Introduction The complex landscape of medical coding and billing has taken on a critical role, particularly in the context of the ongoing COVID 19 pandemic. Adapting to the changing dynamics of healthcare is crucial for accurately documenting tests, treatments, and diagnoses related to the virus. Healthcare practitioners have integrated new codes and guidelines, often sourced […]
Introduction The evolving landscape of healthcare encourages continuous adaptation, particularly in the area of Acute Respiratory Infections (ARIs) and their complicated billing procedures. This article explores different aspects of Acute Respiratory Infections and the associated billing challenges under the billing guidelines 2023. It also provides an in-depth exploration of the changes and updates that define […]
Introduction The field of molecular medical billing is growing due to the expanding genetic testing industry. Despite being relatively new, genetic testing is rapidly gaining popularity. It offers patients fact-oriented lab results that help in making rational medical decisions. Molecular testing also helps healthcare providers in recommending preventive care, monitoring, and treatment based on genetics. […]
Introduction Current Procedural Terminology (CPT) is a fundamental coding system used within the healthcare industry. It was established by the U.S. Department of Health and Human Services under the Health Insurance Portability and Accountability Act (HIPAA) to provide a standardized coding set for wide-ranging procedures used by healthcare professionals. CPT codes are maintained and published […]
Introduction Diagnostic codes are assigning unique codes to patient diagnosis, treatment, or procedures selected to cure the patients. The codes ensure accurate documentation, analysis, and patient condition tracking. It is a process of information that represents fixed or recorded statements. In the healthcare industry, such procedures are termed diagnostic coding. Insurance companies and healthcare industries […]
Introduction Claim scrubbers play a crucial role in the medical billing process as they are designed to meticulously scan claims for errors before they are submitted to payers. These claim scrubbing automated software programs are responsible for ensuring that all information on the claim is accurate and complete, including patient demographics, diagnosis codes, and CPT […]
Introduction Denial codes refer to specific codes healthcare insurance companies assign to indicate problematic insurance claims. These codes briefly describe the reasons and remark codes that provide insights into why patients’ treatment expenses are unable to be covered under the existing circumstances. These error codes provide descriptions that are causing claim denials. Denial codes are […]
Introduction Financial management has a pivotal role in medical billing and revenue cycle management. However, it is inevitable for contemporary healthcare organizations to adopt the emerging trends of financial management practices. These practices should be incorporated into the organization’s strategy to gain the best revenue management results through business growth and revenue generation in the […]
Introduction Entity codes have been used in medical billing to identify the entity billing for solutions. The billing office, healthcare professional, and payer allocate these codes. If it codes incorrectly, then an incorrect entity may be billed. It is also possible to face trouble from Medicaid and Medicare programs. Because the billing processes of different […]
Introduction Medical billing is all about converting a medical procedure into transaction codes. Professional medics use these codes in claiming reimbursements. In other words, medical billing is all about securing the payment for a service provided by a doctor to a patient. This process might look simple for a medium-sized hospital, but it becomes complex […]