Precertification, or insurance prior authorization, is the process of seeking approval from the patient’s health care plan before moving forward with the treatment. In the complex world of...
What Can Be Done If A Prior Authorization Is Denied?
Obtaining prior authorization (PA) is a complex, time-consuming, and often frustrating process that inadvertently delays access to timely patient care. Pre-authorization requirements are stringent,...
Ophthalmology Medical Coding Myths Pertaining to Foreign Body Removal
When coding for foreign body removal, it is necessary to evaluate all the potential CPT codes. After careful examination, select the most relevant codes that accurately reflect the treatment...
CPT Codes Used to Report Neuraxial Labor Analgesia/Anesthesia
The coding and billing considerations for an obstetric anesthesia procedure differ from the surgical anesthesia procedure. So, navigating the nuances of obstetric anesthesia requires precise...
Strategies to Improve Medical Billing and Coding Compliance
Staying compliant with current medical billing and coding practices is vital for healthcare entities to reduce claim errors, avoid any potential legal and financial risks, and thus ensure accurate...
Medical Coding and Billing Challenges in Neurology
Neurology billing and coding pose unique challenges due to the complexity of neurological disorders, intricate documentation requirements, need for regulatory compliance, and the healthcare system...
Tips to Always Succeed with Claim Submission and Maximize Reimbursement
Every medical practice needs to have effective processes and policies to maintain its financial well-being. That’s where success with claim submission plays a crucial role. However, denials are on...
What Is the Difference between Insurance Verification and Insurance Authorization?
Suppose that you managed to provide exemplary patient care at your medical practice and your patients leave satisfied with the treatment received, leading to positive feedback and improved health...
How to Code and Bill for Mental Health Services
The National Institutes of Health (NIH) concluded that over 20% of Americans (57.8 million) live with some form of mental illness. Treatments include various forms of psychotherapy, medications,...