What Is Authorization in Medical Billing?
Authorization in medical billing plays a critical role by ensuring that healthcare services receive approval and reimbursement correctly. It is an important process. It helps healthcare providers check if a patient is eligible. It also helps them get approval from the payer before doing certain procedures or treatments. Let’s explore in detail what authorization means, […]
What Is an Entity Code in Medical Billing? Explained
In the world of medical billing, accuracy is everything. One small error can lead to claim rejections, delays in payment, or administrative confusion. Among these common issues is something called an entity code. But what exactly is an entity code in medical billing, and why does it matter? An entity code indicates the type of […]
Incident to Billing Rules and Medicare Guidelines
“Incident to” billing is a term used by Medicare and other payers. It refers to services provided by non-physician practitioners (NPPs). These include nurse practitioners and physician assistants. They work under the direct supervision of a qualified physician. You can bill these services using the physician’s National Provider Identifier (NPI). This lets the practice get […]
What Is Place of Service (POS) 21 in Medical Billing?
In the world of healthcare billing, understanding various codes is essential for smooth claim processing and insurance reimbursements. One such crucial set of codes is the Place of Service (POS) code. These codes identify where a medical service provider delivered care, which helps insurance companies determine the correct reimbursement rate. POS 21, or Place of […]
What Is a Superbill in Medical Billing? Full Guide
A superbill is a detailed document used in medical billing. It lists the services given to a patient during a healthcare visit. It serves as a receipt for the patient and a claims document for insurance reimbursement. A superbill is different from a regular invoice. It has all the information a health insurance provider needs […]
Best Low Cost Medical Billing Software for Small Practices
Running a small medical practice entails numerous responsibilities, and efficiently managing billing is one of the most crucial. Without a proper billing system, practices risk delayed reimbursements, coding errors, and unnecessary administrative burdens. Fortunately, today’s medical billing software landscape offers a variety of affordable software tailored specifically for small businesses, home-based setups, and independent practitioners. […]
Medical Bills & The Statute Of Limitations Explained
Understanding medical billing can be confusing. This is especially true when critical legal issues, like the statute of limitations, come into play. If you’ve ever wondered how long hospitals have to bill you, you’re not alone. What happens if a medical provider sends you a bill months or even years later? This guide explains the […]
Medical Credentialing Services: What You Need to Know?
Medical credentialing is a foundational part of modern healthcare. It ensures that physicians, nurse practitioners, and other healthcare providers are qualified, verified, and authorised to deliver care within their respective scopes. Whether you’re starting a private practice, joining a group, or expanding your insurance partnerships, understanding the medical credentialing process is essential. In this guide, […]
How AI Is Transforming Medical Billing and Coding?
The integration of artificial intelligence (AI) into healthcare has opened doors to new levels of efficiency, accuracy, and innovation. One area experiencing significant transformation is medical billing and coding. By using AI, healthcare providers and billing specialists are speeding up processes and reducing errors. This blog will look at how AI is changing medical billing […]
8 Minute Rule Billing Explained for Therapy and Medicare
When it comes to outpatient therapy billing, one of the most essential rules to understand is the 8 Minute Rule. Whether you’re a provider, therapist, or administrative professional, understanding this billing rule is key to receiving accurate reimbursement from Medicare. In this article, we’ll explain the 8-Minute Rule, how it applies to therapy sessions—particularly physical […]
