The healthcare industry is under more pressure than ever. Costs keep rising, patient demand is growing, and insurance companies are enforcing stricter reimbursement rules. For many providers, one of the biggest challenges is medical billing. Studies show that up to 80% of medical bills have errors, costing the U.S. healthcare system over $125 billion every […]
In medical billing, doctors and healthcare providers use Place of Service (POS) codes to show where a service was given. These are two-digit numbers created by the Centers for Medicare & Medicaid Services (CMS), which help insurance companies determine how to process claims and pay providers accurately. For laboratories, using the correct POS code is
Anemia is a health condition that happens when your body doesn’t have enough red blood cells or hemoglobin. Hemoglobin is the part of red blood cells that carries oxygen, so when levels are low, your body can’t get the oxygen it needs. Anemia can cause tiredness, weakness, shortness of breath, and, in serious cases, problems
ICD-10 Code F33.1 is the medical code for Major Depressive Disorder, recurrent, moderate. It’s part of the International Classification of Diseases, 10th Revision (ICD-10), A system used around the world so healthcare providers can describe, diagnose, and record health conditions in the same way. This shared “language” helps ensure patients get the right treatment, no
In medical billing, not all payment adjustments are the same, especially when it comes to refunds and recoupments. These two terms are often confused, but they mean very different things. Knowing the difference can help healthcare providers avoid mistakes, stay compliant with rules, and build trust with patients and insurance companies. In this blog, we’ll
CPT codes, or Current Procedural Terminology codes, are used in mental health billing to describe the services that healthcare providers give to their patients. These codes help ensure that mental health professionals receive accurate payment and that insurance companies understand the type of care provided. In this blog, we’ll take a closer look at the
Artificial Intelligence (AI) is changing the way healthcare works. It’s helping doctors and nurses provide better care that is faster, more accurate, and more focused on the patient. One exciting new tool leading this change is ambient listening. What Is Ambient Listening in Healthcare? This technology listens to and understands conversations between doctors and patients
Dementia is a condition that slowly damages the brain, making it harder for people to remember things, think, control their behavior, and do everyday tasks. As more people live longer, dementia is becoming more common and is now a major health concern around the world. To give the right care and get proper payment from
The shift from fee-for-service to value-based care is transforming how healthcare is delivered and how providers are compensated. The Merit-based Incentive Payment System (MIPS) is at the center of this change. It was designed by the Centers for Medicare & Medicaid Services (CMS) to reward high-quality, low-cost care. As a healthcare provider, it’s essential to
Accurate documentation is the foundation of effective and compliant medical billing. It not only ensures timely and correct reimbursement but also promotes transparency in healthcare operations. One of the important aspects of EOR in medical billing is the Explanation of Review. Typically issued by workers’ compensation and auto insurance carriers, the EOR explains how a
Getting paid isn’t the only reason for accurate medical billing; it’s also important for keeping the healthcare system working efficiently for both patients and providers. The circumstances can get confusing quickly when a lot of people have more than one insurance plan. That is where Coordination of Benefits (COB) comes in. COB lets insurance companies
Weight loss counseling is more than a supportive conversation; it’s a vital component of preventive healthcare. With over 41.9% of U.S. adults classified as obese (CDC, 2023), the need for structured guidance has never been greater. Obesity significantly increases the risk of chronic conditions such as type 2 diabetes (risk increased by up to 7
A medical coding audit helps ensure your documentation and codes are accurate, compliant, and optimized for reimbursement. Coding errors are somehow costly, leading to 80% of medical bills containing mistakes, and claim denial rates can reach 20% for some providers. Regular audits reduce denials, improve compliance, and strengthen your revenue cycle. Whether handled internally or
As healthcare costs rise and insurance plans become more complex, self-pay in medical billing is becoming increasingly common. More than 30 million Americans remain uninsured, and nearly 43% of insured adults are underinsured due to high deductibles and out-of-pocket expenses (Commonwealth Fund, 2023). Because of this, a lot of people are paying for their medical
Ever received a claim denial and wondered what went wrong? Denial codes are the key to unlocking that answer. These standardized codes are based on the Claim Adjustment Reason Codes (CARC) system, explaining why a claim wasn’t reimbursed and how you can fix it. One important code to understand is Denial Code PR 272, which
Subscribe to our Newsletter to receive latest updates
Phone
Resilient Medical Billing Service Pvt. Ltd. is on a mission to create a global community focused on simplifying medical billing processes and fostering seamless business interactions within the healthcare industry.
