Medical Billing Mistakes that Impact Healthcare Revenue

Rejected and Denied Claims Common medical billing mistakes lead to claims rejections and denials. But just because insurers reject a claim, this does not mean it has been denied. Rejected claims are often not processed because of incomplete or inaccurate patient data or insurance eligibility issues. Often, these claims will ultimately be accepted and paid if the applicable information is corrected and resubmitted to the insurance company. Accurate Information – Begin with the initial contact with the patient and gather information at the time of appointment-setting. Make sure all information is collected and entered correctly, including the patient's insurance and policy numbers, correct spelling of the patient’s full name, date of birth, gender as listed on their insurance information, primary policyholder name and social security number, and billing codes for any services provided to the patient. Eligibility Issues – Front-end staff must verify health insurance status and coverage. Eligibility issues are among the top reasons for claim rejections, and about 8% are rejected because of eligibility problems. Even if an insurance company ultimately determines a claim is not eligible for payment and denies it, the claim can be resubmitted and appealed if additional information can support its validity.

An estimated 49% to 80% of medical bills contain at least one error, and that equates to revenue loss. Every error increases the risk that claims will be denied, and denied claims cost time, money, and resources to correct. Accuracy is critical in every step of the billing process to avoid such loss.  Common medical billing mistakes can wreak havoc on your bottom line and lead to frustration […]

How to Maximize Telemedicine Billing

Telemedicine is no longer just the future of healthcare. In today’s healthcare climate, it is an absolute necessity. As telemedicine, or telehealth, becomes the norm for healthcare providers, those providers as well as insurance companies will need claim processing software that best optimizes their telehealth billing.   Telemedicine’s Growth  Telemedicine, or telehealth, has come into its own in the last several years. Patients are more connected than ever before. They value online reviews, prefer to make appointments […]

Your Guide to Telehealth Billing

The Mayo Clinic defines telehealth as “the use of digital information and communication technologies, such as computers and mobile devices, to access health care services remotely and manage your health care.” Telehealth is often referred to as “telemedicine,” although it encompasses a broader range of services than remote clinical sessions. Not surprisingly, telehealth has exploded […]

How Artificial Intelligence Is Increasing Medical Billing and Coding Efficiency

Medical billing and coding is an essential component of the health care industry, providing a standardized format for determining the costs of different treatments and procedures. However, while these procedures are necessary for providing fair prices to medical procedures, billing and coding is a practice rife with potential for error, which can affect patients, providers, […]

How Blockchain Will Affect the Medical Billing Industry

The term blockchain has steadily worked its way into the modern lexicon thanks to the growing popularity of cryptocurrencies. But managing digital money isn’t all that blockchain is capable of, and industries of every shape and size have started to work on ways to implement blockchain into their work. The medical industry is no exception, […]

How the Medical Billing Outsourcing Market Is Going to Expand

Hospitals and independent practitioners, much as they may deny it, usually run as businesses. Even if their end goals aren’t the same as other private enterprise, private practice operates in much the same way as other private sector industries. What this means, of course, is that the billing department is the lifeline for healthcare. More […]

The Growing Trend of Outsourced Medical Billing

Many medical clinics have already made the change from in-house medical billing to outsourced billing. At this point, there are no clear-cut deciding factors of which method is best. Medical billing operations rely heavily on the needs of individual clinics and physicians. Finding the right answer for your business involves analyzing needs and taking inventory […]

Shocking Number of Providers Still Use Paper Billing

A Navicure survey reveals even though more than half of patients prefer electronic medical bills, 77 percent of providers still send bills through the mail. Researchers also found while only 28 percent of providers keep a patient’s credit card on file to make paying easier, the number of patients who would be willing to use […]

What Makes the Highest-Rated Medical Practice Management Software?

There’s a lot more to running a medical practice than just treating patients. Physicians and administrators balance human resources and ever-changing regulations. They make daily decisions that involve vendor relationships and revenue streams. Technology can make many aspects of healthcare easier with claims processing software and systems that coordinate aspects of patient care. However, many […]

How to Maximize Telemedicine Billing

Telemedicine is not a passing trend. It’s the future of healthcare, with 60 percent of millennials supporting telehealth options and 71 percent desiring a mobile app from doctors as of 2015. There is no stopping the train that is telehealth – there is only acceptance and adaptation. One facet of telehealth that will need to […]