NTMD RCM | Medical Coding Services

  Introduction One of the most critical challenges in the intricate world of healthcare revenue cycle management is claim denials. They create unnecessary delays in reimbursement timelines, administrative workloads, and negatively impact the finances of medical practices. Nonetheless, with effective denial management strategies, it's achievable to decrease claim rejections by as much as 70%. These strategies will be discussed in this guide alongside maintaining a seamless healthcare revenue cycle and smoother revenue operations. Chapter 1: Understanding the Denial Landscape 1.1 The Financial Impact of Claim Denials Claim denials can cause adverse impacts worth billions in revenue and income opportunities. As one of the many examples, healthcare organizations collectively lose almost  to rework, which gives rise to a considerable financial loss. 1.2 Common Reasons for Claim Denials The first step toward effective management is developing a strategy to tackle the root causes of ...

In the context of today's modern, evolving healthcare system, revenue cycle management (RCM) affects the business viability of medical practices. Through the billing automation solutions offered by TriZetto, administrative functions can be simplified, operational costs lowered, and revenue collections enhanced. This article focuses on how administrative costs can be lowered and revenue cycles optimized using TriZetto’s tools. Problems Faced in Volume Cycle Management Healthcare providers and practitioners face the issue of: Labor-Intensive Work: Outdated methods of billing consume a generous amount of time and resources, and are prone to human error. Revenue Losses: Claims that do not meet the accuracy or completeness requirements lead to denial, which ultimately limits revenue collection. Resource Intensive: Billing, coding, and compliance needs consume a lot of resources. These problems highlight the need for automating high-level billing functions that require precision and effi...

Healthcare providers struggle with receiving payments on time and dealing with claim denials, which only seem to worsen with time. The problems are further exacerbated by the never-ending advancement of technology in healthcare revenue cycle management. Availity , a reputed expert in information exchange in the healthcare industry, provides solutions to these very problems and helps track real-time claims. This article delves into how healthcare organizations can improve their revenue cycles in 2023 using Availity’s claim tracking tools and denial prevention strategies. Lack of Streamlined Processes in Revenue Cycle Management The most pressing challenges healthcare providers face involve: High Claim Denial Rates: Claims can get denied for many reasons, including but not limited to inaccurate insurance data and failure to obtain prior authorization. Delayed Reimbursements: Handling payment delays through manual processes lacking real-time oversight is problematic. Resource Constraints:...

Every day, new software solutions are being released into the alert world of the healthcare system. They claim to manage your healthcare facility and even help in optimizing revenues. One such famous medical billing software is Medisoft. It offers an extensive range of tools to help perform administrative tasks and to improve the financial outcomes of the organization. Some best practices while using Medisoft are captured in this document, which deals with the seven best practices: Utilize Medisoft's Scheduling and Billing Functions The synchronization of these processes reduces the amount of work done manually in entering billing-related data and aids in ensuring that claims are processed on time. Actionary Measures Allow Medisoft to do the appointment scheduling so billing details can be fetched automatically. Train administrative staff to capture the precise details of the appointment so that billing may be done accurately. Automated Real-Time Eligibility Verification Checking ...

Introduction Elective health services, along with their billing and collections functions, should have an integrated workflow as well as a simple and efficient EHR workflow in today’s healthcare practice. eClinicalWorks (eCW) is one of the front-runners in offering integrated EHR solutions, featuring integrated billing systems for improved efficiency and enhanced accuracy of operations. In this blog, we discuss the billing integration error reduction with eClinicalWorks and its effect on EHR workflows. Understanding eClinicalWorks Billing Integration eClinicalWorks offers an all-inclusive billing system that incorporates clinical documentation. Such integration facilitates the seamless transition of the patient’s information post-clinical encounter to billing, thus reducing manual data entry and the possibility of error. Key Features: Suggested Automatic Coding: Automated coding suggestion systems based on clinical documentation are available in eCW. Claim Submission: The system allow...