Posts Categorized: Medical Billing & Coding

Denial Management Best Practices

Denial management is a never-ending process. Lowering your denial rate and then keeping it low requires clearly established workflows, quality technology, and staff members who are committed to the process. Below are some of the best practices that help healthcare organizations reduce denials and improve their revenue cycle outcomes. 4 Denial Management Best Practices 1….


These 2 Coders Tripled Their Productivity in Less Than 5 Months

Recently, 2 coders in an orthopaedic practice in North Carolina were able to more than triple their productivity in less than 5 months. Chrissy & Lynn, 2 coders at Carolina Orthopaedic & Sports Medicine Center, were able to increase their productivity in the midst of operational changes. With the help of White Plume products and…


The Basics of Medical Billing & Coding

Medical Billing and Medical Coding are two parts that make up the process by which healthcare organizations get paid. Within the revenue cycle, the processes of medical billing and medical coding work together to create a claim and submit it for reimbursement. A complete understanding of the basics of medical billing & coding is important…


Coding Corner: Billing For Date of Service

CMS recently released a document reminding physicians, non-physician practitioners, and others submitting claims of the guidelines for billing for date of service. The fact that they released this reminder indicates that many people are not following the guidelines correctly. Use this summary of the guidelines to refresh your practices and make sure you are following the…


Top Reasons For Denied Claims

Every practice deals with the headache of denied claims. Insurance companies are strict, and their rules are constantly changing. It takes a lot of time and attention to detail to keep a low denial rate. Reducing your denial rate is a critical way practices can improve their revenue cycle outcomes. A low denial rate and…


5 Payment Plans Under New CMS Primary Cares Initiative

On April 22nd, the HHS and CMS announced the new CMS Primary Cares Initiative. The goal of this initiative is to reduce administrative burdens and free up primary care physicians to focus on caring for patients, all while cutting down healthcare costs. This move by CMS shows the continual industry trend towards value-based care. If value-based…


Top 5 Diagnosis Additions for Orthopedic Practices

We collected data from our entire client base, and these were the top five diagnosis additions that orthopedic practices are making. If you are a coder at an orthopedic practice, most likely you will not be surprised by these results. However, this is an opportunity to measure against your peers and see if you are…


This Claim Denial Statistic Will Blow You Away

Here’s a jaw-dropping statistic about denied claims: Over 50% of denied claims are never resubmitted. Surprised by this number? If it seems far-fetched, you may want to take a closer look at your denial numbers. The fact is that denied claims are easy to forget about. As the revenue cycle workload increases, there’s plenty of work…


Are You Correctly Coding for Durolane Injections?

As of January 1, 2019, a new HCPCS code J7318 “Hyaluronan or derivative, durolane, for intr-articualr injection, 1mg” became available to treat joint pain (Knee, hip, and other joints) usually caused by osteoarthritis. Typically, durolane is administered to patients when other osteoarthritis treatments or pain drugs have proven ineffective. Osteoarthritis (OA) occurs when cartilage in…


Understanding ICD-10 Specificity

As we begin the fourth year since the introduction of ICD-10, some practices are beginning to see an increase in denials and reduced reimbursements due to the use of unspecified diagnosis codes. Now that the grace period has passed, insurance companies are expecting more from practices with regards to coding specificity. If your practice is experiencing…