ASC - expEDIum Solutions Blog

Understanding Medical Claims: Navigating the Basics, Challenges, and Solutions

By Suvarnna Babu November 14, 2024

Navigating medical claims can be daunting, whether you're an individual or a business seeking healthcare for employees. This comprehensive guide will cover the fundamentals of medical claims, explore common challenges, and offer actionable insights to simplify the process, ensuring smoother…

Understanding the Difference Between Explanation of Benefits (EOB) and Medical Bills

By Suvarnna Babu November 14, 2024

If you’ve received a notice from your insurance provider labeled “Explanation of Benefits” (EOB) shortly after a medical appointment or procedure, you might be wondering if this document is a bill that requires immediate payment. The EOB and medical bill…

Navigating Medical Billing Analytics: Addressing Operational Challenges with Efficiency

By Suvarnna Babu October 3, 2024

Medical billing remains one of the most complex aspects of healthcare management, and it continues to pose significant operational challenges for healthcare providers. According to a report from the Consumer Finance Protection Bureau (CFPB), medical billing errors impact millions of…

Streamline Your Revenue: Improving Healthcare Claims Denial Management

By Suvarnna Babu April 19, 2024

Healthcare providers face a constant challenge: claim denials. Up to 8% of revenue can be lost due to denied claims, impacting not only an organization's financial health but also its ability to deliver quality patient care. An effective denial management…

EHR Adoption in ASCs: Challenges and Solutions

By Suvarnna Babu April 15, 2024

Imagine a world where patient records are instantly accessible, streamlining care and communication. This is the promise of Electronic Health Records (EHR) systems in Ambulatory Surgery Centers (ASCs). While EHRs offer a clear path to improved efficiency and quality of…

RCM compliance and audits for healthcare providers

By Anupriya Oraon April 5, 2024

The healthcare industry is undergoing a dynamic revolution, and within this transformation, Revenue Cycle Management (RCM) compliance and audits have become critical elements for providers. Striking a balance between financial stability and observing regulations is crucial, impacting healthcare practitioners' livelihoods. …

Identifying & Addressing Underpayments in Medical Billing

By Anupriya Oraon April 5, 2024

Is your medical practice unsure if it's receiving full reimbursement for services provided? Underpayment in medical billing is a common concern, especially for smaller practices. Unlike denials, where a claim is rejected, underpayments involve receiving less than the billed amount.…

Streamline Your ASC Operations with Efficient Prior Authorization

By Suvarnna Babu April 5, 2024

Prior authorization is a necessary step for ASCs (Ambulatory Surgical Centers) to ensure insurance coverage for procedures. While it helps manage costs, the process can be complex and time-consuming, leading to delays in care and frustration for patients and staff.…

Addressing the Challenge: How Healthcare Organizations Can Improve Patient Collections in 2024

By Suvarnna Babu March 15, 2024

The healthcare landscape faces a complex challenge: declining patient collection rates. This trend, fueled by factors like rising deductibles and increasing out-of-pocket costs, creates a financial squeeze for healthcare organizations, hindering their ability to deliver quality care. A recent study…

Addressing Common Challenges in Insurance Verification

By Anupriya Oraon March 15, 2024

In today's healthcare system, checking insurance is key for hospitals and clinics. But sometimes, it feels more like navigating a tangle than a simple process. Insurance verification is one of the critical aspects of healthcare administration, ensuring providers receive the…