What is a Provider Agreement in a Medical Billing Company

The health care industry runs on a long chain of medical billing and claims to compensate health care providers for their services. However, managing bills and filing claims is not a cakewalk

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What is the Revenue Code in Medical Billing

Definition of Revenue Codes Maintained by the National Uniform Billing Committee (NUBC), revenue codes are defined by NUBC as “codes that identify specific accommodations, ancillary services

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What is a Modifier in Medical Billing?

Modifiers play an important role in modifying the medical codes for various medical situations. They are used when the physician decides to perform a procedure in a slightly different manner

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What is the Maximum Allowable Charge in Medical Billing

The health care industry functions on cash inflow from patients and health care insurance payers. Without a good revenue cycle, the medical institutes won’t be able to invest

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What is a Condition Code in Medical Billing

The CMS-1450 form of the UB-04 form plays an important role in filing claims. Designed to promote uniform billing across medical institutes, the UB-04 contains 81 fields called Form Locators

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What is a Carrier Block in Medical Billing

To understand the term Carrier Block one must have a good understanding of the CMS-1500 claim form. What is the CMS-1500 claim form? According to the Centers for Medicare

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What is the Global Period in Medical Billing

The health care industry serves thousands of Medicare patients regularly. Some of these patients are treated using non-surgical procedures while others are required to undergo surgical

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What is a DRG Code in Medical Billing

Definition of DRG In medical billing, the term DRG stands for Diagnosis-related Groups—a system created to control care costs or standardize reimbursement rates.

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What is a 52 modifier in Medical Billing

Definition of Modifier-52 In the CPT® Appendix A, Modifier-52 is stated to be used “under certain circumstances a service or procedure is partially reduced or eliminated at the physician’s discretion.

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Outsource Medical Billing Services

Outsourcing has changed the face of many businesses including the medical industry. It allows a firm to outsource certain services that are essential for customer satisfaction and business to grow

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