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 […]
Challenges in J Code Billing and How to Overcome Them
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 […]
Stop Leaving Money on the Table: Infusion Billing Tips for More Revenue
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 […]
How NCCI Edits Can Help Reduce the $68 Billion in Annual Healthcare Billing Errors
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 […]
Strategies to Minimize Denials and Maximize Revenue for Healthcare Practices
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 […]
Navigating Behavioral Health Agency Credentialing and RCM Best Practices in New Mexico
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 […]
How to Avoid Common Denials for EEG’s
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 […]
Boosting Medical Billing Reimbursements: An Essential Guide for Small to Medium Medical Practices
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 […]
Optimizing Billing and Coding in Anesthesia and Pain Management
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 […]
Choosing the Right EHR: A Detailed Comparison of eClinicalWorks and Kareo for Healthcare Practices
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 […]