Medical Billing Blogs

  The SNF billing industry is experiencing a rapid transformation as we approach 2025. Technological advancements, evolving patient expectations, and innovative healthcare delivery models are reshaping traditional billing practices. This shift impacts how SNF providers, payers, and patients interact, leading to streamlined processes, enhanced care delivery, and improved financial outcomes. Starting from artificial intelligence (AI) to blockchain technology, and from the adoption of value-based care models to the growing importance of telehealth, the tools and methodologies in  SNF billing  are becoming increasingly sophisticated. These innovations bring opportunities for efficiency, accuracy, and compliance but also introduce complexities that require expertise to navigate effectively. Let’s have a look at the emerging technology-driven trends in SNF billing: Emerging Technology-Driven Trends in SNF Billing for 2025 AI and Machine Learning in Medical Billing: AI and machi...

Chiropractors are skilled healthcare professionals dedicated to treating musculoskeletal issues, but their expertise is often stretched thin due to the complexities of managing billing and administrative tasks.   Outsourcing chiropractic billing   to experts like   24/7 Medical Billing Services   can transform practice operations, reduce administrative burdens, and significantly improve revenue collection. This blog explores how chiropractic practices can benefit from outsourcing their billing services and why 24/7 Medical Billing Services is the ideal partner for this task. Challenges in Chiropractic Billing Chiropractic billing involves intricate processes, from filing claims to managing denied submissions, all while adhering to ever-changing  healthcare regulations . Practices often face these key challenges: 1. Complex Billing Codes and Compliance Requirements Keeping up with chiropractic-specific coding and insurance regulations is time-consuming and error-...

  In the long-term care industry, Skilled Nursing Facilities (SNFs) must comply with the Centers for Medicare and Medicaid Services (CMS) regulations for submitting claims and receiving payments electronically. This requirement applies to various claim types, including Medicare, Medicaid, Veterans Affairs (VA), and private insurance claims. As the healthcare industry increasingly relies on digital infrastructure for these processes, the risk of system breaches and inefficiencies also grows. This case study examines the billing challenges faced by an SNF in California and how   24/7 Medical Billing Services   resolved these issues after a major technical disruption. Background: The Importance of Electronic Claims Submission To comply with CMS requirements, SNFs use specialized software to submit claims electronically to federal agencies and insurance companies. Electronic Funds Transfer (EFT) is the preferred method for receiving payments, simplifying the process and reduc...

  New regulations from the   Centers for Medicare & Medicaid Services (CMS)  continue to shape medical billing practices, with notable implications for healthcare providers’ credentialing. Credentialing is a foundational component of the medical billing process, ensuring that providers meet the necessary standards to participate in Medicare and Medicaid programs and are eligible for reimbursement. With recent regulatory shifts impacting telehealth, primary care, cardiovascular care, and other service areas, healthcare providers must stay updated on evolving credentialing requirements to remain compliant and avoid potential billing issues. This analysis examines how these regulatory changes affect credentialing. Impact of 2025 Regulations on Credentialing 1. Telehealth Policies Telehealth has become an essential mode of healthcare delivery, and new CMS policies for 2025 reflect continued flexibility while tightening standards for  telehealth credentialing . Effect...

  The 2025 Medicare Inpatient Prospective Payment System (IPPS) Final Rule, issued by the   Centers for Medicare & Medicaid Services (CMS)   on August 1, 2024, outlines significant updates that will impact hospitals, particularly in the domains of payment rates, quality reporting, and the adoption of new medical technologies. These updates are especially relevant for hospital administrators, medical billing and coding professionals, as they directly influence hospital reimbursement, reporting obligations, and compliance requirements. The key elements of the Final Rule and its expected impact on hospitals: 1. Increased Payment Rates and Adjustments CMS has projected an increase in the hospital market basket rate by 3.4% for FY 2025. However, after a 0.5% productivity adjustment, the net increase in payment rates for hospitals that meet reporting and electronic health record (EHR) use requirements is 2.9%. This increase translates into higher reimbursement rates for Med...

  The 2025 Medicare Physician Fee Schedule (PFS) update by the Centers for Medicare & Medicaid Services (CMS) introduces significant changes to physician reimbursement, with far-reaching effects on medical practices, especially in the areas of   Medical billing and coding . This update, finalized on November 4, 2024, impacts conversion factors, introduces new codes, and makes several policy adjustments. While some changes aim to support primary care, behavioral health, and preventive services, others raise concerns about the financial stability of practices due to payment cuts and adjustments for inflation. Let’s have a look at the analysis of key aspects of the 2025 PFS and their implications for medical billing and coding practices: Key Insights on 2025 PFS: Implications for Medical Billing and Coding Conversion Factor Reduction The conversion factor, which is used to calculate payments for Medicare Part B services, is a fundamental element of the Medicare payment system...