Differences Between Medical Billing Software & Practice Management Software

Healthcare practices of every scale rely on setting firm financial goals to continue to grow and serve their patients. For some, this involves maximizing efficiency while for others it's about streamlining the claims processing to prevent potential losses. Most thriving practices strive to communicate with their patients. Making sure to notify them well in advance about their bills, schedule appointments, and acquire pre-approval for potentially expensive specialty services. There are even some practices that prefer to outsource administrative functions [...]

By |February 3rd, 2023|Categories: Tips|Tags: , , , |0 Comments

What is Bundling and Unbundling in Medical Coding?

Medical coding is a detailed process of translating critical patient healthcare diagnoses, treatments, therapeutic services, and medical equipment into the standard ICD-10, CPT, and HCPCS codes that are used by the healthcare industry, insurance companies, and public health institutions. These codes serve as a universal language that makes for clear communication while also facilitating coverage and reimbursement for services. Medical practices of every scale and discipline need to use the correct medical codes to accurately describe the services provided. [...]

By |February 2nd, 2023|Categories: Tips|0 Comments

What Does A Revenue Cycle Specialist Do?

A consistent revenue stream is the lifeblood of any medical, dental, or mental health care practice. Incoming revenue is dependent on a properly managed and efficient revenue cycle. When there are delays caused by things like missing information, incorrect information, failure to receive prior authorization, claim rejections, and claim denials it can hamper your practice’s ability to grow. Not to mention taking up needless time sorting out the reasons for the delay. When your skills would be better served [...]

By |February 2nd, 2023|Categories: Tips|0 Comments

Top Medical Credentialing Mistakes You Should Avoid

Maintaining the highest quality of care for all patients in the United States requires many facets and attention to detail. One of the most important of all these quality care standards is medical credentialing. It plays a role not just in making sure that patients are seeing the best possible provider for their condition. It also is crucial in claim submission, determining reimbursement rates, and ensuring that you or your practice is adequately compensated by various medical insurance providers. [...]

By |December 26th, 2022|Categories: Tips|Tags: , |0 Comments

ABA Practice Audit Prevention Tips

Applied Behavioral Analysis (ABA) therapy is an increasingly popular field in the mental healthcare industry. ABA providers often have to work intensively with insurance carriers to ensure their patients are qualified for various treatment strategies. This level of interaction and scrutiny means that as an ABA therapist you’re likely to go through several audits in the course of your career. Even though auditing for ABA practices is no longer a probability but a certainty. While it’s a natural part [...]

By |December 22nd, 2022|Categories: Tips|Tags: |0 Comments

Improving ABA Therapy Utilization Review Processes

Applied Behavior Analysis (ABA) therapy is seen as the gold standard for treating individuals with autism spectrum disorder as well as many other behavioral conditions within the mental health sphere. It’s currently estimated that approximately 50% of currently practicing BCBAs have received their certification within the last five years. While this is certainly something to celebrate for all the patients who need ABA therapy to live their best possible lives, it also means that there are a lot of [...]

By |December 20th, 2022|Categories: Tips|Tags: |0 Comments

How To File An ABA Therapy Claim

Applied behavioral analysis therapy (ABA) practices often find themselves repeating the same traditional claim submissions formula that they were taught back at the university level. Though sometimes consistency can give an ABA provider a false sense of security against claim rejections, denials, and potential payer institution audits. More than one ABA therapy practice that made a change in their claim submission practices found that their previous stagnation was directly contributing to a loss of revenue or unnecessary delays in [...]

By |December 5th, 2022|Categories: Tips|Tags: , |0 Comments

Letter of Interest for Insurance Credentialing Tips

A lot of small practices and solo practitioners send a letter of interest to an insurance carrier in hopes of getting paneled with them, as a credentialed in-network provider. In a lot of ways, a letter of Interest is very similar to a cover letter though there are some significant differences. With a cover letter like you might write when applying for a new job, you’re really only sending a small amount of information. Usually, a resume or an [...]

By |December 4th, 2022|Categories: Tips|Tags: , |0 Comments

My ABA Billing Was Underpaid. What Should I Do?

It's an unfortunate reality that most ABA therapists experience occasional underpayments for a claim that was submitted in good faith. A lot of these cases occur when a health insurance company fails to accurately reimburse a provider the full requested/contracted amount due to a medical coding error, missing information, or an outright miscalculation by the insurance company. Compounding this hassle is that some sizable underpayments can lead to long-term financial problems for an ABA practice. Especially if the issue [...]

By |December 4th, 2022|Categories: Tips|Tags: |0 Comments

How To Prevent Patient Debt With RCM

It’s not uncommon for patients to be financially stressed to the point where they cannot feasibly pay their medical bills at the time of service. This means that the payment ends up getting delayed. Sometimes it can be delayed so much that it turns into an outright case of non-payment. The patient might even stop receiving necessary care. This pattern of delayed payments can even end the long-term relationship between the patient and the provider. Thus, leaving the patient [...]

By |December 2nd, 2022|Categories: Tips|Tags: , , |0 Comments