Medical Billing and Coding Resources
A strong understanding of various codes that Medical treatments comprise of is required to be able to successfully bill the claims. It is important for practices to bring in reliable and expert vendors to handle billing, to overcome unique Medical billing challenges. Outsourcing Medical billing services can reduce practices’ overhead costs, increase reimbursements, decrease claim denials, and rejections. This can enable practices to focus more on their patients rather than spending hours constructing and interpreting the billing reports.
Beginning January 1, 2022, psychologists and other health care providers will be required by law to give uninsured and self-pay patients a good faith estimate of costs for services that they offer, when scheduling care or when the patient requests an estimate. This new requirement was finalized in regulations issued on October 7, 2021. The […]
Medical billing reports show you how your practice is performing on important revenue cycle metrics, whether claims are being paid in a timely fashion, and how well insurance carriers are paying you for key procedures. Depending upon medical specialty and size of practice, there are different formats of medical billing reports. In this article, we […]
Outstanding accounts receivable in healthcare are one of the most critical issues that the healthcare industry faces today. Organizations are often seeking the right answers to reduce their receivables for over 30 days and also the way to prevent them from happening in the first place. Accounts receivable (AR) over 90 days is a key […]
Eligibility and Benefits Verification Eligibility and benefits verification can be complex, with patients taking on more payment responsibility and frequently changing insurance providers. You need to identify coverage fast and reduce the number of claims being denied on the back end due to inactive insurance or non-coverage. There are many things that can influence the […]
Missing/Invalid Payer ID: This rejection is stating that the payer ID that was used on the claim is not a valid payer ID for electronic claims submission through your billing software. Claims are most often rejected due to incorrect or invalid information that does not match what’s on record with the payer/insurance company. Medical claim […]
Invalid Mbr: It means the insurance company cannot find the member. With this type of error, you may need to call the insurance company to check on why they cannot find the member. There might few reasons why you may be getting this error. While on the phone with the insurance company, open the copy […]
Definition of Accounts Receivable (A/R) The term A/R days or accounts receivable days may be defined as the number of days that a medical billing office/hospital takes to collect the outstanding amount from an insurance carrier for all the services it provides to insured patients. A/R days are calculated for the time period of 3 […]
It’s no secret that missed appointments are a source of frustration to every practice. From the wasted preparation time to the lost revenue, a no-show can throw off the flow of your practice. Whatever the cause, from lack of transportation to forgetfulness or financial issues, you will reduce the number of patient no-shows in your […]
Basics of CMS 1500 Most insurances allow you to send an electronic version of CMS 1500, called an 837 file. But, unfortunately, some paper-only payers are still hanging around, and they require that billers print and fill out the entire form. The bad news is that you can’t just look up a PDF of the […]
Supplemental Information in Item 24 Supplemental information in Item 24 could be confusing. Sometimes, to process a medical claim this supplemental information is required. Without this supplemental information CMS 1500 form is considered incomplete hence can’t be processed. We have shared all required information along with examples. Kindly note that following examples demonstrate how the […]
