Blogs

Principal Care Management (PCM) is designed to assist carriers manage sufferers with single, excessive-danger chronic situations. Whether you’re handling patients with severe bronchial asthma, diabetes, or coronary heart failure, PCM permits committed care and a common communique to keep away from hospitalization and functional decline.

When a healthcare issuer submits a claim to a clearinghouse, the declaration goes through several levels before it reaches the coverage organization. First, the clearinghouse checks the claim for any missing or error facts. If a mistake is detected, the clearinghouse sends the claim lower back to the healthcare company with a notification of what desires to be corrected. Once all problems are resolved, the claim is then translated into

CPT codes (Current Procedural Terminology) are used to explain medical techniques and services. In occupational remedy, those codes represent numerous treatments, opinions, and re-opinions. One of the maxima generally used codes is the CPT code for occupational therapy evaluation, which includes 97165. This code is particular to a preliminary evaluation, helping therapists document their first interactions with patients. Accurate usage of those codes guarantees that the right remedy is billed,

As a Medicaid billing consultant with 12+ years of experience, I’ve seen firsthand how misunderstandings about fee-for-service (FFS) Medicaid lead to claim denials and lost revenue. As a Medicaid billing specialist who’s helped clinics recover over $1.2M in denied claims. I’ll break down exactly how FFS Medicaid works, share state-specific tips, and reveal proven strategies to maximize reimbursements.

Navigating the field of medical billing may be overwhelming, especially while you’re handling a big array of HCPC codes that decide repayment for healthcare services. However, knowledge of the Healthcare Common Procedure Coding System (HCPCS) is critical for healthcare providers, medical coders, and billing professionals. These codes ensure proper documentation and help talk medical services and tactics as they should be to insurers.

Ultrasound has appeared as an important diagnostic tool within the clinical area, conveying a non-invasive way to visualize inner organs, tissues, and blood vessels. However, coding these approaches effectively is vital for ensuring right reimbursement and accurate medical statistics. In this guide, we’re working to explore the ultrasound CPT codes, together with today’s updates for 2024, and the way they follow numerous medical specialities.

Chronic Care Management (CCM) plays an important role in improve healthcare for patients with long-term conditions. Medicare recognizes CCM services as essential in reduced healthcare costs while ensuring better patient care. These services involve constant care coordination, medication management, and patient education for individuals with multiple chronic conditions expected to last at least 12 months or until the patient’s passing.

Electronic Health Record (EHR) software program is a virtual model of a patient’s paper chart. It lets in real-time, patient-focused data, making facts instantly available to authorized users. The EHR software program serves the purpose of improving information sharing amongst healthcare providers and making sure of outstanding patient care.

An Internal Control Number (ICN) is a unique 13-digit identifier assigned to healthcare claims during processing. It acts as a digital fingerprint, enabling providers and payers (like Medicare) to track claims, resolve disputes, and ensure accurate reimbursement.