Whenever a medical facility provides services for patients, a request will be sent, asking to receive money for the services that were provided. This request is known as a medical claim. While many claims can be approved, it’s possible that… Read More
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Comparing Denied Claims With Rejected Claims
Getting healthcare claims submitted is going to take a lot of work. It’s a highly complex and technical process, but if you know the fundamentals of claim submitting, you’ll have an easier time working through it. One critical detail to… Read More
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Mistakes That Substance Abuse Billing Companies Can Make
Insurance billing is a vital part of your daily operations. Helping patients might be the end-all-be-all of your calling, but consistent and proper billing is necessary for the doors to stay open for long. For many smaller offices, staying on… Read More
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Defining Prior Authorization, and When to Use It
Some medical services require prior authorization from an insurance company before they can be performed. This is a critical step within the insurance verification service, wherein a typical healthcare plan will specify what services require prior authorization in their medical… Read More
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Making Your Denial Management Process Better
All medical practices will face denied claims at some point, as much as we try to avoid them. While these denials can’t be prevented in their entirety, there are ways to reduce them significantly. As long as you follow the… Read More
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Why Outsourcing Nursing Facility Billing is a Good Idea
Skilled nursing facility billing is a special kind of medical billing. It’s meant for people who need to be monitored and given nursing care constantly or for people who require perpetual care if they are sick or have a disability…. Read More
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Comparing Medical Billing Claim Denials and Claim Rejections
There are two large obstacles that negatively impact healthcare reimbursements. These obstacles are insurance claim denials and rejections. Many people in the billing industry will try to use these terms interchangeably. However, rejections and denials have distinctions between them, and… Read More
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How You Can Automate Your Denial Management
Do you struggle with your current denial management process? For billing managers, it’s easy to understand how tough it can be to handle denied claims. Denied claims are sometimes hard to detect, and they serve as a constant drain on… Read More
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Putting an End to Physical Therapy Denials
Like other specialties, physical therapy (PT), as well as occupational therapy (OT), have special billing and coding hurdles to overcome. It is not enough to get defensible documentation; you also have to understand the guidelines that all payers follow for… Read More
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When Your Insurance Claim is Denied, Keep These Tips in Mind
The last thing anyone wants to worry about when in need of medical care is whether their health insurance will cover the issue. Unfortunately, there are many reasons a medical claim may get denied. Fortunately, there are ways of potentially… Read More