Capminds Blog

Streamlining the prior authorization process could be a game-changing factor in healthcare 2021 which ultimately transforms the overall patient outcomes.  Based on the survey conducted by American Medical Association with 1000 physicians, nearly 64% of physicians reported they face long wait times (one business day) for payers to decide on prior authorization which negatively impacts the patient outcomes.

As the majority of today’s healthcare organizations formalizing compliance programs, the need for accurate medical coding audits is very clear. Regular coding audits provide numerous benefits like maintaining the highest compliance standards and saving a significant amount of money and time.  It also equips healthcare organizations with the knowledge to improve coding policies and procedures. If you are failing to evaluate the coding procedures of your organization, then, it’s time to know about the importance and benefits of conducting coding audits.

In today’s emerging healthcare industry, everyone has been heard about the word MIPS and its quality measures. But most of us don’t have a clear view of how MIPS benefits your medical practices and how does it work based on the performance categories. In this article, we discussed briefly MIPS and its four performance categories that make up your final score.

The payment posting is a day to day challenges faced by almost every healthcare provider. It would be impossible to complete the reimbursement process without payment posting by the medical billing companies. That’s why they recognize it as an important component of the revenue cycle management process. In this article, we explain everything about payment posting in medical billing.

Medical coding quality is a very crucial part of revenue cycle management to ensure clear claims and better reimbursement. So, when done inadequately, it may impact each part of the revenue cycle.

Insurance eligibility verification plays a vital role in ensuring accurate and timely receipt of information regarding insurance coverage in revenue cycle management. Most claim denials happen when a patient is ineligible for services billed by the provider.

A successful AR follow-up process increases the healthcare organization’s cash flow tremendously. Are you facing serious problems within your medical accounts receivable management processes? Here are a few common problems to avoid in your AR follow up process.

The modern healthcare world started shifting towards electronic claim submission for timely claim payments. So if you haven’t switched over to electronic claim submission, may cause your practice to decline in value and effectiveness. You may be thinking about how to speed up your claim process. The easy way is to go with the best medical billing software that includes provisions for electronic claims submission. Here is how electronic claim submission speeds up your claim process and results with more timely payments.

The patient payment plans represent the fastest-growing share of hospital receivables today. As healthcare providers rely more on patients for revenue nowadays, many large healthcare practices have started using patient-centered strategies, like payment plans, to collect payments. Here is the importance of payment plans in revenue cycle strategy and the best practices in place.

Medical credentialing is one of the most important compliance issues in medical practice today. It is a time-consuming task and a complicated process to do it correctly. If not done accurately, the medical practices will result in the loss in their valuable time and money. A poor medical credentialing system may not only lead to enrollment issues but it also leads to legal and financial complications. Do you know what drops down the medical credentialing process? Here are the top most common 4 medical credentialing challenges every practice should be aware of and the solution – how to overcome those challenges in the credentialing process.

In today’s healthcare industry, medical billing and coding process is considered to be a complex and time consuming task. In this process, the important factor to be considered is AR Aging report. Do you correctly review medical practice AR aging report? Here are the importance of reviewing your medical practice’s AR Aging report and the ways to improve the Aging process.

Why improving patient collection important?

Improving patient collections is one of the important key components of effective revenue cycle management. Medical payments have undergone a drastic change over the past few months due to the COVID -19 and patients are becoming increasingly affected by the rising healthcare costs and expensive medical bills.

Credentialing might be seems just like a paperwork task, but it’s increasingly important and essential too as it allows patients to confidently trust their healthcare providers. Through a standardized process including  data collection, essential source confirmation and panel audit by hospitals and other healthcare organisations, patients are guaranteed of their medicinal professional’s merit and experience. In today’s digital world, with the arrival of new innovative technological developments in healthcare industry, credentialing is one among the key area for increased productivity and process improvement. Here are the 10 best things about medical credentialing and its importance for healthcare providers.

The International Classification of Diseases (ICD) was established by the World Health Organization to standardize medical records. Guess what? Now, the version ICD-9 coding was replaced by new version ICD-10-CM/PCS to modernize the medical coding pattern and adopt with the latest changes in today’s advanced healthcare marketplace.

Maintaining a healthy cash flow is one of the major challenges that every healthcare organization faces. In general, “Account Receivable” (AR) is a commonly used term referring to the amount of money that customer owes to the company. Same wise, in the healthcare industry AR, refers to the patient’s account balance becoming due for payment within a year. 

Medical auditing plays an important role in providing accurate and efficient documentation for any healthcare organization. This medical auditing helps to figure out the areas in which healthcare providers need to improve.

The U.S healthcare system has undergone new technological changes and both the providers and the patients are facing new challenges daily to adapt to today’s healthcare reform. The frequent alterations of medical billing rules and regulations and the value-based compensation models can cause revenue losses for providers across the United States.

The accuracy of billing and claims processing is very important as medical billing is a critical process to the financial health of any medical practice. Even a very small medical billing and coding errors could be the foremost reason for claim denials or payment delays.

Medical billing and coding are considered to be complex processes, as even small errors can lead to claim denials and delay in payments. Can you say, how accurate your medical billing department submits all the medical claims?  Absolutely NO, even a very well trained and experienced team can also make errors and it’s very common too.

In today’s technology-driven world, to achieve complete success in the medical billing services, perfect financial health planning is a necessary key factor. However, physicians fail to go with it, due to the changes in billing and coding regulations and software updates in the healthcare industry.