Payers denying healthcare insurance claims is something we all are very familiar with. Whether the claims are denied for missing information, incorrect medical coding, or anything in between, 9% of claims are initially denied, on average. The national pandemic has … Read More
Medical Billing
Measuring RCM Performance – The Concept of Clean Claim Rate
Key Performance Indicators (KPIs) are used to measure how an organization or department is performing. Companies often evaluate and analyze their business processes against industry standards to see if there is room for improvement. With the help of industry leaders, … Read More
Need for Management of Complex Denials
Improved medical claim management has been a necessity in the healthcare industry for some time. According to an article in Becker’s Hospital Review, a study showed that 62% of the healthcare executives interviewed noted declining reimbursements to be the most … Read More
Artificial Intelligence in Revenue Cycle Management
What is Artificial Intelligence? Artificial Intelligence (AI) is defined as computers imitating “intellectual processes characteristic of humans, such as the ability to reason, discover meaning, generalize, or learn from past experience” with the ability to achieve goals. AI in healthcare … Read More
New COVID-19 Medical Billing Codes
Medical coding is a standardized method to assign alphanumeric codes for medical diagnostics, surgical and external procedures to generate billing for an episode of care. Medical coding professionals translate the medical records and providers’ notes to create a claim to … Read More