Medical Billing Blogs

  Payment posting is essential to any solo practitioner’s or healthcare organization’s revenue cycle management. It entails posting and deposit functions and reconciling posting activities and deposits. The payment posting process impacts many other aspects of the healthcare organization, including efficiency, patient satisfaction, and overall financial performance. Payment posting also offers insight into a practice’s daily revenue stream and enables practices to identify and correct potential issues quickly. It is essential for your practice to be apt to see daily insurance payments from EOBs, patient payments, insurance checks from   ERAs , and other information. In addition, having an efficient ERA/EOB payment posting system provides a clear picture of your day-to-day financial situation. Let’s have a deep understanding of payment posting services: Types of Payment Posting Payment posting in medical billing  is done in two ways, depending on the level of insurance cov...

  Every medical provider understands how tricky it is to be compensated for their services. According to 73 percent of healthcare providers, it takes 30 days or more to recover their payment fully. The payment cycle is complicated by various issues, such as: ·          Changing payer fee schedules, ·          Complicated billing procedures, ·          Government directives, ·          A lack of training and resources, and ·          High-deductible health plans. Furthermore, the critical communication triangle between the patient, the healthcare provider, and the insurance company exacerbates the problem. Medical providers must develop strong systems and procedures to ensure long-term success in order to be paid efficiently. This blog will provide you with proactive tips t...

  The healthcare system has undergone an immense transformation in the last couple of years. With the rise of technology and the implementation of virtual care, medical billing has also undergone a significant change. It can be proved by the statistics in medical billing, which point toward advancing several new trends. It includes a substantial rise in the adoption of virtual payment systems and new medical billing technology implementation. As the year 2022 ends, and we move into 2023, it’s time to look into some of the top five trends in medical billing services in 2023 that will revamp the healthcare system. Knowing the latest trends will help you understand where your facility lacks and implement them for better revenue for the following year. 1. Autonomous Coding A report by Kaufman Hall stated that operating margins for hospitals were down by 80% in 2021 compared to the pre-pandemic phase. The number indicates that hospitals and other healthcare facilities need encourag...

  From the initial appointment stage to the collection of the claims after the services are rendered, a healthcare facility goes through a lengthy process that includes several organizations and people. The result is of having a scenario of too many cooks in the kitchen, which can open the medical billing process to mistakes. In medical practice, errors in billing coding are thus most common and occur often. It eventually affects the facility’s income, exposing it to scrutiny by the authorities. Many healthcare providers hence prefer to work with medical billing partner. It decreased the in-house burden of medical billing and training the staff while increasing the revenue with proper claims. However, the impact can be tremendous when the wrong medical billing partner is chosen. Some of the effects are: 1. Coding & Billing Errors In medical practice, one of the most complex but vital steps is to do correct coding, documentation, and billing to ensure the facility gets paid for ...

  Understanding HCC coding has become critical for healthcare organizations to succeed in new payment models as we transition to value-based care. As a reminder, HCC coding enables providers and billing/coding teams to account for future health risks and costs at the patient level. Thereby, HCC accuracy impacts program success, especially for innovative programs such as Primary Care First. If your patients are not correctly coded, your patient panel may be assigned to the incorrect risk group. Inaccurate risk classification has significant financial implications for the potential payments your healthcare organization will receive. Therefore, it is crucial to implement the following strategies to improve the HCC coding performance: ·          Adhere to the M.E.A.T. Criteria The only way to support a diagnosis for a face-to-face visit is via M.E.A.T. Each encounter should be treated as distinct and in accordance with M.E.A.T. criteria wh...

  In 2004, the Centres for Medicare and Medicaid Services (CMS) launched the Hierarchical Condition Category (HCC) code set. While approaching its 20th anniversary, HCC coding is becoming more common as healthcare shifts to value-based payment models, a change that has been actively pursued over the last decade. HCC, as it is colloquially known, was created to estimate and possibly predict a patient's healthcare costs over the course of his or her life. It requires a long-term perspective on multiple conditions, factors, and determinants that may affect their individual prognosis over many months or years. HCC codes are directly related to ICD-10 codes - approximately 10,000 ICD-10 diagnosis codes out of 70,000 diagnoses are directly related to at least one of the 86 HCCs. HCC coefficients vary depending on the patient category. The HCC set assigns risk scores to patients based on demographic factors such as age and gender. There are lot more things to know about the HCC Co...

  Did you know? According to an American Hospitals Association report, the total cost of uncompensated hospital care since 2000 has exceeded $620 billion. As per another survey, 99% of medical bills in excess of $3,000 were not paid in full. Furthermore, bankruptcies in the health care sector have tripled with eight hospitals declared bankrupt and nine others closed their doors. Also, failures in claims processing, payments, billing, and bad debt collection cost healthcare providers $300 billion per year. All these statistics highlight a major issue confronting US healthcare providers today, i.e., revenue erosion. That’s why it is important to deal with these issues at the earliest and OUTSOURCING your medical billing is a one-stop solution to all your problems.   Let’s have a deep dive into the different reasons for medical billing outsourcing : ●         Fewer Errors: Incorrect patient data, duplicate billing, and authoriz...