Medical billing is the process of submitting claims to insurance companies or patients for reimbursement of medical services, involving coding, claim generation, and following up on payments to ensure healthcare providers get paid.
New Patient A new patient is one who visits to take a service for the first time or one who has not received any professional services from the physician, or another physician of the same specialty who belongs to the same group practice, within the past three years. New Patient Codes – 99202, 99203, 99204, 99205 Established … Read more
1) CLIA Waived Test 2) CLIA Non-Waived Test
Managed care organization (MCO) is a type of health insurance that have contracts with healthcare providers to help members to provide services at low cost. Providers are contracted with health insurance under MCO plans and based on these plans, the cost of the patient’s health services is dependent. An individual can select any plan and … Read more
CPT codes are classified into 3 categories: I) Category I – This is the main category of CPT that used by providers to represent their different services and reimburse the payment. Below are the 6 different sections of this category with specialties and CPT range, 1. Anesthesia Services: 00100 – 01999 & 99100 – 991502. Surgery: 10004 – 699903. Radiology … Read more
The Health Insurance Portability and Accountability Act (HIPAA) is a cornerstone of the U.S. healthcare system, ensuring the privacy, security, and efficiency of patient data. Enacted in 1996, HIPAA has far-reaching implications for healthcare providers, payers, and patients alike. This article delves into the importance of HIPAA, the key processes involved in medical billing, the … Read more
What is Denial Code CO 27? Denial Code 27 in medical billing refers to “Expenses incurred after coverage terminated”. This means that the claim was denied because the services were provided after the patient’s insurance coverage had expired or was no longer active. Common Causes of Denial Code 27 How to Fix Denial Code CO … Read more
What is Denial Code 22? Denial Code 22 in medical billing refers to “This care may be covered by another payer per coordination of benefits (COB).” This denial occurs when the insurance payer determines that another insurer should be the primary payer, leading to claim rejection or a delay in reimbursement. Common Causes of Denial … Read more