As we approach 2025, the Merit-based Incentive Payment System (MIPS) continues to evolve, introducing new challenges and opportunities for healthcare providers. The latest updates bring significant changes across various performance categories, including quality measures, cost measures, and improvement activities. Here’s an overview of the key updates. Threshold and Data Completeness To avoid a negative payment […]
In today’s competitive healthcare environment, maximizing practice revenue is more crucial than ever. For many practices, traditional revenue cycle management (RCM) methods no longer meet the demands of a dynamic market. This is where RevXL, Svast Healthcare Technologies’ cutting-edge Practice Revenue Maximization System, steps in as a game-changer. Why Practices Struggle with Revenue Leakage A […]
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 […]
Billing in pain management is complex, requiring pain physicians to navigate unique coding challenges, payer requirements, and compliance standards. From proper documentation of single-use vials to understanding Evaluation and Management (E/M) code changes, staying informed on billing practices can directly impact a practice’s revenue and reduce risks of audits and penalties. Here are some critical […]
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 […]
According to Worldmetrics.org medical billing errors account for an estimated $68 billion in unnecessary healthcare revenue loss. Given this staggering figure, understanding the ins and outs of medical coding and billing becomes crucial for healthcare practices. Accurate documentation of services and procedures during patient visits can make the difference between receiving timely revenue or facing […]
In healthcare practices, one of the most pressing concerns is managing claim denials. Denials not only reduce revenue but also burden staff with additional administrative tasks. For many practices, this challenge is compounded by the increasing number of denial codes and complex reasons for denials. According to industry experts, denials can range from 8% to […]
In New Mexico, Behavioral Health (BH) agencies play a vital role in delivering specialized treatment and training to providers seeking independent licensure. These agencies provide an array of services, from comprehensive community support to opioid treatment programs. To effectively manage the complexities of Revenue Cycle Management (RCM) and credentialing, healthcare practices must stay compliant with […]
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 […]
