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A biller’s most important task is to send ‘clean’ claims to Medicare and Medicaid. Though both are high volume payers, they perform differently in the US healthcare system. In 1965, Medicare (a federal healthcare program) was created to target persons over 65 and those under 65 with certain disabilities. It is…
The financial strength of your drug and alcohol addiction treatment practice is directly correlated to timely billing and account reimbursement. Inpatient and outpatient drug and alcohol billing is entirely different than most medical billing. If the clinic is credentialed as a facility insurance claims must be submitted on UB04 claim…
While many providers might view coding audits as a necessary evil, an effective auditing program yields many distinct benefits. Given the intricate nature of coding rules and the myriad ways they can influence an organisation’s financial performance for better or worse code auditing makes a great deal of sense.Coding audits…
Medical coding productivity may be returning to pre-ICD-10 productivity levels but there still is more ICD-10 coders. To meet that demand. For the Record explains how remote coding could provide strong advantages for healthcare providers: Greater flexibility in staffing. Availability of medical coders when case loads increase. Deeper pool of medical…
It’s especially frustrating to file insurance claims for mental and behavioural health benefits. From the types of services offered to the pre-authorizations needed and who takes care of the books, you’re at a disadvantage compared to other health professionals. If you’ve been struggling to get claims honoured, don’t worry you’re…
There are two changes in the psychiatry section of CPT for 2017 behavioral health billing. The first is the description of psychotherapy CPT codes were revised to remove the words “and/or family.” In 2016, CPT code 90832 was defined as “Psychotherapy, 30 minutes with patient and/or family member.” In 2017…
Electronic Fund Transfer: Electronic Funds Transfer or “EFT” is the process of using of telecommunications to move funds from one financial institution to another. EFT has two basic EFT transaction types: Wire transfers and Automated Clearing House (ACH) transactions. Effective January 2014, all health plans must be able to make…
Orthotics & Prosthetics coverage may be subject to a copay or coinsurance. Authorization is required for various devices and this varies from payer to payer. This is considered a part of the member’s benefits provisions. Operational efficiency and boosting the revenue cycle says it all to understand and improve orthotics…
Revenue cycle management in the behavioral health treatmnet centres is constantly evolving. If your behavioral health billing organisation is not up to date with the many intricacies of the insurance billing processes you are subject to extreme losses in revenue as well as a disservice to your patients. In this blog we will break…
Podiatry Billing is a very specialised field of medical billing and comes with its very own set of challenges. Without in depth knowledge of podiatry and extensive experience in podiatry billing, general billing service providers or even in house specialists can’t attempt to maximise revenue. Awareness about foot care is slowly…
