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Latest Updates on Medical Billing

Latest Updates on Medical Billing

Did you know, in 2015, Medicare lost $3.2 billion due to improper medical billing for DME claims? Even today, DME suppliers have to encounter heightened scrutiny of their claims for obtaining Medicare payments. In order to receive timely payments, it has become imperative for DME suppliers to demonstrate medical necessity of the durable medical equipment. Without securing and retaining the right documentation of medical necessity, obtaining Medicare payments can become a nightmare for those involved

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In order to survive 2019 and get timely payments, DME billing service providers will have to primarily focus on error-free coding. DME coding intricacies are deep rooted in HCPCS (Healthcare Common Procedure Coding System) Level II codes and policies by Medicare. Providers will have to hire DME coders who are experts at assigning the right HCPCS Level II codes for timely and error-free billing. They will have to have a good understanding of Medicare policies

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Ambulatory surgical centers in the USA have not shown any significant growth in the past few years. Many of them either closed down or merged with bigger medical groups due to revenue issues. According to Pro-vista Report of ASC Survey Findings, reimbursement is the biggest challenge faced by ASCs across the country along with management of days in A/R. 2019 will demand effective revenue cycle management for ambulatory surgery centers. This is because even after changes

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As per the U.S. Physician Employment Report, conducted by Doximity, physician employment opportunities increased by 7% in 2018. In 2017, this employment growth rate was 5.1%. As per another survey conducted by Physicians Foundation in 2017, more that 57% of physicians were employed at hospitals and medical groups, whereas only 32% were independent practice owners. Results from these surveys are a clear indication that physicians are opting hospital employment over private practices. Here are some

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2018 witnessed many changes, from rise of automation to increase in medical billing outsourcing. With the advent of 2019, it is a critical time for every provider to look out for latest changes in medical billing services. For healthcare practices, efficient revenue cycle management is the most important element of success and in order to achieve a seamless cashflow, practices will have to focus on having systematised medical billing. Following are few of the key

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For many healthcare providers, maintaining optimal cash flow and improving payment collection has become a challenge. They are losing money due to lack of rigorous and regular monitoring of their revenue cycles. Mentioned-below are six key revenue cycle performance metrics that should be discussed and analysed monthly by practices: Number of days in A/R. This is one of the most important metrics that helps in understanding the efficiency of the current revenue cycle. Calculating the

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As per a survey conducted by Black Book Market Research, outsourcing of complex claims to a specialized medical billing company increased from 20.4% in 2013 to 39.8% in 2016 for almost all US hospitals. Why is there a steep rise in outsourcing medical billing? In the following paragraphs, we will try to understand why most of the medical practitioners are choosing outsourcing over having an in-house billing team. Understanding In-house billing Setup and Running Costs

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As per Medliminal Healthcare Solutions (MHS), at least four in five medical bills have mistakes, which costs US$68 billion annually in unnecessary healthcare expenditure by doctors and patients alike. A lot of medical practitioners are thus choosing to outsource their billing needs to a medical billing company rather than going for an in-house team. However, both in-house and outsourcing have their benefits and complications. There are a few challenges involved in outsourcing billing services rather

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According to a consumer credit report survey by CFPB (Consumer Financial Protection Bureau), approximately 42.9 million people with credit records have outstanding medical bills. This is a clear indication that collecting money from patients is a serious challenge for most practices. In an article published by the MGMA (Medical Group Management Association) there are various challenges due to which practices fail to collect money from patients, ranging from high deductible plans, nature of patient expectations,

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