It has been brought to our attention that there is quite a bit of confusion surrounding CO 253, a Claim Adjustment Reason Code (CARC) that appears on the Remittance Advice (RA) when Medicare sequestration, a 2% reduction to the final amount, is applied to a Medicare Fee-for-Service (FFS) claim. Often perceived as the CO 253 […]
Is CO 253 Really a Denial Code? Let’s Clear the Confusion Read More »
Are you confused about how to evaluate your medical billing workflow performance? Key performance indicators (KPIs) for medical billing are the solution you are looking for! These metrics can help you identify areas of improvement and optimize your process for optimal results. The next question that pops into your mind must be, HOW? Don’t worry!
KPIs and Metrics to Track Medical Billing Performance Read More »
Did you know that medical billing is only a single element of revenue cycle management (RCM)? However, both of them are essential for sustaining your practice. While medical billing specifically deals with medical claims, RCM is a comprehensive financial process. It optimizes the entire financial arm of a practice to maximize revenue. We all understand
Medical Billing vs. Revenue Cycle Management Read More »
You may find it hilarious and ask why a healthcare practice would downcode their services. BUT! It is a significant medical billing error that can impact the healthcare facility’s financial health, hurt patient care, and lead to legal repercussions. Thus, we have curated this comprehensive guide to help you understand downcoding in medical billing. We
Downcoding in Medical Billing and Its Impact on RCM Read More »
The dermatology industry is booming. Thus, as a dermatology practice or a dermatologist, you may have experienced patients crowding your front door as the demand upticks. This rise in demand should have positively impacted your revenue, but if it’s the other way around, you may need to take a step back and analyze what is
Dermatology CPT Codes and Billing Guidelines 2024 Read More »
What is upcoding in medical billing? Well! It is a coding error that can make insurance companies pay more than what they owe the provider. But things are not as simple! This coding error can also be termed fraudulent activity, costing you your reputation and resulting in heavy penalties, such as cancellation of your practice
What is Upcoding and Unbundling in Medical Billing? Read More »
Identifiers are necessary for processing online information. An entity code is exactly that! This medical identifier labels different entities (individuals) involved in the billing process, including healthcare providers, such as doctors, hospitals or clinics, patients, insurance companies, or a third-party billing service. If you are a healthcare or medical billing professional, you might already understand
What is an Entity Code in Medical Billing? Read More »
Hospital and professional billing are a part of medical billing, but both are used in different settings and for different services. This guide will break down the key differences between hospital billing and professional billing and how they can be used in combination in different scenarios. What’s more? Both professional billing and hospital billing services
Hospital Billing vs. Professional Billing Read More »
Collecting outstanding balances from patients is challenging, but it is also essential to keep your practice afloat. It is difficult to pay the bills and provide quality care services without a steady cash flow. Thus, this guide will discuss the best strategies to maximize patient collections. That’s not all! We will also walk you through
Strategies to Maximize Patient Collections Read More »
Healthcare facilities struggle to stay profitable amidst reimbursement cuts and ever-evolving regulations. A/R, or accounts receivable in healthcare, is one of the many metrics that need constant monitoring to avoid flushing your rightful payments down the drain. This comprehensive guide will explore it in detail. We will start by discussing what is A/R and what
What is Accounts Receivable (A/R) in Healthcare and How to Improve It? Read More »
