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Define CPT Modifier. | How is it Essential for Accurate Medical Billing and Coding?

Accurate billing and coding are critical in healthcare medical processes. The CPT modifier is one key element that ensures medical claims are processed correctly. These two-digit codes provide extra information about the services healthcare providers offer. By using them correctly, providers can get adequately paid for their services, avoid having claims denied, and follow the […]

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Role of ClearingHouse during Claims Submission

A clearinghouse is a third-party service during claims submission and a central medium between healthcare providers and insurance companies. It plays a vital role in medical claims and healthcare billing. The clearinghouse efficiently manages payment transactions between healthcare providers and insurance companies. Moreover, it facilitates their clients ‘ smoother communication and provides faster reimbursement, reducing […]

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What is Bundling and Unbundling in Medical Billing?

Bundling and unbundling are two widely used terms in medical billing. Medical billing services providers use appropriate methods to describe their payment methods to insurance companies and some government programs. Billing accuracy depends on the accuracy of the CPT code. Healthcare service providers analyze a patient’s record and then choose the correct code that completely […]

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Benefits of Electronic Medical Billing Services

Electronic medical billing services offer many benefits. Medical billing service providers are also changing as the world moves from traditional paper-based systems to electronic or digital systems. Electronic or digital billing helps healthcare providers improve their management processes, reduces administration costs, and enhances patient care.  This article will explore the advantages and benefits of electronic […]

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Guide to Insurance Eligibility Verification in Medical Billing

Insurance eligibility verification in medical billing refers to the process in which the team members of medical billing understand entirely the patient’s insurance coverage for medical services. They also cover the financial responsibility of the patient. Before the medical services are scheduled, complete the patient’s verification. Let’s start to understand the insurance eligibility verification.  Importance […]

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In-House vs. Outsourced Medical Billing

Medical billing is submitting and following up on claims to insurance companies to receive payments for healthcare services provided to patients. The main goal of medical billing is to ensure that healthcare providers receive complete and accurate service payments. Efficient medical billing enhances patient satisfaction by providing accurate billing information.  In this blog, you will […]

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Types of Denials in Medical Billing: A Complete Guide

Medical billing plays a critical role in the healthcare system. It ensures that healthcare providers get paid for the services they offer. However, not every claim submitted to insurance companies gets approved. Denials are common and can disrupt providers’ cash flow. Understanding the different types of denials in medical billing is essential for reducing errors […]

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Understanding the Credentialing and Recredentialing Process

In the healthcare industry, Credentialing and re-credentialing are both critical processes. These processes ensure that medical providers meet safe and effective care standards. But what exactly do these terms mean? What makes them so crucial? Let’s explore the details one by one. What Is Credentialing? Credentialing verifies whether or not healthcare providers are certified. A […]

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