What is the False Claims Act in Healthcare?
Did you know that False Claims Act (FCA) settlements and judgments exceeded $6.8 billion in fiscal year 2025? This huge […]
Billing & Coding Guides
How to Bill Out-of-Network Insurance?
Did you know that insurers of qualified health plans (QHPs) sold on HealthCare.gov denied 36% of out-of-network (OON) claims in
Understanding Merit-Based Incentive Payment System (MIPS)
Did you know that compliance with MIPS costs $12,800 per clinician annually? Besides, physicians spend 53 hours annually on MIPS-related
Understanding Merit-Based Incentive Payment System (MIPS) Read More »
Appointment of Representative (AOR) Form in Medical Billing
Did you know that a beneficiary or supplier can appoint a representative to act on their behalf for requesting an
Appointment of Representative (AOR) Form in Medical Billing Read More »
Understanding Healthcare Claims Data Analytics
In this Age of Information, data is power. It is a strategic asset that entities and individuals use to gain
Prior Authorization Challenges in Ophthalmology Practices
In the United States, every 2 out of 3 adults have eye or vision problems. Still, a majority of them
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Prior Authorization Challenges in Dermatology Practices
Did you know that dermatologists earn an average of $240,000 to $500,000 annually? Sounds like a lot of money, doesn’t
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Understanding the Medical Billing Revenue Cycle
The financial management of a healthcare practice or medical facility involves a deep understanding of the revenue cycle. The entire
What is HCC (Risk Adjustment) Coding?
Did you know that hierarchical condition category (HCC) coding relies on ICD-10-CM codes to assign risk scores to patients? But
Best Practices to Reduce Claim Denials in Healthcare
Did you know that on average, 41% of healthcare providers face claim denial rates of at least 10%? Even though
Best Practices to Reduce Claim Denials in Healthcare Read More »
