Our client, a Maryland-based Medical Billing & Coding Company, was challenged with billing & coding for all vaccinations done at an urgent care clinic in North Carolina. The urgent care center had partnered with the North Carolina Department of Health & Human Services, thereby conduction the majority of the Vaccination drives at their care centers. In this case study, we share the best practices applied by our team while billing & coding for COVID-19 vaccination.

This article describes how the MBW accounts receivable and calling team worked to fix the problem in submitting the primary claims to Indiana Medicaid by looking for an alternative way to submit the claims, thereby preventing timely filing issues and obtaining payment duly.

RCM for Specialty healthcare can be daunting to most healthcare organizations, considering the frequent changes in regulations. In addition, it can be complex as it requires attention to financial & administrative challenges that usually have a hyperbolic effect on its financial stability. This article brings you a few revenue cycle management challenges in Specialty Healthcare and a few tools & strategies to overcome them.

Oncology coding requires the knowledge of medical treatment, surgical treatment, snd radiation therapy, and they should be well versed with these areas. Download this guide on Oncology Best Practices to learn more.

Practitioners working on the healthcare revenue cycle need to be conscious of multiple state-specific rules and payer-specific nuances to be successful. AI can help simplify the complexities of today's revenue cycle. The usage of AI in RCM can be a gamechanger and help healthcare entities improve patient experience, improve collections, improve compliance, and reduce their RCM team members' workload. This article will help you understand the use cases for applying artificial intelligence in the revenue cycle.

A credential provider gets an increased number of patients through referrals from payers. Physicians/providers must credential themselves, i.e., enroll and attest with the payer's network and get authorized to provide services to patients who are members of the payer's plans. This article brings a few things that need to be checked off to ensure a hurdle-free credentialing process.

Urology surgery coding requires training & knowledge as the coders have to keep up with thousands of yearly changes made to the ICD & CPT systems. Despite the frequent changes, few guidelines have remained consistent and continue to serve as key urology surgery & radiology coding rules. Download this guide for more information on urology surgery & radiology coding guidelines.

Amidst the uncertainties of the pandemic, our client, a healthcare provider in Central Florida, had launched Covid-19 testing for both insurers and non-insured patients. Although the client got reimbursed successfully for the insured patients' claims, they were looking for a third-party RCM management company like MBW to help them submit claims electronically under the HRSA program. In this case study, read more about how our team helped collect $60k with a first-pass claim submission rate for Covid testing under the HRSA program.

With COVID-19 vaccinations now being administered across the United States, we have compiled these medical coding guidelines to account for the treatment and vaccinations for the novel Coronavirus.

Invalid Diagnosis codes can cause coding errors and inflate claim denial rates. Often, healthcare providers tend to utilize superbills and mark the nearest available codes on the superbills. One of our clients, a podiatry provider, used superbills. The providers habitually marked the 99309 procedure on the superbill and notified the billing team for processing. However, as per Medicare and Medicaid regulations, 99309 and 99252 need to be entered for the claims to get reimbursements. Due to the lack of a clear understanding of the coding guidelines, the providers marked invalid diagnosis codes on the superbill.

Ob/GYN billing & coding can be challenging to most billers & coders due to the global claims, widely varying coverage terms, and multiple tests performed at numerous facilities. Apart from this, many OB/GYN practitioners lack the billing support provided to large hospitals. Learn more about the challenges in Ob/Gyn coding and best practices followed by our coding experts.

Most Central Billing Offices (CBOs) and outsourced billing companies rely on dedicated accounts receivable calling to overcome their receivables' challenges. Running an AR calling team needs a solid understanding of the receivables patterns and diligent processes to follow-up and close underlying issues. In this article, we list some of the critical operational issues and solutions to overcome them.

As of January 1, 2021, there will be significant changes to the office and outpatient Evaluation and Management (E&M) services (CPT ® codes 99202-99215) for both new and established patients. Practices, physicians, and staff must be aware of the modifications to ensure a successful transition next year and avoid any reimbursement disruption. Their clinical documentation systems (EHR systems) need to be adjusted accordingly as per the 2021 E&M changes.

The 2019 Kareo Success Summit offered an opportunity to meet the owners and managers of billing companies that we serve.   Our CEO, Vinod Sankaran, was joined by our COO Melvin Miller, at the Kareo Success Summit, 2019.

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.

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

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 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.

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.

Understanding California, Payer, and Behavioral health-specific nuances and diligent focus on enrollment, timely filing, and payments reconciliations reduced denial rates and increased collections by 52%.