What is Medical Billing Audit? And what is its scope?

Medical Billing Audit is the systematic process of examining and evaluating all billing processes’ effectiveness, accuracy, and compliance. Thus audit of the entire medical billing process  will ultimately help a practice have a superior revenue cycle management system in place, which will aid in maintaining a healthy bottom-line.

Billing Audits are by nature more comprehensive than coding audits.  Hence they cover the entire revenue cycle starting from the eligibility verification process to denial management processes. The audit may examine all clinical records, financial records and policy-related documents reviewed by payors/government. (more…)

What is EHR and medical billing integration

Medical practices struggling with time and energy-consuming paperwork can achieve enhanced RCM metrics by adopting Electronic Health Records (EHR) and integrating EHR and medical billing. Electronic processing of the billing-related tasks, managing claims, payment processing and tracking/reporting problems can be made simpler, accurate and faster through integrated medical billing. EHR is becoming the norm across the healthcare industry, and EHR and medical billing integration is the way forward.

An integrated medical billing system must be able to lead to total automation in a practice. EHR integration requires the medical billing system to have the ability to build charts towards medical claims that include details of patient visits, diagnosis details, lab details, etc. This is to say, all operational dimensions of the practice must be successfully merged into the integrated medical billing solution.  (more…)

Press Release on “Bristol Healthcare Services partners with Papaya to enhance their clients’ patient experience” was published in www.1888pressrelease.com on 27 July 2021.

 Bristol Healthcare Services, a medical billing and coding company located in Los Angeles, California, is pleased to announce that it is partnering with Papaya to enable its clients to offer their patients a better experience while making payments.  (more…)

Medical Billing Reports help a physician to understand the financial health and the business side of the practice. The reports clearly show the different revenue cycle metrics, which indicate the areas of concern needing corrective action and the areas where revenue can be increased. Whether revenue comes from payors or patients, medical reports help a practice stay profitable while delivering excellent patient care.

Listed below are four impactful medical billing reports that will help a physician monitor the practice’s financial health and not leave money on the table. (more…)

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…)

What is 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…)