Deciphering the No Surprises Act and ABN Forms
Navigating the complexities of healthcare billing and insurance can be a puzzling and confusing journey, often filled with surprises, many of which are not enjoyable. Patients have often been caught unprepared by bills they didn’t expect and hidden costs. However, with the introduction of the No Surprises Act and the continued use of Advance Beneficiary […]
The Power of EFTs and EDI Enrollments
In today’s rapidly evolving world of business and technology, streamlining processes and improving efficiency are top priorities for organizations. Electronic Funds Transfer (EFT) and Electronic Data Interchange (EDI) are two powerful tools that play a pivotal role in achieving these objectives. EFT and EDI enrollments have become increasingly important, offering a seamless and secure way […]
The Golden Rule of Medical Billing
The world of healthcare is complex, with countless intricacies and regulations to navigate. One of the fundamental aspects of this field is medical billing and coding. Accurate billing and coding are not only essential for healthcare providers to get reimbursed for their services but also crucial for maintaining patient trust and complying with legal requirements. […]
Top Credentialing Tips for Renegotiating Payer Contracts
Running a small private medical practice comes with its unique set of challenges, and one of the most important aspects is negotiating and renegotiating payer contracts. These contracts determine the reimbursement rates and terms for the services you provide to your patients. In this blog post, we’ll explore some valuable tips to help small private […]
Telehealth Billing in 2024: 3 Essential Coding Tips
Telehealth has transformed the way healthcare is delivered, making it more accessible and convenient for patients. As telehealth continues to evolve, so do the regulations and coding requirements for billing. In 2024, staying up-to-date with the latest coding guidelines is crucial for healthcare providers to ensure accurate and timely reimbursement. In this blog post, we’ll […]
E/M Medical Coding Basics
Medical students and residents are infrequently taught and we are often asked about basic coding skills. Today we will review basic outpatient/office E/M coding after the 2021 updates. Come back next week for sample cases to help understand. As always, please consult with your medical billers/coders should you have questions. If you are looking for […]
Mind your Modifiers
Managing your healthcare claims requires knowledge of CPT modifiers. They are critical to have a high clean claim rate and reduce denials. It is critical to make sure that the modifier is billed on the correct day, on the correct CPT code, and with sufficient documentation in the clinical note. At National Revenue Consulting, we offer […]
Unbundling Part 2
Happy Friday! Last Friday we discussed the principles around unbundling CPTs and how that can be inappropriate leading to denials and even legal action. This can occur either unknowingly or intentionally to increase revenue and is an important reminder to have a dedicated coder or knowledgeable billing reviewing your codes. As a reminder, the Medicare […]
Finding the Right Biller – One Size Does Not Fit All
One of the reasons we opened National Revenue Consulting was because we saw healthcare professionals who loved seeing patients but could not find the time or energy after a full day to manage the billing. Among other things, they also struggled with outsourced services and always had to manage those partners. Our number one commitment is […]
Unbundling CPTs
Unbundling is the topic for Friday’s Fraud Alert! Join us every Friday for tips on medical billing. Unknowingly or knowingly, offices sometimes improperly unbundle CPT (current procedural terminology) codes to increase reimbursement or due to misunderstanding. Unbundling occurs when an office will bill multiple CPT codes for services that should be covered by a single […]
