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 […]
Denied claims are a common challenge in the healthcare industry, with one-third of all submitted claims being denied or ignored upon initial submission. While this might sound discouraging, it also means that 66% of your claim revenue is still being received. However, the financial impact of denied claims is substantial, with hospitals losing an average […]
Pain management practices are a vital component of modern healthcare, addressing complex patient needs and contributing significantly to the overall quality of life for individuals suffering from chronic pain. However, the success of these practices relies not only on excellent patient care but also on efficient and accurate medical coding. This article delves into the […]
The American Medical Association (AMA) manages the Current Procedural Terminology (CPT) codes, which are pivotal in documenting various medical procedures and services. Within OB/GYN, these codes play a crucial role in accurately billing for antepartum, delivery, and postpartum phases of maternity care. Understanding the Challenges of Delivery Coding Coding for deliveries in OB/GYN presents unique […]
In the face of spiraling healthcare costs and the pressing need for enhanced patient outcomes, Accountable Care Organizations (ACOs) and Clinically Integrated Networks (CINs) have emerged as pivotal models in the transition to value-based care (VBC). These organizations, while sharing a common goal of improving healthcare delivery, embody distinct structures and strategies to manage the […]
In the quest to enhance financial performance in medical practices, especially in small settings, the implementation of robust small practice billing strategies is a game-changer. Recognizing the unique challenges independent practitioners face, effective revenue cycle management for independent practitioners is not simply an administrative task; it is critical to the sustainability and growth of their […]
