Category Archives: Medical Billing Services

Patients’ Electronic Access to Health Information

Patients’ Electronic Access to Health Information

CMS Rule Building on the CMS Interoperability and Patient Access final rule (CMS-9115-F), this proposed rule would place new requirements on Medicaid and CHIP managed care plans, state Medicaid and CHIP fee-for-service programs, and Qualified Health Plans (QHP) issuers on the Federally-facilitated Exchanges (FFEs) to improve the electronic exchange of health care data, and streamline […]

Provider Credentialing Consultant

Provider Credentialing Consultant

Provider credentialing is the one of the important administrative process which contribute significant in to the quality of medical care. It also plays an important role in providers revenue cycle management to reimburse the deserving amount from payers. Without credentialing, providers cannot perform credentialing verification effectively and efficiently. This is the reason, providers are willing […]

Reimbursement for telephone calls

Reimbursement for telephone calls

The COVID-19 pandemic has changed how physicians provide patient care in the outpatient setting rapidly and dramatically. During this Public Health Emergency, continuity of treatment of existing patients as well as maintaining a professional relationship with new patients has become difficult. To prevent COVID-19 exposure threats, many geographic areas are under “stay at home” or […]

Importance of provider credentialing

Importance of provider credentialing

What is the credentialing process for healthcare providers? Provider credentialing is the process of establishing that medical providers have proper qualifications to perform their jobs. This requires contacting a range of organizations, including medical schools, licensing boards, and other entities, to verify that the providers have the correct licenses and certificates. What are credentialing services? […]

The health insurance affordability gap

The health insurance affordability gap

Targeted Medicaid growth, boosting state contributions to Affordable Care Act marketplace grants, or a hybrid of these options may help rise payer coverage affordability. Healthcare coverage is far away out of reach for many low-income Americans due to healthcare cost. But 3 innovative solutions for Connecticut might shed light on how to boost payer coverage […]

How to improve medical billing accuracy in CY 2021

How to improve medical billing accuracy in CY 2021?

The medical billing and coding process is a complex. When a patient presents with a significant medical history or complicated case billing can be time-consuming taking days, or months, to finalize. On top of that recent amendments to the U.S. healthcare system have added a variety of new challenges for both providers and patients. Various […]

When is it appropriate to use modifier 90?

When is it appropriate to use modifier 90?

Reference (Outside) Laboratory When laboratory procedures are performed by a party other than the treating or reporting physician, the procedure may be identified by adding the modifier 90 to the usual procedure number. Modifier 90 should be appended to the procedure code representing the laboratory service that is being submitted to an outside laboratory for […]