The Revenue Cycle Blog
A Provider Credentialing & Contracting Checklist
A credential provider gets an increased number of patients through referrals from payers. Physicians/providers must credential themselves, i.e., enroll and attest with the payer's network and get authorized to provide services to patients who are members of the payer's plans. This article brings a few things that need to be checked off to ensure a hurdle-free credentialing process.
Urology Surgery and Radiology Coding Guidelines
Urology surgery coding requires training & knowledge as the coders have to keep up with thousands of yearly changes made to the ICD & CPT systems. Despite the frequent changes, few guidelines have remained consistent and continue to serve as key urology surgery & radiology coding rules. Download this guide for more information on urology surgery & radiology coding guidelines.
Medical Coding Guidelines for COVID-19 Treatment and Vaccinations
With COVID-19 vaccinations now being administered across the United States, we have compiled these medical coding guidelines to account for the treatment and vaccinations for the novel Coronavirus.
OB-GYN Coding Guidelines and Best practices
Ob/GYN billing & coding can be challenging to most billers & coders due to the global claims, widely varying coverage terms, and multiple tests performed at numerous facilities. Apart from this, many OB/GYN practitioners lack the billing support provided to large hospitals. Learn more about the challenges in Ob/Gyn coding and best practices followed by our coding experts.
Overcoming common issues in Accounts Receivable Management
Most Central Billing Offices (CBOs) and outsourced billing companies rely on dedicated accounts receivable calling to overcome their receivables' challenges. Running an AR calling team needs a solid understanding of the receivables patterns and diligent processes to follow-up and close underlying issues. In this article, we list some of the critical operational issues and solutions to overcome them.
Utilizing Global Delivery for your medical billing processes? Let your clients know!
Global Medical Billing and Coding services teams hold the key to your financial success. As a medical billing services provider, you should let your clients know that you are utilizing global delivery. It is imperative that you bring up the capabilities of your offshore partner in such conversations.
Internal Performance Monitoring is the Key to Client Retention in Medical Billing
Retaining Healthcare Provider customers is key to profitability for Medical Billing companies. Therefore, the role of exceptional service and achievement of revenue cycle KPIs is paramount
Physician Practice metrics to watch
Three additional key performance indicators (KPIs) - patient slots occupied, point-of-service (POS) collections percentage, and days to claim submission from the date of service (DOS) are key to running a successful practice.
Improving Clinical Quality and Patient Experience is key to financial success
Improving the overall patient experience requires a comprehensive re-look at your clinical, administrative, and financial processes. From reducing time to care delivery to improving transparency around the costs of care, healthcare provides need to focus on improving quality, timeliness, and responsiveness.
The Potential of Efficient Payment Posting - Analytics
Inefficient payment posting can be a cause of extended days in A/R – creating frustration for your clients. High labor costs with this department can cut into your profitability. Efficient Payment Posting can provide the right visibility into your revenue cycle performance.
Recruiting and Training the Best Medical Billing Talent
With changes in technology, a successful medical biller needs to understand (and be proficient) in using technology, applying deductive and critical thinking skills, and be an excellent communicator. Ideally, one should look for strong analytical, communication, and inter-personal skills in a medical biller
ED Coding Guidelines and Best practices
Emergency departments are fast-paced environments where care is delivered quickly depending on the patient's condition's criticality. Further, ED does not deal with one specialty per se. ED provides Medical services across specialties. It also requires close coordination of services from when a patient enters an ambulance or an ED facility to discharge, working with multiple clinical practitioners. Learn more about ED coding best practices in this guide from Medical Billing Wholesalers..
Internal Medicine – Coding Best Practices Guide
Internal medicine can be defined as the medical specialty dedicated to the diagnosis and medical treatment of adults. With so many new codes introduced and trickier coding, claim denials have increased for many internal medicine practices. Keep your coding team updated with the latest best practices in internal medicine coding with this guide from Medical Billing Wholesalers.
Successful Physician Credentialing: A Quick Reference Guide
Physician credentialing is the process of obtaining, verifying, and assessing the qualifications of a medical practitioner to be able to provide medical services. Credentials are documented evidence of licensure, education, training, experience, or other qualifications of the medical practitioner. In this guide from Medical Billing Wholesalers, we bring you a few tips on successful provider credentialing.
Revenue per Encounter – The top revenue cycle metric
Revenue per encounter can be defined and computed by dividing net collections by the total number of patient visits in a given month. This metric can provide a quick view of the health of your revenue cycle. In this whitepaper from Medical Billing Wholesalers, learn more about how to calculate and increase Revenue per encounter.
Shifting the Focus from Denial Management to Denial Prevention
The adage, “Prevention is better than cure”, does apply to Claim Denials as well. An effective denial prevention program requires an iterative process that includes identification of root cause, finding solutions to prevent the issue from recurring in the future, the institutionalization of these procedures through updates to standard operating procedures, and training the staff on these practices. In this whitepaper from Medical Billing Wholesalers, we bring you a few steps that you can take to prevent denials.
Medical Coding & Best Practices Guide - Podiatry
Podiatry billing can be complicated in many ways, beginning the need to determine and prove the medical necessity of the treatment, to the coding nuances. It demands meticulous use of modifiers and an understanding of coding for inclusive procedures. In this guide, Medical Billing Wholesalers bring you the guidelines & best practices to be followed to increase collections of your Podiatry practice.
How to Arrest Revenue Leakage in Medical Billing?
Inefficiency & carelessness in the revenue cycle stages can cause revenue leakage, which if undetected, could result in the loss of thousands of dollars. In this whitepaper, we bring you 10 things that you can implement to reduce revenue leakage in your practice. These best practices will help you improve revenue and reduce your costs.
4 Reasons for Physical Therapy Claim Denials and Solutions
Denied claims are the type of claims that were received and processed by the insurance payer and a negative determination was made. It is no wonder that in Physical Therapy there are a greater number of denied claims compared to any other specialty. Read more about reasons for claim denials in Physical Therapy and ways to rectify them.
Mastering Physical Therapy Billing - Codes & Terminologies You should Know
Medical Codes and Terminologies are two essential things that a Physical Therapist should learn about. The Medical codes define the diagnoses, treatment, procedures, and medication used through the alphanumeric ICD-10 Coding System. In this article, we provide you a view of the physical therapy codes and terminologies.