Category: Blog

Medical billing plays an important role in revenue generation from various sources like patients, insurance payers and suppliers, etc. The process can be quite complex and tiresome

Hospitals generate revenue from federal insurance programs, private insurance payers, and self-paying patients. The revenue coming from these three sources is calculated

There are various ways to bill accounts receivable in the world of business. However, medical billing uses different billing types as compared to other business sectors

In layman’s term, both hospital billing and physician billing, fall under the umbrella of medical billing. However, the professionals involved in the healthcare industry

The UB-04 and CMS-1500 forms are designed and maintained by the National Uniform Claim Committee (NUCC). Both of these forms are used for reimbursement purposes

The Centers for Medicare and Medicaid Services (CMS) define the fee schedule as “a complete listing of fees used by Medicare to pay doctors or other providers/suppliers

Developed by the Centers for Medicare and Medicaid Services (CMS) the Medically Unlikely Edits (MUEs) are used “to reduce the improper payment rate for Part B claims.”

In the health care industry claim denials and fraud are quite common due to thousands of insured patients visiting health care providers to avails best medical services

Sometimes providers tend to bill insurance companies for medical services that are not covered by insurance companies. This may happen because the provider may have forgotten

Based on the general understanding, a contractual adjustment may be defined in the following manner:“A binding agreement between a provider, patient, and insurance company