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WHY PRE-AUTHORIZATION IS VITAL IN MEDICAL BILLING MANAGEMENT

What is pre-authorization?

Pre-authorization is the procedure of obtaining prior approval from payors before medical services are rendered to patients. It indicates that the payor confirms the medical necessity of the service, treatment plan, prescription drug, or durable medical equipment being offered/prescribed. (more…)

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Essential steps for smooth Medicare provider credentialing

 

 

Medicare provider credentialing is the process of approving a physician, supplier, or other medical professionals as part of the Medicare supply chain. A credentialed Medicare provider renders medical services to Medicare beneficiaries. 

To get credentialed with Medicare, a provider must fulfill specific criteria to go through the enrolment process. Essential steps in Medicare credentialing are: (more…)

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NAVIGATE DME BILLING WITH EASE

                                                                                          

Durable Medical Equipment (DME) is therapeutic equipment such as nebulizers, ventilators prescribed by physicians to patients having certain medical conditions. However, equipment used for convenience or beyond reasonable medical requirements is not covered under DME billing.

DME billing can be challenging due to constant changes in regulations and documentation requirements. Thorough knowledge of Medicare, Medicaid and commercial payors’ guidelines is necessary for claims to be passed.  (more…)

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