Author name: Team UMBS

Credentialing is the verification of a practitioner’s qualifications to become an in-network provider with insurance companies. It includes their education, training, license, and experience. It is a critical step in the healthcare industry that cannot be ignored. It is a lengthy and detailed process. In this article, you will learn the process of understanding and […]

Insurance eligibility verification is a crucial aspect of healthcare that practitioners must perform before providing services to patients. In this process, the healthcare providers verify the patient’s insurance coverage, benefits, and eligibility to ensure timely payments and prevent claim rejections. Insurance eligibility verification is associated with many benefits, including improving patient experience, ensuring compliance with

Taking care of your medical bills is important even when you are insured. Medical bills affect your credit but there are particular rules for it and you get time to manage those debts. It helps you to manage your bills and improve your credit score. According to recent estimates, the number of people who carry

An ABN is a formal notice given to Medicare beneficiaries to inform them about a particular service (before taking it) that may not be reimbursed by Medicare. If Medicare denies coverage for a particular treatment, the patient is responsible for its payment. The reason is that treatment does not fall under the Medicare coverage guidelines or

Medical billing requires proper coding for successful reimbursement procedures. As you know, many codes are used in medical billing and J codes place a significant place. In this article, we will discuss in detail the J codes, their purpose and specifications in healthcare medical billing. Understanding J-Code:  The Healthcare Common Procedure Coding System (HCPCS) level

Every year, the current procedural code set is updated by AMA and Centers for Medicare and Medicaid before it implementation. If you are looking for CPT Code Updates 2024, this article is for you.  The 2024 CPT code updates comprise 349 modifications, with 230 additions, 49 deletions, and 70 revisions. According to 2024 Medicare coding

The analysis and treatment of patients from a distance using communication technology is known as telemedicine.  The World Health Organization (WHO) defines telemedicine as “Healing from a distance.” Through the use of telemedicine, a patient can receive medical care from a doctor even when they are not there in person. Telemedicine services include examinations, consultations,

The adoption of a new Electronic Health Records (EHR) system is a significant milestone for healthcare organizations. It promises improved patient care, streamlined workflows, and enhanced data management. However, the transition can also pose challenges, particularly when it comes to revenue management. In this article, we’ll delve into the complexities of managing revenue during an

Reimbursement Models: The landscape of healthcare reimbursement is undergoing a significant transformation, shifting from traditional fee-for-service models to value-based reimbursement models. This shift represents a fundamental change in how healthcare providers are compensated and aims to prioritize the delivery of high-quality care over the quantity of services rendered. In this article, we’ll explore the essence

In the ever-evolving landscape of healthcare, revenue cycle management (RCM) stands as a critical pillar supporting the financial health of medical practices and healthcare facilities. At its core, RCM encompasses the complex processes involved in managing patient billing, claims submission, reimbursement, and financial optimization. Given its intricacies and the constant evolution of regulations and technology,