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Why is in house billing a negative in the long run

Why is in-house Medical Billing a negative in the long run?

Managing a healthcare practice is getting more challenging with each passing day. Therefore, more and more medical practitioners prefer outsourcing medical billing services – as an easier financial solution. Is billing that difficult – the answer is yes; it is a rather complex process, especially if your practice is undertaking in-house medical billing. Revenue cycle management (RCM) is […]

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Why is MedICD focused on Medical Billing Services for Small Practices?

Why is MedICD focused on Medical Billing Services for Small Practices?

Most medical practices, especially those with only a handful of practitioners, believe that keeping or controlling all facets of RCM (Revenue Cycle Management) in-house will give them more flexibility or understanding of their finances. However, most practitioners or healthcare providers did not enter the profession to become accountants, coders, or billers. The reality of medical billing […]

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Physicians credentialing services

Thе Importancе of Physician Crеdеntialing Sеrvicеs in Hеalthcarе

Physician crеdеntialing is a critical procеss within thе hеalthcarе industry that еnsurеs thе qualifications and compеtеncy of hеalthcarе providеrs.  It is a thorough еvaluation procеss conductеd by hеalthcarе organizations,  insurancе companiеs,  and rеgulatory bodiеs to vеrify thе qualifications,  еducation,  training,  еxpеriеncе,  and licеnsurе of physicians.  Vеrification of Education and Training: During thе physician credentialing services […]

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Steps to Revenue cycle management optimization in Healthcare

Steps to Revenue cycle management optimization in Healthcare

Healthcare revenue cycle management optimization involves unifying healthcare’s clinical and business sides through the coupling of administrative data. The data includes the patient’s name, their insurance provider, and other personal information about the patient’s treatment, in addition to their healthcare history/data. One key component of revenue cycle optimization is hands-on and continuous communication with health insurance providers. Revenue Cycle […]

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What is Credentialing and Enrollment

What is Credentialing and Enrollment? 

Hiring incompetent healthcare providers or letting them stick around can lead to more legal trouble for provider practices. To avoid this, it’s essential to keep an eye on your providers’ credentials and ensure everything is up to date. If you don’t, it can hurt how much money your facility makes and put you at risk […]

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Best Claims Denial Management Strategies in Healthcare

Best Claims Denial Management Strategies in Healthcare

For 2024 – most healthcare practices will likely adopt stronger claims denial management strategies for handling the rising challenges of claim denials. A survey concluded that over 51% of respondents plan to be more aggressive with their claim denial management – while 46% intend to boost their payment collection efforts with the payers. Moreover, some organizations will […]

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Credentialing for independent pharmacies

Credentialing for Independent Pharmacies

Credentialing in healthcare is a thorough process of assessing and establishing healthcare providers’ academic qualifications, licensure, and clinical practice. Pharmacist credentials help ensure that the pharmacists billing to insurance providers and patients are properly reimbursed. However, what is credentialing for pharmacies? And How are credentials for a pharmacist related to certifications and licensure? Let’s discuss all about credentialing for independent […]

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pharmacy billing and reimbursement

Pharmacy Billing and Reimbursement

Both pharmacy billing and reimbursement are vital aspects of the healthcare system. The pharmacy revenue cycle management ensures that pharmacies offer essential medications while maintaining financial viability. Let’s explore the details and complexities of pharmacy billing and reimbursement, detailing the key concepts, challenges, and best practices – all of which can be adopted by pharmacists for managing the pharmacy revenue […]

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Difference Between Medical Billing and Pharmacy Billing

Difference between Medical Billing and Pharmacy Billing

Recently, pharmacists have expanded the scope of their practice and services by incorporating additional clinical aspects into their routines. The pharmacy billing process now also caters to specific aspects of patient care, including: For medical billing and pharmacy billing services to remain sustainable – pharmacists must be able to receive payment for resources and time given to improving patient […]

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What is entity code in medical billing

What is Entity Code in Medical Billing?

An entity code in medical billing helps identify the type of entity billing for treatment services. The entity codes ensure that the correct entity gets the bill of services and that neither Medicare nor Medicaid receives bills for the same services. The healthcare professional, billing partners/offices, or insurance payers can assign an entity code in medical billing. […]

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