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RCM + Billing - Office Practicum

RCM + Billing

Very few things about medical billing are straightforward, but it’s especially true in pediatrics. Proper coding, modifiers, and changes in Medicaid rules and payer guidelines can turn a simple office visit into a minefield of dependencies. Add staffing shortages and the challenge of finding qualified medical billers to the mix, and it further exacerbates the stress of billing for pediatric practices. When it comes to running a pediatric practice, the days of “one size fits all” are over. You can no longer thrive and work efficiently using a generic, non-specialty-specific EHR, and the same is true for billing and revenue cycle...

When reviewing (or developing) your revenue cycle management plan, don't overlook the first steps: making sure all your providers are appropriately credentialed with all your payers and associated products. Credentialing and Provider Enrollment are more than just arduous tasks of paperwork; without them, claims aren’t paid. Opportunities to grow your practice and strengthen your revenue cycle depend on a solid credentialing and contracting program. Here are several key functions that will help your practice receive proper reimbursement from insurers Payer Product Analysis: Most insurers offer multiple products and these products can change annually, especially Medicare Advantage, Medicaid HMO, and ACA plans. Review...

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