START TYPING AND PRESS ENTER TO SEARCH

why medical claims get denied

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.

Read More

Myths Medical Billing

Misconceptions About Medical Billing

Medical billing is an important part of your practice.  In fact, it is one of the crucial aspects, which if ignored or not handled properly, can even lead to the practice eventually facing closure.  Healthcare providers handle their medical billing either in-house or through outsourcing.  However, the benefits of outsourcing your medical billing are far more than keeping them in-house. 

Read More

Fraudulent Medical Billing

Hospitals Pay to Settle Inflated Billing Lawsuit

Robert was shocked, as he read the news regarding the settlements made by the hospitals, for incorrect Kyphoplasty procedures.  He clearly remembered that day, when his mom had to undergo the same procedure, way back in 2006.  Although active and otherwise healthy, his mom suffered from osteoporosis since the last three years.  Last week, she slipped in the kitchen and felt a sharp pain in her lower back. 

Read More

Understanding Revenue Cycle Management

Understanding Revenue Cycle Management

Revenue cycle is defined by the Healthcare Financial Management Association as “All administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue.”  The term includes the entire tenure of a patient account – from its creation to the payment.  The process of revenue cycle flows into and affects each component of the system. 

Read More

Medical Billing and Medical Coding

Difference between Medical Coding and Billing

Often mistakenly assumed to be the same, medical billing and medical coding are two very distinctly separate jobs.  Although there are many similarities between the two and small healthcare settings may entrust a single person for doing both the tasks; most medium and large healthcare facilities have different individuals responsible for the two different jobs. 

Read More

revenue cycle management

Technology to the Rescue of Your Revenue Cycle

The Healthcare Industry has always been on top of the game when it comes to technological advancements and usage.  Computers, ECG machines, even artificial intelligence has been integrated with leading US hospitals.  However, most of these advancements have been in the core medical practices.

It is universally known that American Healthcare has one of the most complex billing systems. 

Read More

Pt Pymts

5 Ways to Improve Patient Payments

University of Pittsburgh Medical Center (UPMC) reported $212 million in bad debts for the fiscal year 2014. The numbers are not deniable – the reason for bad debt is higher deductibles. While choosing their medical insurance plan, most people tend to choose the plan with the least annual premium, what they fail to realize is lower premium means higher deductible.

Read More

ICD 10 Switch

ICD-10: Prepare For the Big Switch

MedConverge helps physician practices become ICD-10 ready.

A lot of discussion has gone into how ICD-10 (International Classification of Diseases, 10th Revision) will impact physician practices, and ultimately change the face of their bottom-line.

However, what seem less debated are the possible solutions that physician practices can adopt, and do well as usual,

Read More

Track your Revenue

3 Simple Ways to Track Your Practice’s Revenue

Yes, truly!  You can be assured of your practice’s financial health by asking yourself these Three Questions periodically:

1. Is my front office efficient? Because front office is where it all begins. When we consider the fact that most patients have a minimum of $10-$15 primary physician copay and $30-$40 specialist copay,

You should never,

Read More