In the complex medical billing scenario, accurate eligibility verification serves as a cornerstone for successful revenue cycle management. It ensures that healthcare providers confirm a patient’s insurance coverage and benefits before delivering medical services. This proacti...

As we approach 2025, the scenario of Substance Use Disorder (SUD) billing is evolving significantly, driven by new regulations, reimbursement models, and technological advancements. These changes reflect a broader shift toward integrated, patient-centered care, and aim to enha...

Chiropractors are skilled healthcare professionals dedicated to treating musculoskeletal issues, but their expertise is often stretched thin due to the complexities of managing billing and administrative tasks. Outsourcing chiropractic billing to experts like 24/7 Medical Bill...

The SNF billing industry is experiencing a rapid transformation as we approach 2025. Technological advancements, evolving patient expectations, and innovative healthcare delivery models are reshaping traditional billing practices. This shift impacts how SNF providers, payers,...

New regulations from the Centers for Medicare & Medicaid Services (CMS) continue to shape medical billing practices, with notable implications for healthcare providers’ credentialing. Credentialing is a foundational component of the medical billing process, ensuring that p...

The 2025 Medicare Physician Fee Schedule (PFS) update by the Centers for Medicare & Medicaid Services (CMS) introduces significant changes to physician reimbursement, with far-reaching effects on medical practices, especially in the areas of Medical billing and coding. Thi...

In 2025, telehealth billing is set to undergo critical adjustments as several temporary flexibilities introduced during the COVID-19 public health emergency (PHE) expire. In fact, understanding these updates is essential for telehealth providers to ensure compliance and optimi...

Durable Medical Equipment (DME) billing compliance is critical for healthcare providers, as improper practices can lead to sign ificant financial and reputational damages. Statistics indicate that the healthcare sector, particularly DME providers, faces a high risk of audit sc...

Nutrition therapy is becoming a vital part of patient care, helping manage and prevent conditions like diabetes, obesity, and heart disease. With the recognition of nutrition’s role in health, there are new billing codes available in 2025 that support these services. These cod...

Managing billing for a physical therapy practice is no easy task. Practices often feel overwhelmed when navigating complex insurance regulations, ensuring accurate claims submission, and keeping up with ever-changing compliance requirements. Even minor errors in billing can le...

Value-based care (VBC) models are changing the healthcare industry across various specialties, including mental health. This shift from the traditional fee-for-service system, prioritizing the quantity of care delivered, moves toward a model emphasizing quality, patient outcom...

Medication-assisted treatment (MAT) plays a pivotal role in addressing opioid use disorder (OUD), offering a comprehensive approach that integrates medications with counseling and behavioral therapies. While the clinical benefits of MAT are widely recognized, navigating the co...

Chronic Care Management (CCM) services, as defined by the Centers for Medicare & Medicaid Services (CMS), provide the best opportunity for healthcare providers in Rural Health Clinics (RHCs) to enhance care for patients with chronic conditions while increasing their value-...

Medical billing compliance in healthcare is a crucial component that ensures the accuracy, integrity, and ethical practices of billing processes. For specialized services like nutrition therapy, where patient dietary needs are addressed through clinical nutrition interventions...

Billing for Durable Medical Equipment (DME) is a complex process that requires healthcare providers to deal with stringent regulations, detailed documentation requirements, and changing payer guidelines. In fact, mistakes in DME billing can lead to claim denials, delays in rei...

Pharmacy billing and coding are integral to the healthcare system, enabling pharmacies to receive reimbursement for the medications and services provided to patients. However, the complexities of this process often result in significant challenges, ranging from coding errors t...

Rural Health Clinics (RHCs) play a crucial role in delivering essential healthcare services to communities in rural and underserved areas, where access to primary care might be limited or even non-existent. Established in 1977, the RHC program was designed to incentivize physi...

Undoubtedly, the complexities of wound care billing pose a significant challenge for healthcare providers. The intricate details involved in accurate billing, coding, and compliance with ever-changing regulations can be overwhelming, leading to errors, claim denials, and finan...

The healthcare industry is constantly evolving, and billing practices are no exception. Among the critical components of healthcare billing are Home Health billing and Durable Medical Equipment (DME) billing. Both play pivotal roles in providing quality patient care but functi...

Accurate and timely billing is fundamental to Skilled Nursing Facilities (SNFs) financial success. These facilities provide crucial care to residents with complex medical needs, often relying on Medicare Part A as a primary payer. Understanding and dealing with the complexitie...

Undoubtedly, managing the billing processes for specialized services such as nutrition therapy can be particularly challenging. Nutrition therapy involves creating and managing dietary plans for patients with various health conditions and requires meticulous documentation and...

Managing the complexities of hospital revenue cycles requires more than just diligent billing practices. With ever-changing regulations, the intricacies of insurance claims, and the need for accurate medical coding, hospitals must adopt a comprehensive strategy to maintain fin...

Chronic wounds, such as diabetic ulcers and pressure injuries, are not only clinically challenging but also require careful management to ensure healthcare providers receive appropriate reimbursement. Understanding and adhering to Medicare guidelines is crucial in optimizing r...

Risk-based payment models, also known as budget-based contracting, are evolving in the healthcare industry as an alternative to traditional fee-for-service models. These models aim to control healthcare costs and improve care quality by holding providers financially accountabl...

Navigating Medicare billing can be challenging for chiropractors, but it’s difficult to run a compliant and financially sound practice. Understanding Medicare’s coverage, documentation requirements, billing chiropractic processes, and patient responsibilities is essential. Thi...

Medical billing is a complex and time-consuming process that involves various steps, from patient pre-registration to the completion of a visit. It includes extracting patient data, verifying eligibility, checking medical billing codes, and approving healthcare insurance claim...

The healthcare industry is continuously evolving, and one area witnessing significant transformation is Revenue Cycle Management (RCM). The integration of artificial intelligence (AI) and automated workflows is poised to revolutionize RCM by enhancing operational efficiency, r...

Optimizing Revenue Cycle Management (RCM) is critical for Rural Health Clinics (RHCs) to ensure financial stability and enhance patient care. With new CMS rules effective January 2024 and expanded Medicare coverage for Marriage and Family Therapists (MFTs), Mental Health Couns...

Long-term care facilities are essential for the growing elderly population, with the number of people aged 65 and older expected to double by 2050. As the demand for long-term care services increases, the complexity of managing Medicare billing also rises. Currently, about 70%...

Effective billing practices are essential for Skilled Nursing Facilities (SNFs) to maintain financial stability and ensure seamless operations. With the complexity of healthcare billing, SNFs often face challenges such as claim denials and payment delays, which can significant...