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Stopping Healthcare Fraud Before It Can Start

In response to a reporter’s question, notorious bank robber Willie Sutton was quoted as saying thieves rob banks “because that’s where the money is”. Today, the money is in a wide variety of areas beyond banks, including the enormous – and growing – healthcare business. As a result, the amount of theft in the healthcare […]

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Medical Billing and Coding for Small Private Practices in the US

Medical billing and coding companies in the US are gaining popularity with their efficient services.

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Texas Lawmakers Study Regulations on Surprise Medical Bills

Even though they may have health insurance, growing numbers of Texas consumers are getting unexpected bills from doctors not in the consumers’ health care network.

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Medical Billing Complaints Escalate

The KVUE Defenders uncovered more concerns involving medical billing transparency following a nation-wide investigation.

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6 Tips For Medical Practices To Enhance Billing And Collections Process

How can medical practices work effectively with payers to receive payment? Business News Daily sought answers from healthcare experts.

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It’s Time to Get a Second Opinion Before Paying That Medical Bill

The next time you get a medical bill, don’t pay it — at least not right away. It pays to check for errors first.

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Don’t Write Off Patient Co-pays

It comes naturally to want to help your patients; especially the ones struggling to get by on a meager income or retirement.

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Is the Cloud Safe for Medical Billing Data?

Just how safe is the cloud and can we trust online software to keep sensitive medical billing data secure from a breach?

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Ups and Downs in Workers’ Compensation Bills

Businesses, counties and municipalities could see a potentially significant increase in workers’ compensation benefits under legislation introduced in the House of Representatives involving permanent partial disability awards that have been reopened and modified due to worsening conditions.

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Are Revenue Recycles Recovering From ICD-10 Impacts?

One of the things we are worried about is how ICD-10 implementation affects reimbursements for healthcare providers. And since Oct. 1, we’ve saying it’s too early to tell.

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ICD-10: Good For Starters But Much Work Ahead

As it was billed and touted, ICD-10-CM/PCS gives medical personnel vastly expanded powers of specificity when diagnosing diseases and other health issues. Yet that greatly enhanced specificity comes with a price tag—a transition period that some observers believed could be messy and disruptive.

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How Provider Interaction Reduces Claims Reimbursement Waste

Unreliable provider communication leaves patients vulnerable to expensive and potentially harmful medical errors, delays the medical billing process, and distorts quality of care.

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Upcoding vs. Downcoding: Know the Difference

“Upcoding” means reporting a higher-level service or procedure or a more complex diagnosis, than is supported by medical necessity, medical facts, or the provider’s documentation. For example, reporting a diagnosis of chronic bronchitis if the patient has acute bronchitis qualifies as upcoding, as would billing a level 5 evaluation and management (E&M) service (e.g., 99215) […]

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Arbitration Suggested For Medical Billing Disputes

After months studying a growing balance billing problem, Pennsylvania Insurance Commissioner Teresa D. Miller suggests patients should be removed from the dispute.

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Medical Billing Errors, Keeping Good Records Can Help You Catch Mistakes

My insurer’s Explanation of Benefits (EOB) showed a claim for a flu shot. That was accurate. But another EOB claimed that I got exactly the same flu shot (again) two weeks later. That was not accurate.

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Combating 3 Big Revenue Cycle Challenges

At Greensboro, NC-based Cone Health—a six-hospital, not-for-profit health system with 1,242 beds and gross annual revenue of $2 billion—a number of revenue pressures are making it tougher than ever to collect payment for services provided.

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