There are many reasons that a patient might report to a physician and leave the office without a diagnosis – maybe the symptoms are nonspecific, or maybe the patient requires a referral to a specialist better suited to make the correct diagnosis. No matter what the reason, coding and billing these cases can be pretty tricky. Medical claims processing is often a complicated and difficult task, and when no diagnosis is reached, properly coding these cases presents a unique challenge. Coding a claim incorrectly can be costly for both your practice and for the patient. Few things lead to irate
Is Federal Action Needed to Stop Surprise Medical Bills? There is a national crisis brewing in medical claims processing, but the federal government has yet to intervene. Surprise medical billing occurs when a patient gets a bill from an out-of-network provider, despite receiving treatment from a facility that’s within a patient’s health care plan. The provider, which is usually employed by a third party, holds the patient responsible for charges that the insurer won’t cover. The corrupt practice occurs in every state, but only one has been actively keeping track of it and taking measures to stop it.
What the FDA Says About Marijuana Claims When California becomes the eighth state to legalize recreational marijuana in 2018, the pressure will be high for the Food and Drug Administration to start enforcing some regulatory practices – despite its use being a federal crime. More states around the nation are expected to approve cannabis for recreational and medicinal use, which will likely transform medical claims processing for marijuana pharmacies. Though many users and doctors who prescribe medical marijuana are concerned about the FDA’s interference, it may be good news when it comes to getting insurance to cover such
You are diligent in making sure your medical claims are clean and correct before sending them to the payer. You have dependable medical billing software to help ensure casual mistakes caught early on. You may have heard medical claims clearinghouses benefit healthcare providers, but wonder what they might offer that you don’t already provide. Is it worth the additional expense or something your practice can do without? Here are some of the reasons your office can benefit from choosing a medical claims clearinghouse. Records Are Increasingly Electronic Most likely you still send paper bills, but healthcare claims are increasingly processed
You’ve made the decision that using a medical claims clearinghouse is the right avenue to take. Now you have the decision of choosing the right clearinghouse. Where do you start and how do you decide what is the best value for your practice? Here’s how to choose the best option for your facility. Understand How a Medical Clearinghouse Works When healthcare facilities install medical billing software, each claim becomes a file known as an ANSI-X12- 837. Software uploads the file to your medical claims clearinghouse where it is checked for errors, then transmitted electronically to the payer. Each transmission takes
Medical billing is a complex task where many things can go wrong. It takes a seamless, highly efficient system to conduct medical claims processing without critical errors. Even minor mistakes can spell trouble for healthcare providers, insurance companies, and patients. One of the best ways to prevent billing mistakes and payer audits is with regular self-audits. Self- auditing the right way could save your office. Common Billing Errors in Medical Claims Processing To understand the value of self-auditing, first explore the many errors that could harm a physician’s office. Billing in the medical field requires innumerable charts, codes, and communications
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 change is billing. As the field of telemedicine continues to grow, insurance companies and healthcare providers will need to upgrade to claims processing software to optimize modern billing. Tracking Telemedicine’s Recent Growth Telemedicine, or telehealth, has come into its own in the last several years.
The U.S. recently faced back-to- back major hurricanes. Texas and Florida had regions that wereunderwater for days. Several other natural disasters caused serious problems for medicalfacilities. When medical providers are inundated by natural disaster victims, medical claimsprocessing is the last thing on their minds. There are steps health-care facilities can take ahead oftime so they do not lose revenue for their hard work. Preparation should include a plan for how providers will collect information and keep it safe.Medical billing software can help quickly capture patient information and send it electronicallyto the medical billing clearinghouse. Employee portals on their website can
The health-care revenue cycle involves more than just mailing out bills and collecting payments.In fact, one of the most frustrating aspects of running a health-care organization can be trackingclaims throughout their life cycle. An efficient revenue cycle, along with the right claimsprocessing software, can keep things running smoothly. Working with a medical billingclearinghouse can be the first step in ensuring medical claims processing goes smoothly. Here’show to avoid some common mistakes. Understand Revenue Cycle Management The revenue cycle is like a health facility’s circulatory system. It requires that several complexprocesses function together for the overall health of the organization. Providers
Rejected medical claims cost you time and money. However, medical claims processing doesn’t need to be so difficult. Getting a medical claim approved on first submission will make life easier for everybody. Most insurance companies know that if they deny a claim right away, the odds are that they will never have to pay it. These are for-profit businesses, after all. So how do you make sure all of your I’s are dotted and your T’s crossed so that the insurance company can’t reject your claims? In this article, we’ll explore why medical claims are typically rejected on first submission
Health insurance has been a highly debated topic over the past few years. With the Affordable Care Act, we have more insured Americans than ever before. With more people using various forms of health insurance, we also have more insurance claims to file. This often means that medical associations and individual practitioners are getting slammed with more and more paperwork. Medical billing can be overwhelming. Medical claims processing can be a stressful ordeal, so let us help you figure out what you need to know. How medical claims processing works We live in a world where technology is expanding at unbelievable rates.
When it comes to technology, perhaps no industry has been so helped by the advent as the healthcare industry. In particular, the claims audit process has evolved leaps and bounds with the development of software for the job. Processing various claims by hand is tedious, painstaking, and frankly, takes too much time out of your day. In the healthcare industry, there are more things to worry about than audits – but how can you when they take up most of your time? With the right software, you’ll be on your way to rearranging your priorities while still maintaining the accuracy
Medical claims processing can be a costly and time-consuming chore for today’s health-care and medical professionals. It’s a daunting task, but it must be done accurately and efficiently. Here’s the good news — today’s medical claims processing software is easier to use and more effective than it ever has been. The added bonus? It actually lowers costs. Manual Claims Management Costs More Organizations that are filing medical claims manually are spending $4 more per transaction! Depending on the size of the organization that really adds up quickly. Once you factor in the cost of labor on top of that, the costs
These days, more and more people seem to be noticing – and questioning – their doctor’s medical claims processing methods. But figuring out how your practice can cut down on medical billing errors is only a part of the process. When determining how to streamline the business side of your practice there is a lot to think about. In this post, we’re going to clearly outline how the right medical claims processing can increase your bottom line. It can even prevent your patients from challenging your medical bill. 1. Make Sure You Know Each Insurance Policy’s Details Your
Recent findings have proven that medical bills are among the leading causes of bankruptcy. But the high costs of staying healthy aren’t just tough for your patients – they can also be a financial strain on your practice. In this post, we’re outlining the best ways to close the loopholes in your medical claims billing by pointing out common errors and the best ways to prevent them by using electronic billing and tracking software, talking to staff, and more. You can’t afford to skip this article. Tip 1: Stop Pushing Paper It’s easy to make mistakes in your medical claims