Revenue Cycle Management - expEDIum Solutions Blog

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. …

How to Avoid Up-Coding and Under-Coding in Medical Billing

By Suvarnna Babu April 5, 2024

Imagine a world where every patient interaction translates smoothly into the appropriate financial compensation for your practice. Sounds idyllic, doesn't it? In reality, the intricate dance between medical services and reimbursement hinges on a crucial factor: accurate medical coding. Unfortunately,…

How to Optimize Reimbursement and Minimize Denials in Mental Health Billing

By Suvarnna Babu April 5, 2024

The intricacies of mental and behavioral health billing pose a unique challenge within the healthcare landscape. The consistency often found in billing practices across traditional medical specialties is absent in the mental health realm. In other areas of medicine, a…

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.…

Maximize Reimbursement in Your Gastroenterology Practice with expEDIum

By Suvarnna Babu April 5, 2024

The ever-changing landscape of gastroenterology billing in 2024 presents a challenge: minimizing revenue leakage and maximizing reimbursement. Complex coding requirements, evolving insurance procedures, and varied billing needs demand a strategic approach. That's where expEDIum comes in. We offer a comprehensive…

Revenue Cycle Optimization: Best Practices for Behavioral Health Billing Services

By Anupriya Oraon March 27, 2024

Like any healthcare provider, behavioral health services depend on a steady flow of income to operate. Like medical billing, behavioral health revenue cycle management (RCM) involves distinct complexities. Understanding these distinctions is crucial for maximizing reimbursement. Behavioral health billing: Different…

Strategies for Shortened Claim Cycles and Improved Cash Flow

By Anupriya Oraon March 21, 2024

Efficiency is one of the most significant aspects of healthcare in today's fast-paced setting. This applies to revenue cycle management (RCM), which is responsible for collecting payment for services provided. A major concern for RCM is the length of time…

Optimizing Your EHR System for Better Revenue Cycle Management

By Suvarnna Babu March 15, 2024

In today's healthcare landscape, efficiency reigns supreme. Every step of the patient journey, from intake to discharge, needs streamlining to ensure quality care and financial stability. Your Electronic Health Record (EHR) system plays a crucial role in this process, but…

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…