How to Avoid Prior Authorization Delays in Healthcare in 2025 | RCM.MEDLIFEGUIDE

How to Avoid Prior Authorization Delays in Healthcare in 2025 | RCM.MEDLIFEGUIDE

Prior authorization delays in healthcare occur when insurers require approval before covering treatments, often causing frustrating waits that can harm patients. To avoid them in 2025, focus on proactive communication, leveraging technology like AI-driven tools, building strong provider-insurer relationships, and implementing streamlined workflows. This guide provides a comprehensive, step-by-step approach to minimize delays, backed by … Read more

Steps to Detect Billing Collection Issues in Medical Billing in 2025: A 7-Step Audit to Reclaim Your Lost Revenue

Steps to Detect Billing Collection Issues in Medical Billing in 2025: A 7-Step Audit to Reclaim Your Lost Revenue

To detect billing collection issues in medical billing, you must systematically track and analyze your financial data. The core steps involve: 1) Calculating and monitoring your Key Performance Indicators (KPIs) like Net Collection Rate and Days in A/R, 2) Performing a deep-dive denial analysis to find root causes, 3) Auditing front-end processes for patient eligibility … Read more

Benefits of Finding Collection Gaps Early in Medical Billing in 2025: The Proactive Framework for a 25% Revenue Lift

Benefits of Finding Collection Gaps Early in Medical Billing in 2025: The Proactive Framework for a 25% Revenue Lift

Finding collection gaps early in medical billing means identifying and fixing errors before a claim is submitted, not after it’s denied. The core benefit is a direct, massive boost to your practice’s revenue and financial health. It transforms your billing from a reactive, loss-chasing process into a proactive, profit-protecting system. By catching mistakes in coding, documentation, or … Read more

How to Use Reports to Find Collection Gaps in Medical Billing in 2025: A 7-Step Framework to Recover Lost Revenue

How to Use Reports to Find Collection Gaps in Medical Billing in 2025: A 7-Step Framework to Recover Lost Revenue

To find collection gaps in medical billing, you must move beyond just checking your bank deposits. The key is systematically analyzing specific reports primarily your Aging Accounts Receivable (A/R) Report, Denial Management Report, and Payment Variance Report. By drilling into these reports weekly, you can identify patterns: which payers deny most often, which codes are consistently underpaid, and … Read more

ICD-10-CM Code for Urinary Tract Infection (UTI) Diagnosis

ICD-10-CM Code for Urinary Tract Infection (UTI) Diagnosis

In 2025, the primary ICD-10-CM code for a urinary tract infection (UTI) without a specified site is N39.0 — “Urinary tract infection, site not specified.”For more precise documentation, codes like N10 (acute pyelonephritis), N30.00–N30.91 (cystitis), and O23.0 (UTI in pregnancy) should be used, depending on the location and clinical context of the infection. Quick Summary … Read more

What does POS 22 mean in U.S. Medical Billing

POS 22 in Medical Billing: What It Means In the U.S. healthcare system, billing codes are used to show where and how medical care was given. One of these codes is POS 22, which stands for “Outpatient Hospital.” This code matters because it affects how doctors and hospitals get paid, and how much patients owe. … Read more

Introduction: Why You Should Care About NDC Codes

NDC code

In today’s healthcare landscape, precision matters more than ever. And nowhere is that more true than in pharmacy-related billing. The National Drug Code (NDC) might seem like a random string of numbers, but it plays a central role in ensuring accurate drug identification, payer compliance, and timely reimbursement. Yet many billing errors stem from NDC … Read more

What Rejection Really Means in Medical Billing

Rejection

Rejection in medical billing is more than just an inconvenience—it’s a revenue disruptor, a productivity killer, and often, a red flag of deeper workflow issues. If you’ve ever received a “claim rejected” notice from a payer, you know the frustration. But here’s the thing: rejections are preventable. You just need to understand what they are, … Read more

Modifier 25 vs Modifier 59: What’s the Difference and When to Use Them

Modifier 25 vs 59

In the world of medical billing, the tiniest details can make the biggest difference—especially when it comes to modifiers. Two of the most commonly misunderstood are modifier 25 and modifier 59. To the untrained eye, they may seem interchangeable. But in reality, using the wrong one could trigger denials, audits, or even compliance issues. If … Read more

26 Modifier In Medical Billing

Modifier_26

The 26 modifier, formally known as the Professional Component Modifier, is used when a procedure has both a technical and a professional component, and the billing provider is only responsible for the professional portion. In simple terms: It tells the payer, “I’m only billing for my interpretation and report of the test—not the equipment or … Read more