Medical Billing

This article delves into the best practices for managing denied family practice claims in the context of legacy accounts receivable (AR) systems. It explores setting up a strategic denial management framework, which includes conducting a thorough root cause analysis to prevent future denials, and highlights the pivotal role of revenue cycle management in sustaining a …

How to Handle Denied Family Practice Claims in Legacy AR Systems Read More »

With the increasing complexity of healthcare policies and the demands for cost containment from insurance payers, the importance of efficiently navigating the prior authorization landscape has never been more critical. Addressing these issues not only helps in reducing healthcare costs but also plays a pivotal role in enhancing patient access to timely and appropriate care. The forthcoming …

Solving Prior Authorization Issues: Best Practices for Healthcare Providers Read More »

At the heart of this system lies the distinction between professional medical billing and hospital billing—two core components that might seem similar on the surface but encompass distinct processes involving healthcare providers, healthcare insurance, and healthcare professionals. This differentiation not only affects the bottom line of medical services rendered by both physicians and skilled nursing facilities but …

Is Physician (Professional) Medical Billing Different from Hospital Billing? Read More »

This article aims to guide through the A-Z of DME HCPCS codes, offering a complete list and guide that spans from ambulation devices to oxygen equipment and monitoring supplies. We’ll explore categories such as bath and bathroom equipment, bed and bedroom equipment, chairs, wheelchairs, and accessories, in addition to addressing the specifics of oxygen and …

A-Z of DME HCPCS Codes: Your Complete List and Guide Read More »

Medical billing is a critical facet of the healthcare sector, involving the submission of claims to health insurance companies to ensure healthcare facilities are compensated for the services they provide. This process is foundational to revenue cycle management, with electronic medical records revolutionizing the integration of patient information and billing data, thereby speeding up billing processes and …

Why Wenour is Your Best Choice to Outsource Medical Billing Services: Top 8 Advantages Read More »

In the healthcare sector, choosing the right approach to manage medical billing and coding operations is crucial for the financial health and operational efficiency of an organization. In-house medical billing involves utilizing internal staff and resources to handle these operations within a healthcare organization. On the other hand, outsourced medical billing services provide an alternative, allowing an …

Choosing Between In-House vs. Outsourcing Medical Billing Services: What You Need to Know Read More »

Leading and lagging indicators serve as pivotal tools in predicting future outcomes and evaluating past performances, respectively. Leading indicators, by identifying trends and patterns early, forecast future performance and signal potential issues before they escalate. Conversely, lagging indicators rely on historical data to offer insights into what has occurred, aiding in tracking progress with greater accuracy than their leading …

Tracking Lag Days: How Leading and Lagging Indicators Can Transform Your Practice Read More »

Podiatry medical billing is a nuanced field where understanding the specifics of coverage can significantly affect the bottom line of practices. Coverage policies like the exclusion of routine foot care services, except under specific conditions, and the limitations on supportive devices, underline the complexity of medical billing in podiatry. Given these intricacies, it is crucial for practices …

Boost Your Bottom Line: Podiatry Medical Billing Techniques for Successful Practices Read More »

The accurate application of DME modifiers, is crucial for ensuring successful reimbursement for Durable Medical Equipment (DME). The Ultimate 2024 Guide to DME Modifiers sheds light on the significant role these modifiers play in medical billing, targeting a range of types including Modifier 59, XE, XP, XS, XU, CPT, NCCI, and HCPCS Level II modifiers. With the …

The Ultimate 2024 Guide to DME Modifiers: Achieving Success in Durable Medical Equipment Read More »

In an evolving healthcare landscape, the American Medical Association (AMA) continues to forefront efforts in enhancing professional documentation and EM time practices, directly impacting how E/M coding will undergo significant changes in 2024. Through addressing digital medicine adoption hurdles and bolstering resources for medical professionals, the AMA sets a foundational stage for the forthcoming shifts in consultation, documentation, and records management that …

How EM Time Shapes the E/M Documentation and Coding Changes for 2024: A Detailed Guide Read More »