72 Hour Rule Implementation in Medical Billing

72 Hour Rule in Medicare Billing

To combat fraud related to the False Claims Act, “the Centers for Medicare” and “Medicaid Services (CMS)” implemented the three-day rule, also known as the “72-hour rule”. This rule requires that all outpatient diagnostic or some other medical services delivered within 72 hours of hospital admission be bundled and billed collectively rather than individually. This …

Read more

What Is ERA in Medical Billing and How Beneficial It Is to Integrate ERA?

What is ERA in medical billing and how beneficial it is to integrate ERA

ERA stands for Electronic Remittance Advice and is used by means of electronic communication where the need for EOB Explanation of Benefits becomes negligible. But what is ERA in medical billing? Medical healthcare providers always wish to have claim acceptance in the first go. And it becomes essential for the providers to reduce/eliminate the recurring …

Read more

What Is a Clearinghouse in Medical Billing? 6 Benefits of Using Clearinghouse

What is a clearinghouse in medical billing 6 benefits of using clearinghouse

A clearinghouse in medical billing reserves a special place in terms of clearing and forwarding reimbursement claims for practices and hospitals. As the process of reimbursing claims and providing financial security to healthcare providers are essential steps in medical billing, clearinghouses play a key role in the healthcare billing process which is undeniable. What is …

Read more

COB in Medical Billing: Rules for Insurance of Patients in Coordination of Benefits Explained

COB in medical billing Rules for Insurance of Patients in Coordination of Benefits Explained

The coordination of benefits is defined by the Centers of Medicare and Medicaid Services as the process by which the patients are allowed to choose who is responsible for their financial medical liability or insurance. This means that through COB, CMS permits patients to have more than one payer or insurance provider. However, through COB, …

Read more

Chiropractic Billing for Dummies: What Chiropractic Billers Need to Know?

Chiropractic billing for dummies What chiropractic billers need to know

Like any other practice, chiropractors also need to adhere to the important set of codes called CPT codes. AMA maintains chiropractic CPT codes – American Medical Association and is regularized by the CMS across the chiropractic providers. CPT codes are comprised of five alphanumeric typo scripts, that are used to evaluate, describe, and diagnose all …

Read more

The Difference Between GV vs GW Modifier: Learn when To Use Them

The difference between GV vs GW modifier - Learn when to use them

Medicare and Medicaid systems regularize a standardized process for allowing medical healthcare providers to facilitate healthcare, provision of medical services, billing and insurance, and almost every aspect included in the haircare industry. To make the process simple and steady, codes and modifiers are there that help medical providers at every level. Similarly, GV and GW …

Read more

Billing for Urgent Care: A Comprehensive Guide to Understanding when To Use Urgent Care Billing

Billing for urgent care A comprehensive guide to understanding when to use urgent care billing

As a practitioner, your practice is prospering while you have enough patients to treat and you’re managing your revenue cycle management solely. Besides, you work dedicatedly and hire other practitioners to cope with the additional burden of healthcare provision, but your profit margin is still not reaching the point where you have expected it to …

Read more