Complete Revenue Cycle Management for
Medical & Dental Clinics, Practices and Hospitals
Outpatient coding refers to assigning medical codes for the services provided for a patient who is treated in a free-standing or hospital-based clinical setting and is under care for less than 24 hours. Medicare determines reimbursement for these services on the basis...
There are certain services that require pre-certification, pre-notification or pre-authorization from the insurance company. You need to make sure whether a particular service requires pre-authorization during the insurance verification process. Most healthcare plans...
Family practice physicians should not only understand the basic changes with the ICD-10 to successfully prepare for ICD-10 implementation but also the additional documentation details the changes demand. The family practice medical coding process generally takes place...
Computed Tomography (CT) scans and services are crucial when it comes to radiology billing for Medicare. During the 2014 reporting period for the Comprehensive Error Rate Testing (CERT) program, it was found that insufficient documentation resulted in more than 94...
Pre-authorization or written approval from the insurance company is required for certain medical procedures (for example, outpatient surgery, MRI, CT or PET scans, chemotherapy or radiotherapy) prior to the point of service. When you obtain insurance authorizations,...
Medicare Part B covers two types of services - medically necessary services and preventive services. While Part A focuses on emergency services, Part B covers day-to-day medical needs and this is why Part B claims are crucial for healthcare providers. Once you furnish...
The properties of some drugs, medicinal and biological substances or their combinations may cause toxic reactions in patients. The ICD-9-CM coding system has classified these reactions into adverse effects, poisoning and toxic effects to report on medical claims. All...
Medical coding for mental and behavioral disorders in ICD-10-CM is different from that of ICD-9. Though some ICD-10 codes mirror ICD-9, there is expanded granularity for certain categories. More specific clinical documentation is required in such cases to choose the...
According to the Centers for Disease Control and Prevention (CDC), more people in the United States are addicted to nicotine (the drug found in tobacco) than any other drug. Many clinics are providing preventive services to help tobacco addicted people to control...
The Centers for Medicare and Medicaid Services (CMS) added several new codes for spine surgery on the ambulatory surgery centers (ASC) payable list this year. It is important for all Ambulatory surgical center billing companies to be aware of. This is a very crucial...