Basic of Medicare Condition Codes National Uniform Billing Committee (NUBC) in its Official UB-04Data Specifications Manual 2007 defines condition codes as codes used to identify conditions or events relating to this bill that may affect processing. Condition codes refer to specific form locators in the UB-04 form that demand to describe the conditions applicable to the billing period. It is important to note that condition codes are situational. These codes should be entered in an alphanumeric sequence.While filling the UB-04 the provider must fill the codes in sequence. For example,…
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Most Common Medical Billing errors
Introduciton | | Medical billing errors Medical billing is a complex process that involves submitting claims for reimbursement of medical services provided to patients. Despite the best efforts of medical providers and billing teams, errors can occur in the billing process. These errors can result in delayed payments, denied claims, and potential legal or financial issues. Some of the most common medical billing errors include Missing or incorrect patient information, incorrect code, duplicate charge, unbundled charges, Mismatched diagnosis/Treatment codes. To avoid these errors, medical providers and billing teams should review…
Read MoreElectronic Health Record (EHR) : The Future of Patient care
What is Electronic Health Record (EHR) An Electronic Health Record (EHR) is a digital version of a patient’s medical record that contains information about their health history, diagnoses, medications, allergies, laboratory and imaging results, and other pertinent medical information. EHRs are designed to be accessible to authorized healthcare providers, such as physicians, nurses, and pharmacists, who need to access the information to provide care for the patient. EHRs can be accessed from multiple locations and can be updated in real-time, allowing healthcare providers to have access to the most up-to-date…
Read MoreDoes Robert Half offer health insurance; know the TRUTH
As an employee or potential candidate for a company, one of the most important benefits to consider is health insurance. Having access to quality healthcare can mean the difference between financial stability and bankruptcy in the event of a medical emergency. For those considering employment with Robert Half, a leading staffing agency in the United States and Canada, the question of whether or not they offer health insurance is an important one. With so many different staffing agencies and employment opportunities available, it’s critical to understand the benefits and options…
Read MoreClaim Adjustment Group & Reason Codes
Claim Adjustment Group Codes In the healthcare industry, Claim Adjustment Group (CAG) codes serve as a standardized system of categorizing and identifying the various reasons why insurance claims have been denied or adjusted. These codes are used by insurance companies and providers to communicate the reasoning behind the adjustments made to a claim. There are several different types of CAG codes, each with its own unique purpose. The most commonly used CAG codes are CO, PR, and OA. CO – Contractual Obligation Start: 05/20/2018 OA – Other Adjustment Start: 05/20/2018…
Read MoreMitigate the Risks of Losing Revenue by Outsourcing OB/GYN Billing
The revenue cycle management of the OB/GYN practices needs to be carefully monitored for reliable outcomes. Getting full payments on time is the main financial goal of every practice. Similarly, OB/GYN medical practices should focus on optimizing the billing process for getting timely reimbursements. In addition, there are risks of losing potential revenue in the form of claim denials if the billing process is inefficient. Under the modern healthcare ecosystem, it is unwise to lose what practices owe. So, hiring OB/GYN billing services is a viable solution to maximize reimbursements…
Read MoreMedical Billing and Coding: Know everything about it
Medical billing is a crucial component of the healthcare industry, which involves the billing and reimbursement process for medical services provided to patients. The process involves several steps that must be performed accurately and efficiently to ensure the timely payment of healthcare providers. Medical billing is a complex process that requires specialized knowledge in medical coding, billing regulations and rules, insurance policies, and patient data management. The healthcare industry is constantly evolving, and it is essential for healthcare providers to keep up with the latest updates and changes in medical…
Read MoreWhat does EOB means in Medical Billing?
EOB means Explanation of Benefits. An Explanation of Benefits (EOB) is NOT a bill. It is a summary sent by a health insurance company every time a patient receives treatment from a medical professional. It outlines the dates and types of treatment received, and the costs the insurance company will pay. Insurance companies send information to both the patient and provider on exactly what they paid and allowed. Allowed amount means the maximum amount the insurance company would consider for payment. Any difference above the allowed amount is written off…
Read MoreMedical Billing Terminology and Glossary
Medical billing is a also a very important part of Revenue Cycle Management (RCM). The Medical bill is the chief important document for the payment from the payer. The medical billing part includes lot of terminologies which needs to be understood by everyone. These important terms will help you clear give more information about medical billing process and the health insurrance part. List of important terms or terminology used in Medical Billing Adjudication The final determination of the issues involving settlement of an insurance claim. Adjustment The portion of medical…
Read MoreMedical Revenue Services : Everything to know about
The main backbone of hospital’s or clinic’s business is Revenue. Medical Revenue Services play an an important role here. Services include the revenue cycle management, medical billing, charge capture etc. These services help in smooth operation of these hospitals. These services are now mainly handled using software programs specifically designed for hospitals to manage all incoming payments from insurance companies while maintaining a control over them. What exactly is Medical Revenue Services? The Medical Revenue Services mainly help the provider groups, hospitals and different practices with the revenue management. Providers…
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