Medical billing seems to be a simple process for someone outside this industry. But it is considered a complex structure, consisting of multiple steps such as reconciliation, appeals, denial management, payment posting, etc. Accurate payment posting helps the healthcare provider keep a close eye on the payment received from patients and
According to the Centers for Disease Control and Prevention report, every year, around 139.8 million patients visit emergency rooms in America. This large number depicts the value of effective emergency room medical services. During urgent medical situations, emergency room services stand as a vital lifeline, providing immediate and critical care. This blog
According to a report under the False Claims Act, upcoding crimes results in some serious consequences, such as 5 years of imprisonment and fines worth up to $250,000. These hardcore penalties grab the attention of everyone related to the healthcare industry. Upcoding needs to be avoided in the first place.
Claim denials pose a significant challenge to healthcare facilities, slow down the reimbursement process, and increase the risk of financial loss to healthcare providers. Understanding the common reasons for claim denial and the causes behind them is vital to optimizing the revenue cycle. In this blog, you will understand claim
Understanding downcoding is essential to ensuring accurate and effective claim submission and timely reimbursement. Downcoding has significant implications for healthcare providers. According to medical billing industry reports, approximately 8%–10% of claims are affected by the downcoding. This percentage has increased with the latest updates in ICD10. The result is a revenue loss to
One of the most challenging situations a healthcare facility can face is claim denial from insurance companies. Denials need to be addressed promptly for timely reimbursement. According to the American Medical Association’s (AMA) recent report on the National Health Insurer Report Card, health insurance companies pay 0 percent of the
Recoupment in medical billingRecoupment in medical billing is a process that holds significant value for both healthcare providers and payers. It revolves around the recovery of overpaid payments from the provider. This process occurs for multiple reasons, such as coding errors, duplicate billing, etc. This blog will help you understand
If you are working for any healthcare organization, you must have heard about entity codes. Understanding the basics of these codes is essential for the impeccable functioning of the medical billing process. Entity codes are essential because they ensure that the right provider is billed for the services. In this
If you run a healthcare facility or any other health organization, claim denials must be the tough nut to crack. According to a recent analysis for the past four years, the claim denial rate has increased by 24%. The situation is quite alarming, and we need a firm strategy to
The insurance eligibility verification process includes a systematic evaluation of a patient’s treatment coverage plan. This is a crucial step that must be completed by a professional medical billing and coding team. Completing this step before providing any medical service, such as consultation or procedure, helps avoid claim rejections and denials.
At Medheave Medical Billing, we transform the healthcare revenue cycle with unmatched precision and dedication. As leaders in the medical billing industry, we excel in streamlining complex processes, ensuring accuracy and efficiency at every step.
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