Medical Billing FAQs

Did you know that, as of 2024, 317,545 laboratories are currently registered with CLIA, including both exempt and non-exempt facilities? The Clinical Laboratory Improvement Amendments (CLIA) of 1988 comprise a set of regulations that apply to all U.S. facilities that test human specimens for health or disease assessment. The Centers for Medicare and Medicaid (CMS), […]

Did you know 82% physicians in the United States agree that pre-authorization requirements sometimes force patients to abandon care? This might bring you to the million-dollar question: In an emergency, should the provider wait for payer approval or do what they pledged, i.e., save lives? Definitely, patient care should be prioritized! There is a process

Did you know that the Recovery Audit Contractor (RAC) audit program was introduced as a pilot project in only three states in 2005? These states were New York, Florida, and California.  It was initiated to find and correct improper payments made in the Medicare program. Between 2005 and 2008, $693.6 million was returned to Medicare

Are you confused about what an ABN is and when you should issue it? This guide will discuss everything you need to understand the CMS-R-131 form, from its components to its applications. However, before we go into the details, let’s first understand what exactly it is. ABN stands for Advance Beneficiary Notice. It is issued

Running a healthcare practice involves more than just patient care. It demands a strong understanding of the rules that govern reimbursement collection. Navigating the world of medical billing can feel complex, but staying compliant is essential for your practice’s financial health and reputation.  This guide will break down the core concepts of medical billing compliance.

Navigating the complexities of modern healthcare demands more than just clinical expertise. Providers and practices face mounting administrative burdens, particularly when it comes to revenue cycle management.  Ensuring timely and accurate reimbursement can feel like a constant uphill battle. But what if there was a strategic partner designed to shoulder these non-clinical yet critical tasks? 

Imagine receiving a recoupment request from an insurance payer in your mailbox or on your electronic health record (EHR) system, notifying you that $2,500 will be deducted from your next reimbursement. How would you feel? Shocked and appalled, right? Most probably, the first question on your mind will be, BUT WHY?  We are here to

Medical coding becomes more complex as you try to understand its various concepts. You start by understanding how the different coding systems work and the concept of modifiers to ensure coding specificity.  However, if you are a healthcare provider just kickstarting your career in the healthcare space, you may not know that you have to

Did you know that around 43 million people in the U.S. had multiple health insurance plans in 2021? Many people enroll in more than one insurance plan due to broader coverage. If you regularly attend to such patients, have you ever wondered how multiple insurance companies work together to cover the costs? The answer is

Wondering why your healthcare provider gave you a receipt instead of your insurance company? Or, as a healthcare provider, have you ever thought about creating an effective superbill? We aim to clarify this confusion! Adding the right prefix can make anything sound important (we all know about Superman). However, a superbill is more than just