Category: Blog

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

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

According to the Current Procedural Terminology (CPT) book, a modifier is a “means to report or indicate that a service or procedure that has been performed has been altered

CMS defines preauthorization as “a process through which a request for provisional affirmation of coverage is submitted to CMS or its contractors for review before the item

Like any other area of practice in medicine, dental practice treats hundreds of patients claiming to have health care insurance. As per the America Dental Association’s survey

According to Healthit.gov, Electronic Health Record (EHR) is defined as a “digital version of a patient’s paper chart. EHRs are real-time, patient-centered records that make information

To understand the term Vendor Submitter ID is it important to understand the terms—submitter, vendor, software vendor, and submitter ID as they are closely associated.

Reviewing medical claims manually is quite a tough task. Moreover, manual submission of claims is a slow process that is likely to delay the processing of claims

When it comes to health care insurance and medical claims, there are a few terms that an individual must know about. These terms are—co-pay, coinsurance, and deductibles.