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 […]
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 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 […]
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 […]
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 […]
