Emergency departments are fast-paced environments where care is delivered quickly depending on the patient's condition's criticality. Further, ED does not deal with one specialty per se. ED provides Medical services across specialties. It also requires close coordination of services from when a patient enters an ambulance or an ED facility to discharge, working with multiple clinical practitioners. Learn more about ED coding best practices in this guide from Medical Billing Wholesalers..

Many Primary Care Physicians lose money because of lack of understanding of payer specific claims submission guidelines. Educating physicians on their documentation responsibilities is an iterative process, that requires an understanding of the reasons for claim denials, ability to nail-down the issues that are causing the denials, determining the corrective actions, and hosting timely sessions between the denials team and the physicians to discuss them.

Most revenue cycle systems have a wealth of unutilized functionality. Revenue cycle professionals need to evaluate workflow and reporting functionality on the revenue cycle system to not only ease their workload but also improve revenue cycle outcomes. Read more in this case study.

Internal medicine can be defined as the medical specialty dedicated to the diagnosis and medical treatment of adults. With so many new codes introduced and trickier coding, claim denials have increased for many internal medicine practices. Keep your coding team updated with the latest best practices in internal medicine coding with this guide from Medical Billing Wholesalers.

Physician credentialing is the process of obtaining, verifying, and assessing the qualifications of a medical practitioner to be able to provide medical services. Credentials are documented evidence of licensure, education, training, experience, or other qualifications of the medical practitioner. In this guide from Medical Billing Wholesalers, we bring you a few tips on successful provider credentialing.

Revenue per encounter can be defined and computed by dividing net collections by the total number of patient visits in a given month. This metric can provide a quick view of the health of your revenue cycle. In this whitepaper from Medical Billing Wholesalers, learn more about how to calculate and increase Revenue per encounter.

The adage, “Prevention is better than cure”, does apply to Claim Denials as well. An effective denial prevention program requires an iterative process that includes identification of root cause, finding solutions to prevent the issue from recurring in the future, the institutionalization of these procedures through updates to standard operating procedures, and training the staff on these practices. In this whitepaper from Medical Billing Wholesalers, we bring you a few steps that you can take to prevent denials.

While the application of prolonged service codes may be fairly simple, very few codes cause more confusion than prolonged service codes. It may be noted that prolonged service codes can be used for outpatient procedures as well as for inpatient care. These codes are typically used to bill for services that significantly exceed the standard time a physician takes while providing care. These may include face-to-face services as well as non-face-to-face services.

While prolonged service coding issues are highlighted in this case study, the principles of educating physicians and clinical staff is applicable for all cases where coding denials are high.

Recovering claim dues from payers for physician assistance claims requires intricate knowledge of payer-specific guidelines. Medical Billing Wholesalers’ denials research team helped the client identify and resolve out-of-network claims.

With a focus on recovering denials of PA claims from UHC and Oxford, we rebilled the claims after adhering to the payer-specific guidelines and were able to recover over $80K of A/R, while reducing the monthly denials from 73 to 11.

Standardized billing and coding practices for Spinal Cord Stimulator (SCS) Procedure Code 63650 reduce medical necessity denials and help collect 281 claims valued over $ 300K in 2 years. The Customer saw over 36% improvement in Collections, as much as 75% reduction in old AR over 61 days, and reduction of denied SCS claims from 68 to 8 over a 7 month period.

Podiatry billing can be complicated in many ways, beginning the need to determine and prove the medical necessity of the treatment, to the coding nuances. It demands meticulous use of modifiers and an understanding of coding for inclusive procedures. In this guide, Medical Billing Wholesalers bring you the guidelines & best practices to be followed to increase collections of your Podiatry practice.

Get the statistics for claim denials and strategies for preventing them in this Denial Management infographic from Medical Billing Wholesalers.

As with all other industries, healthcare providers are facing financial challenges stemming from COVID-19. Getting reimbursements for COVID-19 treatments of uninsured individuals is complicated & requires healthcare providers to stay up to date with the nuances of the HRSA program for the uninsured. In this article we provide a consolidated view of everything one should know about the HRSA program for COVID-19 treatments of the uninsured.

Inefficiency & carelessness in the revenue cycle stages can cause revenue leakage, which if undetected, could result in the loss of thousands of dollars. In this whitepaper, we bring you 10 things that you can implement to reduce revenue leakage in your practice. These best practices will help you improve revenue and reduce your costs.

Telemedicine is gaining increasing acceptance as a direct consequence of the Coronavirus outbreak. The bigger question is if telemedicine will continue and possibly even grow post-COVID-19 or is this just a passing phase that has gained popularity out of necessity and will wane off. In this article, MBW brings you a list of reasons why Telemedicine is the new normal.

Denied claims are the type of claims that were received and processed by the insurance payer and a negative determination was made. It is no wonder that in Physical Therapy there are a greater number of denied claims compared to any other specialty. Read more about reasons for claim denials in Physical Therapy and ways to rectify them.

Medical Codes and Terminologies are two essential things that a Physical Therapist should learn about. The Medical codes define the diagnoses, treatment, procedures, and medication used through the alphanumeric ICD-10 Coding System. In this article, we provide you a view of the physical therapy codes and terminologies. 

COVID-19 updates by the regulators are across the news today. With many physician practices choosing to operate remotely, and reduced patient visits to the outpatient department, the financial health of healthcare providers is now reeling under the shock of COVID-19. MBW brings you some of the areas that financial administrators working at healthcare provider entities must focus on to stabilize financial operations and restore normalcy.

Medical Billing Wholesalers salutes the undying commitment of the medical fraternity across the world. We see our role as helping the healthcare systems improve the economics of healthcare enables caregivers to focus on what they do best, deliver high-quality care. On this day, renew and reaffirm our commitment to helping the medical community reduce administrative costs, and improve care delivery.

The unique CPT code will be used to report laboratory testing services that diagnose the presence of the novel coronavirus. This will help provide the data for analytics as testing to identify the incidence of the virus continues across the United States.