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...
How Outsourcing Medical Coding Drives Healthcare Revenue Integrity
In today’s competitive healthcare environment, financial stability is as critical as clinical excellence. Accurate medical coding is essential for proper reimbursement, compliance, and data...
Medical Coding for Cardiac Arrest
It is estimated that more than 436,000 cardiac arrest deaths occur each year in the United States. Medical coding for cardiac arrest or heart failure is a crucial aspect of cardiology billing and...