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Mastering Prior Authorization in Healthcare: An Overview and Step-by-Step Process

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Prior authorization is the most important process in healthcare RCM. Due to errors in prior authorization, claims over $21 million were denied, while that of $291k was written off. It is important to get prior permission from payers to collect payment for the services offered as a healthcare treatment to the patients. Insurance payers might not approve some tests or treatments; practices must wait until they get permission or inform the patients about the costs.  Prior authorization (PA) is a long process that requires the collaboration and involvement of patients, payers, and healthcare providers. This blog will help you understand the prior authorization process and the steps involved in it.  Explain prior authorization It is a process followed by insurance providers to check if the suggested medical procedures, tests, or treatments are necessary for that medical condition. Insurance payers reject reimbursements if a healthcare provider fails to take prior authorizatio...

AR management tips and tricks by professionals that no one tells you

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Healthcare providers lose 5-15% of annual revenue because of improper AR (accounts receivable) management. A report published by the Medical Group Management Association (MGMA) found that the average AR days for over 13% of healthcare providers is 120 days.  Most healthcare providers need help managing their AR and collecting their payments on time. In this article, our experts with 15+ years of experience have explained tips, tricks, and the importance of AR management. Blog index: Definition of AR management in healthcare RCM Importance of AR management Stages of AR management Efficient AR management tips Definition of AR management in healthcare RCM Tracking and collecting payments from patients and payers for the healthcare services offered is called AR management. It is advised that the average AR for a healthcare organization should be <25 days.  Here are the steps involved in AR management: The first and most important ...

Best-in-class Cardiology Billing Services to Increase Your Profits

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Are you fed up with battling your cardiology billing and coding costs? Do you wish to increase the revenue of your cardiology practice? Plutus Health has got you covered with its cardiology revenue cycle management (RCM) services that help you boost your income, eliminate denials, errors, and A/R days, and streamline your billing and coding process. Plutus Health - A Trusted Cardiology Billing Company Plutus Health is a cardiology billing company that provides AAPC-certified coders, denial and accounts receivable management, and one-click assistance 24/7. With the best cardiology medical billing services from Plutus Health, you can stop compromising on your revenue performance and stand out from your competitors. Stop Compromising on Your Revenue Performance Cardiology billing can be challenging since individuals with heart disease have high financial needs and significant out-of-pocket expenses. Only a fixed fee is paid by payers depending on patient policies, and even the sm...

Streamlining Your Revenue Cycle: How Medical Billing Companies Can Help

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Medical billing services are essential for healthcare providers to receive timely and accurate reimbursement. Medical RCM is a complex process that involves coding and submitting clean claims, following up on denied claims, posting payments, and handling patient billing and collections. It requires specialized knowledge and expertise that many healthcare providers still need. Outsourcing  medical billing services  to professionals can help practices streamline their  healthcare revenue cycle management  and improve their financial performance. This article will explain the benefits of partnering with a medical billing company, how to choose the right provider, and the services offered by top companies. Benefits of partnering with a medical billing company Improved revenue cycle management Effective revenue cycle management is critical for healthcare providers to ensure timely and accurate service reimbursement. Medical billing companies like Plutus Healt...

Maximizing Your Practice's Growth with Accurate Mental Health Billing Services

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Are you sick of investigating unpaid and rejected claims? Are you trying to find a mental health billing company that can adhere to payer and regional regulations? Go no further than Plutus Health, a reliable partner to handle your revenue cycle management (RCM) services for mental health. With one-click help available 24/7* 365 days a year, Plutus Health is a group of AAPC-trained and certified mental health coders who offer end-to-end mental health billing solutions. As your go-to billing and coding experts for mental health, we promise to streamline your billing procedures, improve your coding and billing system, and carry out thorough pre-billing audits to decrease denials. Because of the many types of treatments provided to patients, as well as the insurance plans, deductibles, and other differences by state, payer, and plan, mental health billing can get complicated. With decades of experience in the field of mental health coding and billing , Plutus Health promises to make y...

6 Ways to Combat Healthcare RCM Talent Shortage

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  Hospitals encountered billions of dollars in loss due to the healthcare skill shortage in 2022, and this upset would grow in the forthcoming years. RCM (Revenue cycle management) is primarily pendant on the workforce. The efficiency and productivity of a provider's income rely on how well the staff can address their medical billing and coding. RCM requires timely follow-ups, processing documentation, and handling denials. The ineptitude to perform the above processes leads to cash flow insufficiencies, expanded contradictions, mistakes, and reduced productivity. ‍ The healthcare enterprise will be transient by over 122,000 by 2032, foresaw AAMC (Associates of Medical College). Skill shortage would affect caregivers, the supporting RCM professionals, and administrative staff. The labor expense would grow by $86 billion in the forthcoming year, while the other costs would increase by $49 billion.   Are you ready to fight the impending talent deficiency in the healthcar...