Outsourcing Medical Billing and coding

  Undoubtedly, healthcare providers encounter major difficulty when faced with denied claims as effective management helps prevent notable revenue losses. The initial denial rate exceeds 20% of all claims, according to the American Medical Association study, and most claims are never resubmitted, leading to financial losses for healthcare providers. Studies indicate that insurers maintain 59% of claims rejected by providers throughout the appeals process. The evidence demonstrates strong reasons to implement effective  denial management systems and accounts receivable (AR) follow-up  methods to generate higher revenue and decrease financial risks. Understanding Denial Management and AR Follow-Ups The strategic components of revenue cycle management depend on denial management and AR follow-ups. In fact, an understanding of denial management systems and their operational methods can help healthcare providers minimize financial setbacks while maintaining smooth claim op...

  The healthcare industry relies heavily on medical coding since it is responsible for documenting medical services, diagnoses, and procedures for billing and reimbursement purposes. Out of the multiple coding systems, three basic code sets—CPT (Current Procedural Terminology), HCPCS (Healthcare Common Procedure Coding System), and ICD (International Classification of Diseases)—are commonly applied in medical billing and healthcare documentation. In fact, it is crucial to ensure correct and precise application of such codes to avoid claim denials and ensure optimal reimbursement for medical providers. These coding systems need to be understood to ensure a smooth and seamless  revenue cycle management . What Are CPT, HCPCS, and ICD Codes? Each of these coding systems has a specific role in healthcare billing and documentation. Understanding the distinctions between them is essential: ·         CPT (Current Procedural Terminology): ...