the increasing demand for effective billing solutions for nutritional therapy services within this specialized domain. However, the complexities involved in the billing process for MNT present significant challenges for both practitioners and patients. The intricacies arise from navigating insurance codes, reimbursement procedures, and varying coverage policies, making it a cumbersome task for medical nutritional therapists to bill for their services efficiently. This complexity not only poses financial challenges for therapists but also creates barriers for patients in accessing the nutrition support they need. This highlights the need to be aware of the...

Keeping up with the latest coding and billing updates is crucial for optometry practices to ensure accurate reimbursement and prevent denied payments. As we transition into 2024, several important changes have been implemented that practitioners need to be aware of. Let’s delve into these updates and understand how they impact optometry billing and coding: 2024 Optometry Billing Updates: New ICD-10 Codes: In 2024, the  International Classification of Diseases , Tenth Revision (ICD-10) diagnosis codes observed significant changes with the addition of 34 new eye-related codes, including those related to sickle cell retinopathy and eye movement disorders. These additions aim to provide more specificity in diagnosing eye conditions, facilitating accurate billing and treatment. CPT Changes: The Current Procedural Terminology (CPT) codes for office-based evaluation and management (E/M) services underwent significant modifications. Time ranges for E/M codes were replaced with minimum time...

  The onset of Calendar Year (CY) 2024 heralds significant updates to the Consolidated Billing for Skilled Nursing Facilities (SNFs), marking a pivotal shift in the procedural and financial management landscape of these essential healthcare providers. With changes that span across various billing codes, SNFs are faced with the challenge of incorporating these updates efficiently to maintain compliance and optimize reimbursement processes. At the heart of this transitional phase, a SNF medical billing company stands ready to assist, offering expert guidance and advanced solutions tailored to embrace these updates, thereby ensuring that SNFs can continue to focus on delivering high-quality care while maximizing their financial health and operational effectiveness. Understanding SNF Consolidated Billing CY 2024 Updates: SNF Consolidated Billing encompasses a wide range of services that SNFs must bill under  Medicare Part A . The CY 2024 updates introduce modifications to billing ...

  Outsourcing medical billing and coding is becoming more popular. A report from Market Research Future says the global medical billing market, valued at $14.2 billion in 2022, is expected to reach $31.19 billion by 2030, growing at a rate of 11.9%. The report highlights that the increasing focus on complying with the rules, managing risks, improving billing efficiency, and cutting in-house operational costs drive the demand for   outsourced medical billing services . Handling the various steps of medical billing, like scheduling patients, checking insurance, coding, submitting claims, and following up on payments, requires expertise. Doing all this in-house means practices need to hire staff, increasing costs. That’s why it is preferable to outsource medical billing that involves a service provider handling these tasks, usually getting paid a percentage of the practice’s collections. Not only this but there are many more reasons for outsourcing medical billing tasks in 2024, ...

  Rural Health Clinics (RHCs) are at the heart of healthcare delivery in the United States rural and underserved communities. They provide essential medical services where they are often most needed but least available. Given their critical role, RHCs face unique operational challenges, with billing and financial management at the forefront. Efficient and effective RHC billing practices are crucial for RHCs to maintain financial health, support sustainability, and continue offering indispensable healthcare services. Tailored Billing Strategies for RHCs Focus on Billing and Coding Excellence Continuous Training:  Equip your billing staff with the latest knowledge in  RHC billing and coding  practices through ongoing training programs. This ensures claims are accurately coded and fully compliant with current regulations, reducing denials and delays in reimbursements. Precision in Coding:  Adopt rigorous coding procedures to accurately capture the full scope of ser...

  The healthcare industry is ever-changing, and staying abreast of regulatory changes is paramount for healthcare professionals and hospitals. In 2024, the Centers for Medicare & Medicaid Services (CMS) introduced significant updates to the Hierarchical Condition Categories (HCCs) Risk Adjustment Model. Understanding these changes is crucial for accurate risk assessment,   HCC coding , and reimbursement in the healthcare industry. In this comprehensive guide, we delve into the intricacies of the 2024 CMS-HCC Risk Adjustment Model, exploring the modifications made to various disease categories and their implications. Whether you’re a coder or healthcare provider, this guide aims to equip you with the knowledge needed to navigate the changing scenario of risk adjustment in healthcare. Let’s have a look at the updates: Updates in the 2024 CMS-HCC Risk Adjustment Model Vascular Diseases In the 2024 CMS-HCC risk adjustment model, significant changes have been made to the Vascul...

  The Patient-Driven Groupings Model (PDGM) is a new home health payment system implemented on January 1, 2020, by the Centers for Medicare and Medicaid Services (CMS). It has brought about changes in reimbursement methodology that impact clinicians, therapy services, and the overall workflow of home health agencies. In fact, it is a significant change from the previous payment model and is designed to align reimbursement with patient needs better. Let’s adapt to PDGM in home healthcare as an effort towards patient-centric care: Billing Changes under PDGM The Patient-Driven Groupings Model (PDGM) has significantly changed the  home health billing  process. Here are the key billing changes under PDGM 30-Day Payment Periods PDGM replaces the previous 60-day payment periods with 30-day payment periods. As a result, home healthcare agencies bill for each 30 days, making the billing cycle more frequent. Requests for Anticipated Payment (RAP) Home healthcare agencies continue t...

  Hospice providers often face challenges related to reimbursement rates, regulatory changes, and compliance issues. In 2024, it is crucial to stay informed about any updates from CMS that may impact hospice payments. Industry concerns may include changes in reimbursement methods, adjustments in payment rates, and compliance with changing regulations. Staying proactive and engaging with industry standards can help hospice providers navigate these challenges and ensure financial stability while delivering high-quality patient care. Let’s have a deep dive into the updates, concerns, and the way to address them: CMS Hospice Payment Updates in 2024 In 2024, the U.S.  Centers for Medicare & Medicaid Services (CMS)  is providing a 3.1% increase in per diem payments for hospices. This marks a modest climb from the initially proposed 2.8% payment boost for 2024, announced in March. The finalized rule, published recently, includes several key details: Payment Increase Hospices...