6 Top Medical Billing Mistakes That Cause Denials

Posted by Allen Ranjan on Dec 20, 2018 10:57:16 AM

In Healthcare Revenue Cycle Management, the common meaning of a medical billing denial is, when the insurance carrier refuses to pay for a medical claim/bill submitted to them for the healthcare services.

As a practice owner or administrator, you should know very well what these denials can do to the financial health of your independent medical practice. Well, your revenue gets locked in the Accounts Receivable causing you great pains with your cash-flow, revenue and operational efficiency.

For independent medical practices, denial rates typically range around 7-12%, however for better performing practices this drops down under 5%.  Though at Cosentus we have seen practices struggling at about 15-20% as their billing is not optimized, and they lack in expertise and necessary technology. Just so you clearly understand what the significance of these denials is, a 12% denial rate means one out of 8 medical claims will have to reworked by billers or coders and/ or appealed. The cost to rework these claims can add up and dent your revenue significantly.

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Topics: Revenue Cycle Management, Medical Billing Services, Medical Billing Services Provider, Leading Medical Billing Company, Medical Billing and Coding, Medical Coding

CMS Regulations To Reduce Administrative Burden On Physicians!

Posted by KK Goel on Nov 30, 2018 3:47:25 PM

 

Being able to focus more on patient care than paperwork has long been the desiderata of the physicians. With new CMS regulations for reduced documentation requirements from physicians for their outpatient Evaluation and Management (E/M) office visits, this need seems to be getting addressed gradually, starting from January 1st 2019 to over the next two to three years.

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Topics: Medical Billing Services, Healthcare Revenue Cycle Management Services, Medical Billing and Coding, Medical Coding

6 Tips to Optimize Medical Billing for Maximized Collections

Posted by Allen Ranjan on Nov 8, 2018 8:02:18 AM

The ever-changing healthcare landscape means the billers also have to continuously keep update their skills and concepts to stay on top of the changes and make sure they are not leaving money on the table. With the introduction of EMR and advanced practice management software the general belief is that the standards of billing and collection will be like never before and every claim should be billed out accurately and collected upon in a timely manner. Unfortunately, according to industry sources, independent medical practices are still leaving as much as 30% potential revenue on the table due to the inefficiencies in the billing and collection process. This happens because, the rejection and denial rate is still too high and almost 50 % of denials never get re-worked resulting in 5-7 % loss of potential revenue. When you have too many denials your revenue can pretty easily get locked in the Accounts Receivable and that can have serious impact to your cash flow.

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Topics: Effective AR Management, Accounts Receivable Management, Cosentus News, Medical Coding- Optimization, Contract Negotiation, Urgent Care Industry, Revenue Cycle Management, Medical Billing Services, Healthcare Revenue Cycle Management Services, Medical Billing Company in Orange County, Medical Billing Services Provider, Leading Medical Billing Company, Medical Billing and Coding, Medical Coding