Author name: Team UMBS

Healthcare providers have a vital responsibility to protect patient information, avoiding severe penalties, legal issues, and reputational harm. The Health Insurance Portability and Accountability Act (HIPAA), established in 1996, aims to safeguard the confidentiality of medical records and personal health information (PHI), particularly in electronic transmissions. Compliance with HIPAA is essential for healthcare providers involved […]

Effective communication with patients about billing and healthcare costs is a fundamental aspect of patient-centered care. In this comprehensive guide, we explore the importance of transparent communication, strategies for addressing Costs to Patients billing concerns, and ways to enhance patient engagement in financial discussions. Patients who are well-informed about their financial responsibilities and options are

Healthcare Billing Efficiency: Medical coding is the backbone of healthcare revenue cycle management, translating patient diagnoses and treatments into universally recognized codes for billing and record-keeping. Balancing efficiency and accuracy in medical billing & coding is crucial for healthcare organizations. In this article, we explore the significance of finding this equilibrium and strategies for achieving

Small healthcare practices, including independent clinics and physician offices, play a vital role in providing accessible and personalized care to their communities. However, managing the financial aspects of a small healthcare practice can be challenging, especially in the face of evolving healthcare regulations and economic uncertainties. In this comprehensive guide, we will explore strategies to

Financial Impact of COVID-19: The COVID-19 pandemic unleashed unprecedented challenges upon the healthcare industry, disrupting not only patient care but also the financial stability of healthcare organizations. As the sector grappled with surges in cases, resource shortages, and changing patient behaviors, healthcare finance teams faced the daunting task of mitigating revenue losses and planning for

In today’s data-driven healthcare landscape, the strategic use of analytics has emerged as a pivotal tool for optimizing revenue cycle management (RCM). Analytics empower healthcare organizations to extract actionable insights from vast volumes of financial and operational data, enabling them to make informed decisions, enhance efficiency, and maximize revenue. In this comprehensive guide, we will

In the evolving landscape of healthcare, patient-centricity has become a guiding principle. Beyond clinical care, this approach extends to the financial aspects of healthcare, including billing and payments. More and more healthcare providers are realizing the significance of crafting a patient-focused billing experience emphasizing transparency, affordability, and convenience. In this comprehensive guide, we will explore

The Medicare Outpatient Code Editor (OCE) is a software designed to identify coding errors during the processing of bills submitted by outpatient hospitals. Additionally, it verifies that all outpatient claims submitted to Medicare comply with the pertinent coding guidelines. ‘Integrated’ Outpatient Code Editor (I/OCE) The Integrated Outpatient Code Editor (I/OCE) program handles claims for all

Accounts receivable, often abbreviated as A/R, refers to the money owed to organizations for services provided and billed. Payments from payers, patients, and other guarantors contribute to A/R. Ensuring correct and timely payments is a key objective for every organization. A rise in A/R from one period to another indicates that payments aren’t being collected

Retro Authorization: Medical billing companies strive to assist doctors in minimizing claim rejections and enhancing patient satisfaction through effective methods like insurance verification and preauthorization services. Prior authorization is used by health plans to decide if a prescribed treatment or service will be reimbursed. Insurance verification experts aid healthcare providers in managing this lengthy and