Are you ready to file your claim? Or have you forgotten an important modifier? Choosing the correct modifier can make all the difference, especially if you have performed several procedures on the same patient and within the same visit. Modifiers offer additional information to payers about a service or procedure. The best part is that […]
Modifier 51 vs 59 – What is the Difference? Read More »
2024 has brought many interesting changes, especially in the code set for speech therapy. From eliminating CPT code 92506 and replacing it with four new specific evaluation codes to allowing speech therapists to bill for caregiver training in the absence of patients, the AMA offers a more direct approach toward reimbursements. However, there is one
Speech Therapy CPT Codes for Evaluation and Treatment 2024 Read More »
Just as authors use various circumstances and experiences to provide context in their books, modifiers do the same in medical billing. They provide additional information about procedures or services performed by healthcare providers. Modifiers are concise, two-digit codes that billing specialists pair with HCPCS or CPT codes. They can be alphabetic, numeric, or a combination
What is Modifier 58 in Medical Billing? Read More »
Are you tired of searching for easier and quicker ways to get credentialed with insurance companies? If you are like most doctors, becoming an in-network provider can feel frustrating due to endless paperwork, countless verifications, and tight deadlines. The biggest challenge? Figuring out what the insurance companies actually want. You can find information from various
How To Get Credentialed with Insurance Companies? Read More »
Don’t limit your potential by ignoring claim denials. Did you know that over 86% of denials are easily avoidable? Each denied claim represents a missed opportunity. While this may seem like a minor setback at first, it can quickly lead to significant losses. Unresolved claims can cost healthcare practices up to 5% of their net
Best Denial Management Companies in 2026 Read More »
According to the U.S. Centers for Medicare & Medicaid Services, private and government health insurance payers process over 5 billion medical claims annually. A complaint submitted to the U.S. Department of Justice stated that nearly 95% of these medical claims are transferred electronically via EDI clearinghouses. Since the rise of electronic medical claim filing, clearinghouses
Common Clearinghouse Rejection Codes During Claim Submission Read More »
Coding and its technologies have significantly evolved with time. While these continuous advancements improve the healthcare system in several ways, they also create problems for coders, especially those just starting their careers. As a result, many new coders face productivity issues. This is a major concern because coding productivity is directly linked with billing efficiency.
Tips for Maintaining Productivity of New Medical Coders Read More »
Without vendors, hospitals and small healthcare centers will not have the equipment, supplies, and technology needed to deliver patient care. In the vast and intricate healthcare system, vendors are individuals or entities that provide goods and services to medical facilities, ensuring their proper functioning. However, before a payment contract is signed between the hospital and
What is Hospital Vendor Credentialing? Read More »
Around 14% of patients discharged from hospitals are readmitted within 30 days, and it costs U.S. taxpayers more than $52.4 billion per year to care for the readmitted patients. The U.S. Centers for Medicare and Medicaid Service (CMS) has implemented several programs to reduce the readmission rate of Medicare beneficiaries. Transitional Care Management (TCM) is
Transitional Care Management CPT Codes & Billing Guidelines Read More »
Have you ever wondered how other practices achieved their current revenue growth? Well, they all have one thing in common – an efficient billing process. As the fourth most populated state in the country, New York has over 261 active hospitals. However, complex insurance regulations, high workload, increased scrutiny from payers, and, most importantly, a
Best Medical Billing Companies in New York in 2026 Read More »
