Tag Archives: medical billing

Just Following Orders isn’t a Defense to Fraud

A case from North Carolina highlights what we see too often: healthcare entrepreneurs and providers committing fraud, paying monetary penalties and even facing incarceration. But rarely do we see the penalties travel down the ladder to a company’s employees. A … Read Full Post

Tagged fraud, medical billing |

ICD-10-CM Adds 1468 Codes for 2023

Every year, we’re curious to learn about the changes to ICD-10-CM codes that become effective on October 1st, and this year, there are many interesting additions. Of course, our company looks at codes primarily through the risk adjusted payment lens, … Read Full Post

Tagged ICD-10 Changes, ICD-10-CM Codes, medical billing, mra |

Make 2022 YOUR Year: Set Goals to Tackle Billing No-Nos

Earlier this year, we wrote a series of eight blogs, each highlighting a mistake that medical practice owners and administrators make, and as we wrap up the second weirdest year in our recent history, we thought we’d revisit them and … Read Full Post

Tagged accounts receivable, billing dept., credentialing, eligibility, medical billing, mra, payment plans |

The Investment in Certified Personnel

Some of our clients are reluctant to employ certified coding and billing professionals, believing that anyone with some training can perform the two most crucial medical practice functions after patient care. They usually live to regret this short-sighted perspective, regardless … Read Full Post

Tagged certified biller, certified coder, medical billing |

Billing No-Nos: Selective Billing Activities

Much in the same way no one instrument is the most important in an orchestral piece, so no one aspect of the billing process is the most important. The stops along the billing route all contribute to the steady flow … Read Full Post

Tagged documentation, medical billing, medical claims, patient statements, payment denials |

Billing No-Nos: Ignoring Your A/R – Part 1

Quick… off the top of your head, what’s the approximate dollar value of your practice’s accounts receivable (A/R)? Many providers (and administrators!) will say they don’t know. Our question to you is: why not? In Part 1 of this two-part … Read Full Post

Tagged accounts receivable management, fee schedule, medical billing |

Billing No-Nos: Having the Billing Dept. Transact MA Encounters

Medicare Advantage (MA) plans are paid by the Centers for Medicare and Medicaid Services (CMS) based on the member’s severity of illness as conveyed by codes from the International Classification of Diseases, 10th Revision or ICD-10-CM that map to the … Read Full Post

Tagged FFS, medical billing, medicare advantage, risk adjusted payment |

What We’re Reading – The Power of Outsourcing in Your Medical Practice

Do you ever feel that there aren’t enough hours in the day to get everything done? Join the club! These days, more and more office managers and/or administrators express that despite supposed electronic efficiencies, they are drowning in all the … Read Full Post

Tagged credentialing, medical billing, medical billing outsourcing, medical practice, outsourcing |