Types of Billing for Accounts Receivable

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

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What is the Difference between Hospital and Physician Billing

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

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What is the Difference between UB04 and CMS 1500

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

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What is Fee Schedule in Medical Billing

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

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What is MUE in Medical Billing

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.”

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What is Downcoding in Medical Billing

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

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What is Contractual in Medical Billing

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

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Correct use of CPT Modifiers to Maximize Reimbursement

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

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What is Preauthorization in Medical Billing

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

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Top 5 Reasons why Dental Claims are Denied

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

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