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Streamline Your Revenue: Improving Healthcare Claims Denial Management

By Suvarnna Babu April 19, 2024

Healthcare providers face a constant challenge: claim denials. Up to 8% of revenue can be lost due to denied claims, impacting not only an organization's financial health but also its ability to deliver quality patient care. An effective denial management…

Medical Billing vs. Medical Coding in Healthcare

By Anupriya Oraon April 18, 2024

While both sound similar, medical billing and medical coding are distinct parts of healthcare administration that work together to ensure providers receive payment for their services. While both are involved in the revenue cycle, they have distinct functions and require…

EHR Adoption in ASCs: Challenges and Solutions

By Suvarnna Babu April 15, 2024

Imagine a world where patient records are instantly accessible, streamlining care and communication. This is the promise of Electronic Health Records (EHR) systems in Ambulatory Surgery Centers (ASCs). While EHRs offer a clear path to improved efficiency and quality of…

Human Intelligence vs. AI in RCM: Finding the Perfect Balance

By Suvarnna Babu April 8, 2024

The healthcare revenue cycle management (RCM) landscape is in a constant state of flux. New regulations emerge, payer policies shift, and technological advancements offer opportunities for streamlining processes. One of the most talked-about advancements is artificial intelligence (AI). While AI…

How to Avoid Unbundling in Medical Billing?

By Suvarnna Babu April 8, 2024

Ever submitted a seemingly perfect medical claim, only to have it denied for unbundling? It's a frustrating scenario, leaving you wondering where the error lies. Unbundling in medical billing happens when you bill for individual components of a service, rather…

RCM compliance and audits for healthcare providers

By Anupriya Oraon April 5, 2024

The healthcare industry is undergoing a dynamic revolution, and within this transformation, Revenue Cycle Management (RCM) compliance and audits have become critical elements for providers. Striking a balance between financial stability and observing regulations is crucial, impacting healthcare practitioners' livelihoods. …

How to Avoid Up-Coding and Under-Coding in Medical Billing

By Suvarnna Babu April 5, 2024

Imagine a world where every patient interaction translates smoothly into the appropriate financial compensation for your practice. Sounds idyllic, doesn't it? In reality, the intricate dance between medical services and reimbursement hinges on a crucial factor: accurate medical coding. Unfortunately,…

How to Optimize Reimbursement and Minimize Denials in Mental Health Billing

By Suvarnna Babu April 5, 2024

The intricacies of mental and behavioral health billing pose a unique challenge within the healthcare landscape. The consistency often found in billing practices across traditional medical specialties is absent in the mental health realm. In other areas of medicine, a…

Identifying & Addressing Underpayments in Medical Billing

By Anupriya Oraon April 5, 2024

Is your medical practice unsure if it's receiving full reimbursement for services provided? Underpayment in medical billing is a common concern, especially for smaller practices. Unlike denials, where a claim is rejected, underpayments involve receiving less than the billed amount.…

Streamline Your ASC Operations with Efficient Prior Authorization

By Suvarnna Babu April 5, 2024

Prior authorization is a necessary step for ASCs (Ambulatory Surgical Centers) to ensure insurance coverage for procedures. While it helps manage costs, the process can be complex and time-consuming, leading to delays in care and frustration for patients and staff.…