Accuracy in medical coding doesn’t just affect claim approvals. It also directly influences various aspects of healthcare such as proper reimbursement, compliance, and patient safety. Ensuring...
The Hidden Consequences of Poor RCM in Healthcare
Consider this scenario: a medical facility has been grappling with flawed revenue cycle management (RCM) throughout the past year. The administrative department is overloaded with manual paperwork,...
Understanding Prior Authorization for Orthopedic Billing
Orthopedic practices perform a wide range of joint surgeries, musculoskeletal treatments, ligament reconstructions, and spinal interventions. Managing prior authorization in orthopedic billing is...
Navigating Denial Management in Orthopedic Billing
Medical billing in orthopedic practices involves complex surgical coding, bundled service rules, and high-dollar healthcare claims that receive intense payer scrutiny. These complexities make the...
Technology Tools for Better RCM That Every Healthcare Provider Should Know
Increasing digitization and unorganized workflows in healthcare has fueled the need for efficient revenue cycle management (RCM) solutions. According to Grand View Research, the global RCM market...
Differentiating Between Upcoding and Downcoding in Medical Billing
Claim submission and denial management are the two steps that typically comprise the major portion of the medical billing workflow. While these steps are the key to obtaining proper reimbursements...
The Impact of Prior Authorization Requirement on Mental Health Services
Obtaining behavioral health prior authorization has been considered a longstanding obstacle in providing timely mental healthcare. While intended to be used as a cost containment tool by insurers,...
How to Code for Dermatomyositis – A Common Rheumatology Disorder
Regarded as a chronic inflammatory disease, dermatomyositis affects the muscles and skin. It can affect adults and children and is most commonly seen in females than males. Accurate and compliant...
ICD-10 Coding for Thrombophilia: Best Practices & Common Pitfalls
Thrombophilia is a medical condition that increases the risk of developing abnormal blood clots in the veins or arteries. Accurate ICD-10 coding for thrombophilia is crucial for proper...