Complete Revenue Cycle Management for
Medical & Dental Clinics, Practices and Hospitals
Emergency department (ED) visits identified by CPT code 99285 require three key components: comprehensive history, comprehensive examination, and medical decision making of moderate complexity. However, a large proportion of all emergency department (ED) visits are...
Hospitalists are dedicated to providing care to hospitalized patients, but till recently, quality metrics for these specialists had been clubbed with office-based internal medicine or primary care physicians. With the shift from fee-for-service to quality-based...
Billing for vaccine administration is challenging and explains why many providers choose medical billing and coding outsourcing. There are different codes for Medicare and private insurance companies. Moreover, to correctly report immunizations for children and...
Key coding and billing changes to the Hospital Outpatient Prospective Payment System (OPPS) came into force on July 1, 2016. Medical billing and coding companies are taking note of these updates which are designed to improve the quality of care for Medicare patients...
The Centers for Medicare and Medicaid (CMS) conduct Risk Adjustment Data Validation (RADV) audits to recover improper payments under Medicare Part C or Medicare Advantage (MA) plans. In risk adjustment or Hierarchical Condition Categories (HCCs), the focus is on...
One of the significant developments that have impacted Medicare Advantage (MA) plans during the past decade is HCC (Hierarchical Condition Categories) coding. Medicare has used the HCC coding model to calculate payments to health care providers and insurance plans...
Every physician knows the consequence of using a wrong diagnostic code – it will not only affect reimbursement, but more importantly, also jeopardize patient care. Medical coding outsourcing helps avoid risky coding practices. By entrusting the task to skilled and...
The transition to ICD-10 that took effect in October 2015 is progressing. Physician practices are submitting claims with the new codes quite successfully and getting reimbursed by insurers, many with the help of professional medical billing and coding companies....
Recent reports indicate that the federal government is planning to perform additional insurance eligibility verification for people who enroll outside of the enrollment period. According to a Wall Street Journal report published earlier this year, the government’s...
A new market research report indicates that the number of health care organizations outsourcing medical billing is set to grow quite significantly. The Transparency Market Research report predicts a high single digit growth rate for medical billing services during...