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How payment posting is an analytical tool in medical billing

The medical revenue cycle is a long and complex process. At the end of a medical billing cycle, a patient’s payment records are posted in the patient’s account. Payments can be from both patient and payor. This stage of the billing cycle is called payment posting. Although appearing to be a simple task, accuracy and attention to detail are required besides being time-consuming.

Payment posting will reveal if there are under-payments by payors. Payment for every line item should be closely monitored for issues. Appropriate and immediate action should be taken to resolve the problems. (more…)

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What are the major challenges in physician credentialing?

Credentialing is the process of checking a provider’s competency, as demonstrated by education, training, licensing, and work experience. The Credentials Verification Organization will directly ascertain the medical provider’s education, training, licenses, work history and malpractice history.

Physician credentialing is essential to all parties in the healthcare industry. Hospitals and clinics are guaranteed quality care from the physicians they hire. Physicians, when credentialed, can become part of an insurance company’s network. Medical Credentialing assures patients that the healthcare industry is maintaining the highest standards of care. (more…)

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3 TIPS TO INCREASE REVENUE

Medical professionals go through a long period of training before they can take care of patients. The rigorous training prepares them for a life of service to others. Sadly they are ill-prepared to take care of the business side of their practice. Here are three tips that will help you to increase revenue.

1) Robust knowledge of processes

The primary and the most crucial aspect of reducing claims denials and improving medical practice revenue is understanding the medical coding and billing process completely. Medical billing and coding processes are rather complex and require that the individuals handling them be knowledgeable and aware of the industry’s constant changes. This requires an understanding of the insurance policy, the rules for processing a claim and a thorough knowledge of ICD-10, CPT, HCPCS and HCC. Finally, an excellent Revenue Cycle Management tool is needed for managing the entire process. Since every payor has its policy, it is imperative to understand their rules and regulations for processing claims. Equally, one should keep abreast of the changes introduced by payors. Such knowledge makes sure that claims pass through the system with minimal issues/denials, thus exponentially increasing revenue. Studying and analyzing past denials helps discover trends, which ensures that mistakes/omissions do not recur.  (more…)

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