Medical Billing FAQs

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 […]

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

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

Are you tired of trying but not succeeding? Do you dream of someone who can manage the non-clinical side of your medical practice so you can focus on patient care? Then, we are the bearers of good news.  A medical practice management consultant can trigger 360-degree business transformation and take your practice to new heights.

People around you may be using ERA and EOB interchangeably. However, we are here to tell you that both EOB and ERA are different documents that serve distinct purposes in medical billing.  What is ERA in Medical Billing? Electronic Remittance Advice (ERA) is the electronic version of traditional paper-based Explanation of Benefits (EOB). An insurance

How often do you receive prompt payments for your services without any rejections? Payers deny most medical claims due to billing errors, such as incomplete or missing patient information, mismatched coding, lack of pre-authorization, and missed deadlines. The problem is so severe that according to Premier’s voluntary national survey of 2023, insurance companies, on average,

Every year, hospitals in the USA report nearly $50 billion in bad debt, and 30% of the hospitals (one in three) incur a bad debt of over $10 million. That’s a lot of money being written off!  Write-offs in medical billing are a frequent occurrence. While some write-offs are happily agreed upon by the provider

Many tasks and actions like construction, business operations, and large public gatherings require permission. In medical billing, healthcare providers also need permission to perform certain procedures or services. This extra step is called pre-authorization (PA), or prior authorization in medical billing. But why is authorization so important in medical billing? Insurance companies use the prior

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

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