third-party payer appeals

6 Tips for Successful Third-Party Payer Appeals

When even the slightest mistake on a claim form can lead to a denial or reduced reimbursement, you need to be on your toes. The good news is with some leg work third-party payer appeals can get you paid more of what you are due. While third-party payer appeals are a time-consuming complex process, they’re […]
Credentialing tools

Credentialing Tools: Checklists and Programs to Speed Applications

Your provider cashflow comes to a screeching halt when you fail to secure timely, accurate credentialing. You have to keep track of a lot of steps and forms to ensure timely insurance enrollment and hospital privileges. Streamline the process. Top insider scoop on the best tools you should use. Credentialing Tools to Track Moving Parts: […]

Bust 3 Myths to Boost Pay for Your Fee-for-Compensation Physicians

Are you billing for fee-for-compensation services correctly? Many practices aren’t — and that means leaving money on the table. In today’s healthcare market, that’s not something you can afford to do. Unfortunately, fee-for-compensation billing is often misunderstood, so many practices aren’t getting all the reimbursement they deserve. Plus, incorrect or non-compliant billing practices can catch […]
medical collections front desk helping patient

5 Tips to Prevent Unpaid Medical Collections – Supercharge Your Staff

For years, deductibles were so low. Payers paid most of the patient responsibility on claim submission. Those days are obviously gone putting the onus on your practice’s medical collections to keep your revenue stream healthy. “Most patients maybe had a $250 or $500 deductible,” recalls medical collections expert Tracy Bird, FACMPE, CPC, CPMA, CEMC, CPC-I, […]
provider credentialing

New Provider Credentialing: Your Top 10 Questions — Answered!

Does even thinking about new provider credentialing give you a headache? Sure, you’re anxious for new providers to start generating revenue for your practice. But you’re also dreading those long, complicated forms that are so easy to mess up. Credentialing is anything but simple. One misstep, and your practice’s revenue cycle will slow to a […]
Claim form errors

Best Practices to Avoid Costly Claim Form Errors

Everyone makes mistakes. Unfortunately, sometimes small mistakes will cost you big time. Such is the case with claim form errors. The CMS form 1500 is your primary means of getting reimbursement from Medicaid, Medicare, and Tricare. Even a minor claim form error can delay processing and payment or worse—lead to denial. On the flip side, […]
Medical coding and billing

What Type of Education Is Needed for Medical Billing and Coding?

Pursuing a career in medical billing and coding can be one of the most rewarding experiences in your life. This is a serious and complex field that is becoming more and more competitive. You don’t have to be a doctor or a nurse to help thousands of patients, because you can contribute quite a lot […]
Modifier 59 Separate Is Key

Solve Your 5 Biggest Modifier 59 Problems by Focusing on ‘Separate’

If you’re using Modifier 59 to get paid for multiple procedures, auditors are watching you. Modifier 59 has been on the OIG’s (Office of the Inspector General) radar for a while now, and because of consistent misuse and abuse, it will likely stay that way. Modifier 59 allows you to unbundle — separately report and […]
Medical Credentialing Doctor With Credentials

Medical Credentialing: What Is It & Why Is It Important for Reimbursement?

Without proper medical credentialing, a medical practitioner legally cannot work at a hospital or partner with insurers. Having medical staff credentialing training is crucial to ensure staff properly attain and maintain physicians credentials. Only a new physician or practitioner who is credentialed is allowed to see patients, receive insurance reimbursements, and treat hospital inpatients. Fail […]