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Latest Updates on Medical Billing

Latest Updates on Medical Billing

Just like any other business, DME providers also need to ensure efficiency and sustainability when scaling up their operations. From established workflows and adherence to documented procedures to the right use of technology and measurement tools, they are always in need of adaptable processes to ensure consistent growth. Challenge  Jeff Bailey, a DME provider from Texas was struggling with non-payment of invoices. Un-billed services and inaccuracies or missing information in claim forms were resulting in

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It is important for practices to create a workflow so that HCC Coding becomes easy to implement. If your healthcare facility is struggling with HCC coding, then it is time to make necessary changes. Only when coding is done with extreme specificity, it will become easy to get a clear picture of the cost and status of the patient’s health. Specificity and accuracy will be needed for getting claims reimbursed by payers. So if you

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24/7 Medical Billing Services, a leading medical billing service provider has announced an exclusive Thanksgiving offer for its clients, offering flat billing at 4.5%. With this super favorable offer, 24/7MBS intends to make holidays more cheerful for its clients by giving them a chance to maximize revenue with professional yet affordable medical billing services. According to Harisudan, CEO, 24/7Medical Billing Services – “All healthcare providers need professional billing services that can integrate seamlessly with their

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With several changes taking place in the Medicare Advantage industry, it has become extremely important for physicians to capture data in a timely and accurate manner. It has become more critical than ever for them to also track a patient’s care and condition over a period of time. If any provider fails to do so, it will become difficult for their practice to remain profitable or survive in business. Especially providers who are looking after

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Did you know, most medical claims are denied or delayed due to gaps in patient information? There are several reasons why this happens. For instance, it can be caused due to incorrect filing of forms during the patient visit, due to failure in updating medical dossier of the patient at the front-desk, lack of pre-certifications or a mismatch between the diagnosis and service provided at the practice. Considering this backdrop, it is imperative for practices

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As per reports, the medical billing outsourcing market in the US is expected to reach USD 7.8 billion by 2026. There is a never-ending pressure on physicians to cut down costs and improve quality of care. They are being expected to perform well amidst declining Medicare payments, growing burden on profits, mounting billing volumes and various other challenges. This is one of the main reasons why providers are increasingly outsourcing their billing activities. ICD-10 coding

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Risk adjustment and HCC coding (Hierarchical Condition Category) model was mandated by the CMS in 1997. Today, the payment model plays a crucial role in insurance benefits and reimbursement scenario. Under this model, a risk factor score is assigned to individuals who have been diagnosed with a chronic or serious illness based on demographics or health conditions. High reimbursement can be obtained only when HCC coding is accurate and there is proper documentation to capture

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CMS uses the HCC (Hierarchal Condition Category) risk adjustment model for estimating the predicted costs for Medicare beneficiaries. The results have a direct impact on the revenue received by healthcare organizations for patients who are enrolled in Medicare Advantage Plan. In order to be successful in risk-based contracts, it is necessary for healthcare organizations to ensure accuracy in clinical documentation. The documentation must reflect clinical needs and diagnoses of patients and must have the necessary

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Compensation of any healthcare organization relies heavily on the accuracy and efficiency of medical coding. If the billing department isn’t well-trained to handle the complexities of coding, it might lead to significant revenue loss. Same is the case with HCC coding (Hierarchal Condition Category) in which each HCC is mapped to a certain ICD-10 code. Many healthcare organizations choose to outsource HCC coding because it helps them get rid of revenue worries and focus on

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Today, healthcare industry consists of complicated and rigid coding rules and loads of administrative burden. This is making providers turn more than ever to medical billing companies for assistance. But what is the future of the billing industry? Will it become bigger? As per reports, by 2026, the U.S. medical billing outsourcing market will reach USD 7.8 billion. Since there is a growing burden on revenue and profits, Medicare payments are declining, billing volumes are

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