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

Healthcare Insights, a renowned healthcare publication ranks Medical Billing Wholesalers as the most reliable medical billing service provider. Read the full article here.

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.

Bad quality scanning of superbills and lack of adoption of electronic claims submission creates a charge backlog situation and consequently, result in increased denials on account to timely filing dates not being adhered to. Read this case study about how our structured approach, technical expertise, and revenue cycle rigor combine to create value for our client.

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.

Notice of Levy issues may be wrongly construed to be claim denials if a thorough investigation is not done to understand the reason behind such cases. Further, it is imperative that physicians pay their taxes on time. By educating physicians/practice teams on the importance of filing taxes, an artificial surge in denials on account of notice of levy cases can be avoided.

Physical Therapy billing requires expertise to ensure holistic and sustainable improvement. Medical Necessity and prior authorization issues can cripple a practice’s financial health. Structured revenue cycle processes can help Physical Therapy clinics grow and thrive. Diligent tracking of issues and working with physicians can yield as much as 2X improvement in collections and reduce denials by as much as 50%. Get the strategies in this case study.

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.

Worker’s Comp Claims present unique challenges to billers and claims follow-up agents. By following the processes and guidelines outlined by the Payer, you can improve collections multi-fold.

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.