What is a Grace Period in Medical Billing? – Explained
Understanding the Grace Period in Health Insurance A grace period in medical billing is extra time for policyholders to pay their premiums. This happens after the due date has passed, and it allows them to keep their coverage without losing it right away. This timeframe ensures that temporary financial setbacks don’t cause an abrupt lapse […]
What is an ABN in Medical Billing? – Explained
Understanding ABN: Advanced Beneficiary Notice An ABN, or Advance Beneficiary Notice of Noncoverage, is a written notice for Medicare beneficiaries. It tells them that Medicare might not cover some items or services. It is an important part of medical billing. Providers think a procedure might face denial because of coverage limits. In simple terms, it […]
Simple Glossary of Medical Billing and Coding Terms
If you are new to healthcare or trying to understand your medical bills, it is important to learn medical terms. These terms are not just industry jargon. They help clarify processes, explain charges, and ensure clear communication between providers, insurers, and patients. This simple glossary explains important medical billing and coding terms in easy language. […]
Physical Therapy Billing Units Comprehensive Guide
Understanding Physical Therapy Billing Units When it comes to physical therapy billing, accuracy and compliance are critical. Physical therapy billing units, often referred to as PT billing units or therapy units, form the foundation of how services are reported and reimbursed, particularly under Medicare and Medicaid. In this guide, we’ll break down what billing units […]
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. […]
