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The patient had come into the emergency room panicking after her cat had sunk its teeth into her hand. “I’ve been bitten by a cat!” she exclaimed. The triage nurse clucked in sympathy as she examined the wound. The clinician sighed as he filled out the diagnosis code for the patient’s chart. He knew that […]

Medical costs could cripple a family’s budget in the blink of an eye. To provide relief from the looming threat of medical debt, forward-thinking employers created Medical Expense Reimbursement Plans or MERPs. These plans are designed with the noble goal of helping workers pay for essential medical care without facing financial ruin. For employers mulling […]

Preauthorization, pre-approval, and precertification are all different names for prior authorization which means you need to get approval from your patient’s insurance provider before prescribing medication or delivering care. As a healthcare provider, your top priority is delivering the best possible care to your patients. However, the ever-present reality of insurance can sometimes create roadblocks. […]

Medical claim forms are an essential component of the medical billing process. In simpler terms, a medical claim form is a formal written request that a healthcare provider submits to an insurance company, Medicare or Medicaid, or another affiliated entity seeking compensation for the healthcare services provided to a patient. Healthcare providers firmly believe that […]

Accurate and timely claim processing is crucial for smooth operations in healthcare. The UB-04 claim form, also known as the UB92 or CMS-1450 form, plays an important role in this process, serving as the standardized format for submitting medical billing claims to insurance companies by institutional healthcare providers. Any healthcare provider filling out false or […]

As a doctor, have you ever had a patient who was overjoyed after a successful procedure only to return crestfallen a few weeks later upon receiving an exorbitant bill? Or have you, as a patient, left a hospital visit feeling relieved and assuming your insurance would cover the costs, only to be stunned by an […]

The Medicare program has developed a new system to grade doctors on how well they treat their patients. It’s called the Merit-based Incentive Payment System or MIPS for short. MIPS decides how much money Medicare will pay doctors for seeing people on Medicare. It looks at things like how healthy doctors keep their patients, how […]

You may be running a clinic or working as a physician in a hospital anywhere in the USA. In that case, you know that the patients get insurance on the medical services they receive from any provider. But in some cases, you may have experienced patients visiting you without insurance plans for their treatments. Hence, […]

In the medical billing field, a “SUPERBILL” is a document that provides a detailed invoice of the services provided by a healthcare provider to their patient. Typically, superbills are created and submitted for each treatment session conducted by an out-of-network provider. Once the doctor has concluded their work with the patient, payment is collected in […]

Navigate The Difficulty Of Medicare 8-Minute Rule Billing? Lets schedule a free 1:1 therapy billing services with me right now! Medicare, known for its strict regulations on claim filing and reimbursement, requires careful adherence to its rules to ensure proper patient care and compliance. One such regulation is the “Medicare 8-Minute Rule”. This rule can […]