Laboratory tests were a groundbreaking discovery in the medical industry. Over the decades, testing has helped healthcare providers diagnose different medical conditions to provide a tailored treatment plan and save numerous lives. Regardless of how miraculous this specialty is, the coding guidelines and hundreds of CPT codes do not spare it from the complexity of […]
Laboratory CPT Codes & Guidelines 2024 Read More »
How do you handle patients with more than one insurance policy? It can be frustrating to file multiple medical claims for the same patient manually. However, the process becomes much easier if your client is eligible for supplemental Medicare benefits. This dual eligibility leads to Medicare automatically crossing over your medical claim to Medicaid or
What is a Medicare Crossover Claim? Read More »
Medical billing is an intricate process that can make anyone edgy with varying insurance payer guidelines and ever-evolving billing and coding requirements. Medicare and Medicaid are the two biggest insurance coverage programs administered by the US federal and state governments, respectively. Medicare has over 65 million, while Medicaid has over 72 million beneficiaries. Thus, as
How to Bill Medicare and Medicaid as a Provider? Read More »
If you embarked on this specialization thinking that medical coding and billing for Applied Behavior Analysis (ABA) therapy would be fast and easy, let us set the record straight. It definitely is NOT! In fact, billing ABA therapy services can be harder than conventional medical specialties like OB/GYN and cardiology because evaluation and treatment are
ABA Therapy CPT Codes and Best Practices Read More »
Do you find cardiology billing and coding overwhelming? No judgments! The specialty has its reputation of being complex, and so does the billing and coding workflow. Thus, making mistakes during claim creation is common if you don’t have certified professional coders (CPCs) or billing specialists in-house. But, regardless of how frequently mistakes in claims occur,
Most Common Cardiology CPT Codes and Coding Guidelines Read More »
Credentialing in Medical Billing could be the one thing that stands between you and reimbursements. According to the Medical Group Management Association (MGMA), around 54% of medical practices agree that the rate of claim denials has increased because provider’s credentials are not approved by insurance payers. Don’t let this be your story. Learn everything that
Credentialing in Medical Billing – All You Need to Know! Read More »
Is your practice struggling with a high contractual adjustment rate (CAR), affecting your payment cycle and revenue health? If yes, then this guide is for you! We will discuss what this adjustment means, its rate, industry benchmark, group codes, and allowable rate. Some effective strategies have also been shared to help you improve the contractual
Contractual Adjustment in Medical Billing Read More »
Getting your claim denied due to billing errors like incorrect coding and missing or inaccurate information is one thing. But have you ever submitted a claim to the wrong payer? If you have, then you might already be familiar with the CO 109 denial code. Claim denials are a common problem for many healthcare providers,
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Not knowing the basics about different coding guidelines can keep your healthcare practice away from realizing its deserved profitability, leading to strained cash flow and inefficient operations. Understanding inpatient and outpatient coding is integral to ensuring accurate billing for rendered care services and getting higher and timely reimbursements. Thus, in this guide, we will discuss
Inpatient vs Outpatient Coding: Understanding the Difference Read More »
Insurance policies are already quite complex. To make matters worse, around 43 million people (mostly senior citizens) have more than one insurance plan, according to the United States Census Bureau. Due to this, many healthcare professionals fail to identify their patients’ primary and secondary insurance coverages. As a result, they submit claims to the wrong
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