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Do you need to change your Medical Billing Company?

Healthcare practices typically outsource their billing for two reasons – lack of resources and/or lack of time. While outsourcing your billing has many advantages, there are certain factors that need to be checked before hiring a billing company. Remember that most outsourcing contracts generally last for two to three years and it would be detrimental to your practice if you choose a billing company that exhibits most of the following:

  • The billing company has no existing clients with the same specialty as yours.

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ICD-10 Flexibilities to end October 1st

After ICD-10 went live on October 1, 2015; CMS (Centers for Medicare and Medicaid Services) allowed a one year grace period for ICD-10 flexibility, to overcome the strong opposition from the AMA (American Medical Association) to ICD-10 implementation. For the one year period, even though a more specific code existed, CMS allowed healthcare providers to submit claims with a valid code from the ICD-10 three character category,

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8 Tips On Medical Billing And Patient Collections

One of the biggest challenges faced by healthcare practices and crucial to their very survival is medical billing and collections.  A healthy revenue cycle is important to sustain the process of making patients healthy.  Unfortunately, physicians are trained to manage human health rather than revenue health and this is where the challenges arise. 

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8 Must-Knows for Balance Billing

Billing patients for outstanding balances after receiving the portion covered by the insurance company is known as balance billing.  This can happen if the insurance company gives less than the amount expected or if an episode of care is mistakenly believed to be in-network and hence expected to be covered by the insurance company.  Physicians who are not bound by the in-network rate agreements and are thus classified as out-of-network physicians,

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Patient Centered Care – Redesigning Medical Billing

The biggest problem in revenue cycle management for healthcare facilities is unpaid bills for medical services provided.  The acquisition of medical debt leads to a detrimental impact on medical care provided by the healthcare facility and negatively affects the healthcare industry in general.  There is a dire need to redesign the medical billing system to ensure shrinkage of bad debts,

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Common Reasons For Medical Claim Denials

One of the biggest banes of healthcare revenue cycle management; denied claims are a major source of stress for healthcare facilities and have an adverse impact on the cash flow and net revenue for the facility.  But before we start blaming the payers for these denials, let us look at the common reasons for claim denials.

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Medical Practice Tips to Manage Revenue Cycle

The ever changing policies and reforms in today’s healthcare scenario are forcing medical practices to change the way they manage their revenue cycle.  Revenue cycle management is all about generating the maximum amount of net revenue.  With the recent 5010 transition & ICD-10 switch, growing patient responsibility for payments & declining Medicare reimbursements,

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Managing Denied Claims at your Medical Practice

An ongoing challenge for all hospitals, revenue cycle management requires the use of technology to keep track of claims and address issues as and when they arise.  It is fairly common for claims to be denied, denial management being an industry wide challenge.  Efforts by healthcare facilities have not made much impact in the reduction of claim denials. 

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Where is your Medical Practice Losing Money?

Medical practices have been leaking money for some time now – increasing expenses, shrinking insurance reimbursements, and increased compliance parameters means more paperwork than ‘actual’ work.  Relying on practice managers to help cut down your expenses could prove tricky if not done right, then there are efficiency and technology challenges that have been plaguing a number of practices.  

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Exploring Revenue Cycle Management

Revenue Cycle Management is the process of managing your claims processing, payment and revenue generation.  This includes everything from determining the patient’s eligibility, collecting their co-pay, coding the claims, tracking the claims, collecting payments and following up on denied claims.  A critical part of your office function, it is important that the entire revenue cycle process is managed efficiently.

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