Healthcare groups, hospitals, payers and other medical systems are being constantly inspired by the current healthcare reforms and new payment trends or compensation models. The Centers for Medicare and Medicaid Services (CMS) have been transitioning from a...
Black Book Polls show that Outsourcing Medical Coding and CDI Improves Data Integrity
There's good news for medical coding companies and clinical documentation experts. A Health IT Analytics article reports that a pair of recent industry polls by Black Book show that outsourcing coding and clinical documentation improvement (CDI) efforts has evolved...
Global Revenue Cycle Management Market to Reach US$ 45.50 Billion by 2022
Effective revenue cycle management (RCM) is the most important factor when it comes to maintaining the financial health of any healthcare setting; let that be a clinic, family practice, hospital, or a pain management center. The RCM system manages all payments and...
New MAGMA Survey Highlights Trends in Digital Medical Billing and Payment Best Practices
The findings of a new survey by the Medical Group Management Association (MGMA) have important implications for hospitals, physician practices, and medical billing companies. This national survey was conducted among MGMA member organizations in May 2017 to understand...
Using Medical Codes Correctly for Risk Adjustment in the “Value-based” Payment Scenario
A recent article in Neurology Today highlights the importance of accurate Medicare Risk Adjustment / Hierarchical Condition Categories (HCC) coding for physicians practices and RADV audit services for insurance companies offering Medicare Advantage (MA) plans....
Strategies to Tackle the Challenges of Prior Authorization
Health insurance companies normally require prior authorization for medications, durable medical equipment (DME) and medical services, and insurance authorization services are available to help handle the administrative burden associated with the process. However, the...
An Overview of Advance Beneficiary Notice (ABN) for Physicians
Advance Beneficiary Notice (ABN), this is a familiar term for physicians and their beneficiaries. ABN is a notice that a doctor or supplier should give a Medicare beneficiary when furnishing an item or service for which Medicare is expected to deny payment. ABNs only...
New ICD-10 Codes for Blindness and Low Vision starting Oct 1, 2017
Starting October 1, 2017, a new set of ICD-10 codes have come into effect for blindness and low vision. Coders in medical coding companies will have to fully understand how to use the new code set to correctly report claims for blindness for ophthalmology practices....
New Texas Law Seeks to protect Patients from Surprise Bills in Freestanding ERs
As a reliable medical billing service provider, we are well aware of the impact that surprise medical bills have on patients. Patients who visit emergency rooms (ERs) are often faced charges that are not covered by their insurance as they were treated by an...
Understand the Rules for GI/Endoscopy Coding and Billing
GI/Endoscopy coding and billing can be complex. Providers need to determine medical necessity and the proper site for delivery of services, and know the specific codes and modifiers to bill for services rendered. Also, billing guidelines differ among insurance...