Etactics

JANUARY 18, 2023

Medical billing has plenty more disheartening statistics, but I’ll spare you on all of those for now. Being in the medical billing field, you have to stay on your toes… but you already knew that. Being in the medical billing field, you have to stay on your toes… but you already knew that. Table of Contents.

Healthcare 52

Healthcare Healthcare Providers 52

Etactics

JANUARY 18, 2024

When we think of the healthcare industry, the business aspect of how these institutions run may not come to mind. In this blog, we’ll explain the importance of revenue cycle management in the healthcare space. In fact, it may not be something you want to think about. So what can we do to combat this? Sounds simple…right?

Healthcare 52

Healthcare Doctors Healthcare Providers Hospitals 52

Etactics

FEBRUARY 10, 2023

There are between 5 and 10 percent medical claim denials on average, according to the AAFP. In 2020, across HealthCare.gov insurers, reports show that 18 percent of in-network claims resulted in claim denials. In 2020, across HealthCare.gov insurers, reports show that 18 percent of in-network claims resulted in claim denials.

Healthcare 52

Healthcare Healthcare Providers Medicaid Prevention 52

Etactics

APRIL 13, 2023

When dealing with medical claim denial statistics, Experian Health has some great examples. For instance, according to their 2022 State of Claims Survey , 30% of health professionals say that claim denials are increasing anywhere from 10% to 15%. Why are denials such a pain? Let’s look at the common denial code PR 204!

Regulations 52

Regulations Nursing Prevention Healthcare 52

Etactics

OCTOBER 20, 2023

According to a KFF report , 2021 saw an increase of 17 percent in in-network claim denials. However, average insurer denial rates can vary widely, depending on the payer and practice involved. Not many people can confidently say they understand everything about the medical billing and coding system.

Prevention 52

Prevention Medicare Regulations Medicaid 52

Etactics

DECEMBER 1, 2023

Did you know that poor billing practices cause American doctors to lose around $125 billion each year ? Medical billing and coding has many challenges. If you keep up with our blogs or work in the industry, you know exactly what I’m talking about. These two coding systems both handle medical procedures and services.

Medicare 52

Medicare Medicaid Medical Services Prevention 52

Etactics

OCTOBER 25, 2022

These entities allow providers to extend medical treatment to those who may not be able to afford it. Handling the balance of more procedures, providers and cashflow relies on a good game plan. Revenue cycle management, or RCM, is a term used to describe how healthcare organizations track their patients from registration to billing.

Regulations 52

Regulations Doctors Healthcare Integration 52

Etactics

JANUARY 26, 2024

In this blog, we focus on unveiling the details surrounding the fee-for-service payment model. Details include what it is, how it works, as well as criticisms that surround the practice. So how does FFS work? As is anything in the medical billing industry, there are different hoops and roadblocks to maneuver through.

Healthcare 52

Healthcare Primary Care Medicare Healthcare Providers 52

Etactics

JANUARY 18, 2022

Whether you’re a seasoned behavioral health professional that just opened a private practice or a biller that just landed your first job at a facility, you have to figure out how to bill insurance companies for counseling services. Two statistics help paint the dismal picture that is billing insurance companies.

Private Practices 52

Private Practices Tricare Accountability Medicaid 52

Etactics

DECEMBER 21, 2021

Ask any medical biller what their arch-enemy is and they’ll identify one of the two main types of codes that they work with. Although both types of those codes are an essential part of the medical billing process, they lead to a lot of headaches for billers and the organizations they represent.

Accountability 52

Accountability Doctors Healthcare Patient Experience 52

Etactics

FEBRUARY 8, 2022

it would amount to around $5 million worth of denials per. If the average dollar amount of denials costs providers that much, regardless of the size of their practice, how are they supposed to keep their doors open? The reality is that the denial landscape is different for every healthcare organization.

Medicaid 52

Medicaid Healthcare Healthcare Providers 52

Etactics

JANUARY 11, 2022

If you mention the word “billing” to any mental professional, they’ll shutter. Although the billing rules within the mental health space seem archaic, the practice sends shivers down the spine across the entire medical world…regardless of specialty. But how do you actually solve this problem?

Medicaid 52

Medicaid Integration Medicare Healthcare 52

Etactics

NOVEMBER 3, 2022

Any medical biller with some experience will agree that there are a lot of steps. Billing isn’t as simple as submitting a claim to a patient’s insurance payer, the payer reviewing the document, and you gett paid. If you aren’t a seasoned medical biller, you are probably asking yourself, “what is claim adjudication?”

Healthcare Providers 52

Healthcare Providers Prevention Healthcare Accountability 52

Etactics

SEPTEMBER 1, 2023

If you’ve ever tried to work through the revenue cycle for your business alone, you likely know how convoluted the process is. To put it simply, these file types are essentially the bill and the receipt. To put it simply, these file types are essentially the bill and the receipt. In fact, that last sentence alone fuels a $49.6

Healthcare 52

Healthcare Accountability Healthcare Providers Doctors 52

Etactics

OCTOBER 27, 2022

Medical billing is a headache. After all, you clicked to read this blog post because of those pesky rejection codes, right? For reference, denials are fully processed but inaccurate claims. From a clearinghouse perspective, a claim bounces back to you because of a preliminary step in the medical billing process.

Doctors 52

Doctors Rehabilitation Nursing Hospitals 52

Etactics

JULY 8, 2021

It doesn’t matter how great of care you provide. They might show up repeatedly in the emergency room, have complex medical problems, have low health literacy, use a number of medications, visit multiple specialists, etc. At the end of the day, patient volume is what makes or breaks your practice.

Doctors 52

Doctors Accountability Urgent Care Hospitals 52

Etactics

SEPTEMBER 7, 2023

Based on the total number of in-network claims submitted, that averaged out to a 17% denial rate. A more recent study found that the total denial rate increased by 3% more in 2022 than in 2021. But, in our 20+ years of business as a medical claims clearinghouse with a focus on denial management, we’ve noticed a pattern.

Healthcare 52

Healthcare Doctors Prevention Medical Services 52

HIT Consultant

AUGUST 2, 2022

Exacerbated by pandemic-induced burnout, resignations, and even terminations 1 , chronic coding and revenue cycle management (RCM) staffing shortages have healthcare organizations struggling to find ways to keep revenue flowing despite a lack of qualified professionals to handle critical processes. The Rising Cost of Desperation.

Hospitals 97

Hospitals Accountability Healthcare Regulations 97