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Healthcare Revenue Cycle Management
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What Is Credentialing?
Credentialing is the process of verifying a healthcare provider’s qualifications to ensure they are competent and legally allowed to practice. This includes checking education, training, licensure, work history, certifications, malpractice history, and other...
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COVID-19 Vaccination Mandate for Health Care Workers
Since the first onset of Covid-19 vaccination mandate in May and June 2021, the VAX mandate has been an abrupt disruption in the lives of millions of Health Care workers.
The Biden-Harris Administration has mandated COVID-19 vaccinations for clinical and non-clinical health care workers employed by a certified Medicare or Medicaid-funded facility.
Navigating Facility Credentialing Process in Minnesota
By: Ann Knutson, CPC-A Facility credentialing is a critical aspect of healthcare revenue cycle management. This is the process in which an insurance carrier evaluates a facility for approval to be 'in network' and a participating provider of specific healthcare...
5 Keys to Choosing an Outsourced Medical Billing & Coding Partner
Medical billing and coding is arguably one of the most important aspects of a practice. Quality care, of course, is a priority, but if you don’t bill for the care, your practice won’t succeed. One of the decisions every practice has to make is whether to keep their...
6 Key Benefits of Effective Revenue Cycle Management
By Ranadene Tapio, MBA, CMRS, CPCS As healthcare delivery gets more complex, patient reimbursement decreases, and patient demand increases, practices are forced to reevaluate their revenue cycle management (RCM) process. Some people underestimate the...
7 Tips for Patient Collections
Ranadene Tapio, MBA, CMRS, CPCS Collections aren’t the most glamorous part of running a practice. Perhaps the only thing worse than making collections calls is receiving them! Unfortunately, collections are necessary and if done correctly,...
Successful Insurance Claims Submission & Reimbursement
By Ranadene Tapio, MBA, CMRS, CPCS Does your office experience a rejection rate in insurance denials that’s higher than you’d like it to be? Does your front-desk and billing staff know the type of information that’s important to obtain when registering a...
Maximizing Revenue Cycle Efficiency
By Ann Knutson, CPC-A The healthcare revenue cycle includes all administrative and clinical functions that involve capturing, managing, and collecting the provider’s/facilities revenue. The cycle includes three distinct parts of the practice/facility...
Reduce Your Denials With These 4 Tips
By Ranadene Tapio, MBA, CMRS, CPCS Your practice seems to be doing everything right. You have a team in place, you’ve established your Revenue Cycle Management (RCM) process and you’re submitting claim after claim – but your denial rate...
Medical Necessity and the Revenue Cycle
By Ann Knutson, CPC-A According to the Center for Medicare & Medicaid Services (CMS), medical treatment or supplies provided by a physician is considered medically necessary when they "are proper and needed for the diagnosis or treatment of your medical condition,...