Understanding the Workflow of Prior Authorization Specialists
According to a survey conducted by the American Medical Association (AMA), an overwhelming 89% of physicians have highlighted the negative impact of prior authorization delays on patient outcomes. This statistic underscores the critical nature of prior authorization in healthcare. Moreover, prior authorization is essential for making sure patients receive appropriate medical treatments while effectively managing […]
Technology Solutions to Minimize Medical Coding Errors
Accurate coding ensures proper reimbursement, maintains compliance, and facilitates better communication among the healthcare team. However, the complexity of medical coding often leads to errors. In fact, based on the latest data available, it is approximated that 80% of medical invoices in the United States are inaccurate. Consequently, errors result in financial losses, compliance issues, […]
8 Telehealth Nursing Best Practices for Delivering Quality Care
Telehealth has emerged as a vital tool for modern healthcare providers. Moreover, among the various professionals practicing this digital shift, nurses play an important role in giving quality care through telehealth platforms. The demand for telehealth services continues to rise. Therefore, it becomes important for nurses to adopt best practices that ensure the delivery of […]
Exploring Common Mistakes in Medical Coding and How to Avoid Them
As featured in AMA Journal of Ethics, upcoding and fraud related to misrepresentation of clinical information cost healthcare organizations more than $100 billion annually. Accurate coding ensures proper payment, facilitates research, and maintains compliance with regulatory requirements. Medical coding services have always been the backbone of reimbursement and data collection. However, amidst the complexity of […]
The Vital Link Between Patient Engagement and Medical Billing Success
An international study on patients revealed that countries with higher levels of patient engagement demonstrate lower rates of medical errors and higher overall patient satisfaction compared to those with lower engagement levels. This underscores the critical importance of patient engagement. Not only does it enhance clinical outcomes and satisfaction, it also bolsters the financial stability […]
Measuring Key Performance Indicators (KPIs) for Successful RCM
Efficient Revenue Cycle Management (RCM) is paramount for healthcare organizations striving to optimize their financial performance. Healthcare executives believe that effective revenue cycle management is “very important” or “extremely important” for their organization’s financial health. This is why according to an HFMA and Eliciting Insights report, 40% of healthcare providers prioritize investing in backend RCM […]
Medical Coding in 2024: Challenges, Innovations, and Lessons Learned
Medical coding is a critical component of the healthcare industry, serving as the bridge between patient care and financial reimbursement. As we step into the year 2024, the landscape of medical coding continues to evolve, with the medical coding market forecasted to be valued at more than 29 million USD by 2027. Healthcare professionals will […]
Survey Reveals Healthcare Workforce Crisis: Nearly 50% of U.S. Healthcare Workers Likely to Leave Their Current Job
The healthcare industry has long been regarded as a cornerstone of our society, providing essential services to individuals in times of need. Yet, beneath the surface of medical advancements and compassionate care, a crisis is brewing – one that threatens to undermine the very foundation of healthcare. A recent survey has unveiled a startling truth: […]
The Future of Medical Billing: Trends and Innovations
According to research published by the Harbert College of Business, a hospital increased its annual net revenue by $1.73 million on average implementing one additional clinical IT unit and one additional business IT unit. Successful IT implementations have been proven to bring substantial net revenue growth for healthcare providers, and their success involves the adoption of […]
Financial Success in Healthcare: RCM Strategies that Actually Work
In today’s rapidly evolving healthcare landscape, financial success is a top priority for hospitals, medical practices, and healthcare providers of all sizes. Healthcare organizations need financial resources to cover operating costs, invest in technology and infrastructure, and attract and retain skilled staff. However, the complexities of billing, insurance reimbursement, and regulatory compliance can be overwhelming. […]