Medical Billing vs. RCM: Unveiling the Key Differences
Medical billing has long been the backbone of healthcare financial operations, but its limitations are becoming increasingly evident in the face of advancing technology. In the pursuit of a more accurate gauge of financial health, healthcare organizations are steering away from conventional medical billing services towards a more sophisticated solution – Revenue Cycle Management (RCM). […]
What is a Value-Based Healthcare: Complete Guide
The healthcare industry has undergone a prominent transformation in recent years, shifting its focus from quantity to quality. This major shift has given rise to value-based healthcare (VBHC), one of healthcare professionals’ most important traits. In value-based healthcare, there are two crucial elements known as electronic health records and revenue cycle management. This comprehensive guide […]
How does Clearinghouse for Medical Claims Work
In this complex world of healthcare revenue cycle management, one important aspect that often goes unnoticed is medical claims processing. Behind every medical procedure or service offered, a complex and detailed system ensures that healthcare providers receive proper compensation. A clearinghouse for medical claims is a central part of this process and an important component […]
A Guide to Understanding Urgent Care Billing and Coding
Urgent care centers have become integral in providing efficient and timely healthcare services, handling millions of patient visits annually. However, the backbone of these centers – medical billing and coding – often faces challenges that can impact the overall efficiency and profitability of the practice. This guide will explore the crucial aspects of urgent care […]
Cracking the Code: ICD-10 and CPT Codes on Superbills Explained
In healthcare billing and medical records, two codes are crucial in ensuring that healthcare providers are accurately compensated for their services. These codes are ICD-10 (International Classification of Disease, 10th Edition) and CPT (Current Procedural Terminology). To improve the billing process, patients and medical professionals should understand how these codes work on superbills. This blog […]
Streamline Your Medical Data Exchange with a Trusted Healthcare Clearinghouse
In healthcare, the exchange of medical data is paramount. Healthcare providers, payers, and patients rely on the seamless flow of information to ensure the highest quality of care and financial transparency. To facilitate this, healthcare clearing houses have merged as invaluable intermediaries, simplifying data exchange, improving data quality, and enhancing patient care. According to the […]
The Rise of Automated Medical Billing: Is It the Future?
The healthcare industry has experienced various engrossing transformations that empower professionals to improve their techniques and meet their goals. One of the most prominent advancements is medical billing software. These software solutions have taken the provider’s manual billing hassles to automated medical billing systems. Gone are the days when healthcare professionals had to use traditional […]
What is coordination of benefits (COB)?
Providers are exceptional at providing care. If there is one area that they find challenging, it is medical billing. With so many regulations and codes, a myriad of jargon and rules could confuse anyone. Coordination of Benefits (COB) is another terminology used in healthcare. In this article, we will walk you through the meaning of […]
What is Prior Authorization in Medical Billing?
WHAT IS PRIOR AUTHORIZATION IN MEDICAL BILLING? In today’s complex healthcare environment, certain medications and procedures require additional steps before approval, such as pre-authorization. But what is pre-authorization? And why do some medical procedures and drugs require it? This article will demystify prior Authorization and its importance in the health sector. WHAT IS PRIOR AUTHORIZATION? […]
List of Common Physical Therapy Modifiers
LIST OF COMMON PHYSICAL THERAPY MODIFIERS Physical therapy is a modest yet gratifying profession. However, it is undeniable that practitioners dedicate considerable time and effort to facilitate optimal patient recovery. The use of modifiers in medical billing can become quite complex, mainly when applied in the context of physical therapy. In medical billing, modifiers are […]