What is Prior Authorization in Medical Billing?
Prior authorization or pre-authorization is a requirement from health insurance companies to ensure costly procedures are medically necessary. Doctors or medical providers are required to obtain prior approval before proceeding with a variety of procedures, diagnostics, medical devices, and prescription medications. Without proper pre-authorization in medical billing, there’s a chance of denials, required follow-up, or […]
When Does the Revenue Cycle Begin in a Healthcare Facility?
The revenue cycle in healthcare typically begins when your patient makes an appointment with your facility, and it ends when you received full payment for any services you’ve provided. While the process itself is typically straightforward, there are quite a few areas where you may face challenges. At TempDev, one of our goals is to […]
What Functions Impact Your Medical Practice Revenue Cycle the Most?
Healthcare is complicated, with challenges you must address with your medical practice revenue cycle. With 320 million Americans and more than $3 trillion spent every year on healthcare, there are lots of moving parts to consider. As you work to optimize your medical practice’s revenue cycle management, you first need to understand the functions that […]
What Does Coordination of Benefits (COB) Stand for in Medical Billing?
Patients may enroll in multiple insurance plans, which may mean that there is an overlap in their benefits. With 41% of Americans (72 million people) experiencing medical billing issues, coordination of benefits issues is just one problem you’ll deal with. When you face a COB denial of the claim you send to the insurance provider, you need to know […]
What Does HCPCS Stand for in Medical Billing?
The Healthcare Common Procedure Coding System or HCPCS is a collection of standardized codes produced by the Centers for Medicare and Medicaid Systems (CMS). As part of the annual release, CMS distributes code sets that detail the procedure and modifier codes with descriptions, coverage, and pricing that are able to be billed on a claim. […]
9 Proactive Medical Billing Tips to Maximize Revenue
Your practice needs revenue to be able to care for your patients. Better medical billing processes can increase your revenue without sacrificing patient care. Here are nine proactive medical billing tips to help boost your revenue cycle. Medical Billing Tips to Improve Patient Revenue Many practices struggle with bad debt from patients unable or unwilling […]
Do Medical Bills Affect Your Credit?
Medical bills can sometimes take patients by surprise. In early 2022, almost half of the adults in the US reported difficulty affording medical costs. Because insurance coverage differs, providers and practices cannot always produce accurate estimates of medical bills upfront. Patients may struggle to pay when medical bills arrive, leaving them wondering—do medical bills affect […]
What Is Upcoding in Medical Billing?
Medical billing takes data from your office visits and turns it into revenue for your practice. It is a core component of your practice’s administrative functions. But medical billing is not always straightforward. If your physicians are paid based on the diagnosis and procedure codes they bill, they have an incentive to upcode. So what […]
Revenue Leakage: What Is It and How To Stop It
Healthcare practices receive most of their revenue as reimbursement for services already performed. As a result, revenue leakage leaves your practice underpaid, making it harder to serve your patients well. Here is what your practice needs to know to identify and prevent revenue leakage. What Is Revenue Leakage? Revenue leakage occurs when your practice provides […]
How Are Medical Records Important in Revenue Cycle Management?
The electronic medical records (EMRs) market is expected to reach more than $36 million in revenue by 2026. Maintaining proper medical records in the revenue cycle is crucial because it is such an important cross-section of what you focus on as part of your daily routine. Already more than 89 percent of physicians use EMR or electronic health records, […]