The Revenue Cycle Blog
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Utilizing Global Delivery for your medical billing processes? Let your clients know!
Global Medical Billing and Coding services teams hold the key to your financial success. As a medical billing services provider, you should let your clients know that you are utilizing global delivery. It is imperative that you bring up the capabilities of your offshore partner in such conversations.
Internal Performance Monitoring is the Key to Client Retention in Medical Billing
Retaining Healthcare Provider customers is key to profitability for Medical Billing companies. Therefore, the role of exceptional service and achievement of revenue cycle KPIs is paramount
Physician Practice metrics to watch
Three additional key performance indicators (KPIs) - patient slots occupied, point-of-service (POS) collections percentage, and days to claim submission from the date of service (DOS) are key to running a successful practice.
Improving Clinical Quality and Patient Experience is key to financial success
Improving the overall patient experience requires a comprehensive re-look at your clinical, administrative, and financial processes. From reducing time to care delivery to improving transparency around the costs of care, healthcare provides need to focus on improving quality, timeliness, and responsiveness.
The Potential of Efficient Payment Posting - Analytics
Inefficient payment posting can be a cause of extended days in A/R – creating frustration for your clients. High labor costs with this department can cut into your profitability. Efficient Payment Posting can provide the right visibility into your revenue cycle performance.
Recruiting and Training the Best Medical Billing Talent
With changes in technology, a successful medical biller needs to understand (and be proficient) in using technology, applying deductive and critical thinking skills, and be an excellent communicator. Ideally, one should look for strong analytical, communication, and inter-personal skills in a medical biller
ED Coding Guidelines and Best practices
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..
Case Study: Physician Education helps resolve BMI Diagnosis Claim Denials of over $37 K
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.
Case Study: Improved Revenue Cycle Workflow and reporting functionality accelerates Cash Flow
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 – Coding Best Practices Guide
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.
Successful Physician Credentialing: A Quick Reference Guide
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 – The top revenue cycle metric
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.
Shifting the Focus from Denial Management to Denial Prevention
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.
Improving Collections by using the right CPT Codes for Prolonged Service
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.
Best Practices in filing Physician Assistant Claim enable Recovery of over $80 K in out-of-network claims
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.
Correct Coding and Re-submission of Pain Management Claims help Recover $300K of A/R Backlog
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.
Medical Coding & Best Practices Guide - Podiatry
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.
Denial Management Infographic
Get the statistics for claim denials and strategies for preventing them in this Denial Management infographic from Medical Billing Wholesalers.
Reimbursements for COVID-19 Treatments & Testing of Uninsured Individuals
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.
How to Arrest Revenue Leakage in Medical Billing?
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.