With 30 years of experience, I excel in all aspects of practice management, covering front desk operations, clinical procedures, practice administration, accounting, and revenue cycle management (RCM).
Handling claim denials effectively is crucial for maintaining a healthy revenue cycle in any healthcare practice. One of the more common issues faced by billing teams is Denial Code PR 27. This denial code signifies patient responsibility, usually due to the patient’s insurance coverage ending. Let’s take a deeper look into what Denial Code PR […]
J Codes are critical for billing injectable drugs and biologicals in medical claims. Used primarily in outpatient and physician office settings, they cover a wide range of injectable treatments. However, billing with J Codes comes with specific challenges that can lead to claim denials or underpayment if not handled correctly. Let’s look at these challenges […]
Infusion services are a critical revenue stream for many healthcare practices. By optimizing billing practices, practices have the opportunity to significantly boost their revenue. Even a slight improvement in reimbursement rates for each infusion can add up to substantial gains over time. Without proper attention to billing, practices may be missing out on additional revenue […]
Routine and long-term EEGs are critical diagnostic tools for neurological conditions, but healthcare practices often face denials when submitting claims for these tests. To avoid these denials, it’s essential to understand the most common reasons and how to address them effectively. 1. Routine EEG Not Done Prior to Long-Term EEG Many insurers require a routine […]
In many healthcare practices, medical billing is often an overlooked aspect, treated as a tedious task rather than a critical function. Billers are frequently left to work in isolation, away from the main practice areas, despite being essential to the organization’s cash flow. However, the efficiency and accuracy of these billers directly impact revenue, and […]
Billing and coding are essential components of medical practice management. Proper billing practices not only ensure that physicians are paid correctly but also help maintain compliance with healthcare regulations. This article explores key aspects of billing and coding, focusing on recent changes, common challenges, and strategies for effective management. Importance of Accurate Billing Practices Accurate […]
Electronic Health Records (EHR) systems are crucial tools in modern medical practice management. They streamline operations, enhance patient care, and facilitate communication between healthcare providers and patients. This article will explore two of the most widely used EHR solutions: eClinicalWorks and Kareo. We’ll provide an in-depth comparison of their key features, user experiences, and overall […]
Accurate medical coding is crucial for effective revenue cycle management (RCM) in healthcare practices, especially in the field of obstetrics and gynecology (OB/GYN). This article explores the specific ICD-10-CM coding guidelines for pregnancy-related conditions, providing valuable insights and best practices to enhance coding accuracy and efficiency. Understanding Chapter 15: Pregnancy, Childbirth, and the Puerperium Chapter […]
Billing for newborn office visits can be a complex process for healthcare practices, particularly when navigating the intricate rules of insurance carriers. Understanding the nuances of newborn billing, from initial coding to ensuring proper insurance enrollment, is crucial for minimizing denials and ensuring timely reimbursements. Coding for Newborn Office Visits When a newborn is discharged […]
Diabetes is a widespread diagnosis in the United States, with over 10% of the population affected by this condition. Given its prevalence, healthcare practices need to be well-versed in the coding guidelines for diabetes to ensure accurate documentation, proper patient care, and correct reimbursement. Types of Diabetes When coding for diabetes, the first thing to […]
