Medical Billing Blogs

  Irrespective of the size of the services they provide, many healthcare facilities have been grappling with failure to manage their revenues with the in-house team. It is quite possible that despite all the efforts that the in-house medical billing and coding team is putting into managing the revenue cycle ends up with nothing. The failure is not because they are reluctant to do the job but due to the insights caused by the multiple changes and disruptions in the medical billing system. Added to this, they face continuous obstacles when it comes to payment collection due to the changed behavior of the patients and the insurance providers. Often ignoring all these, the in-house team struggles with the revenue cycle management resulting in the practices to upend their business to stay afloat. So if your in-house medical billing and coding team is also constantly fighting to keep the revenue cycle on track, miserably failing can be due to any one of multiple of the following reas...

  Managing patient collections is one of the most dreaded tasks of any medical facility. Of course, most healthcare providers want to offer the best possible services to the patients, but that collection process becomes the biggest distraction. Yet, a patient collection is vital for any facility or practice or hospital to stay running to offer the best services and ensure they can improve the revenue. Though it may prove to be tedious to continue the practice, it is essential. Unfortunately, the patient collection is quite challenging and often results in revenue loss. For example, a study conducted by J.P. Morgan found that a healthcare provider fails to collect a balance of up to $1,000 in 30 days. It indicates that the uncollected payments affect the revenue and eventually affect the practice. If you have been facing a similar problem with your patient collection, here are three simple strategies to improve it. 1.          Developi...

  With old age, assistance and assistive equipment become essential to help us do things that were natural to us once—for instance, a walker to move and walk around easily without a nurse. But for many older people, the world of insurance and vendors can be pretty overwhelming, mainly when it comes to purchasing Durable Medical Equipment (DME). But the challenges of navigating the world of DME are not only for the end-users, i.e., the patients, but also for the DME service providers. The facility is different from any other services in the medical field, which makes DME billing and coding more challenging. Since DME is given to patients to avail of the therapeutic benefits for certain health conditions or diseases, it is also used at the home, hospital, or other healthcare units regularly by the patients in many cases. What are Standard DME Products? Within the standard DME products, there are two parts, Part A and Part B, which include: ·      ...

  With the changing lifestyle of individuals and the rising number of aged populations, there has been increase in ambulance services and ambulatory care services. But simultaneously, one of the most affected areas for revenue management is the ambulance billing services in the healthcare industry. The simple reason behind failure to get 100% reimbursement for the rendered services is the in-house billing team and more focus on saving the life of the patients (which should be the case) with failure to handle the revenue processing and collection for the services. As a result, the reimbursement decreases significantly from the insurers, both public and private, while the business cost of medical care is growing. Also, the increase in the federal government's involvement is impacting the compensation. Added to this, the Affordable Care Act and other monetary limitations will continue to dwindle the ambulance services if they do not adhere to the time and fee schedules and the...

  MGMA has reported that many physician-owned multi-specialty practices and groups often use non-physician providers (NPPs). According to the report, the reason is that the NPPs with the practices often generate higher income than physicians and are financially more viable. NPPs, however, need to function directly under the supervision of a physician to provide billable medical services. Therefore, registered nurse aestheticians, surgeons, or physicians' assistants can be included in the facility under the NPPs. Further under the Medicare fee schedule, the NPPs' medical practices can receive full payment and reimburse the amount for the services successfully by reporting the NPSS services under 'incident-to' for physician care. But CMS has implemented strict and complex guidelines for incident-to billing. That’s why physicians must understand the rules of the medical billing procedures correctly to receive full payment from the insurers for the services rendered ...