Top 10 Challenges in Physical Therapy Medical Billing and Solutions
Billing for physical therapy services comes with unique challenges that can impact revenue and cash flow. Challenges in physical therapy medical billing include time-based CPT codes, therapy caps, strict medical necessity requirements, frequent claim denials, incorrect modifier usage, missing therapy notes, coding errors, delayed reimbursements, compliance issues, and ever-changing insurance policies. Addressing these challenges with […]
Understanding POS 41 in Medical Billing – When and How to Use It
Place of Service (POS) codes play a crucial role in medical billing. They help healthcare providers and insurance companies classify medical services based on where they are performed. POS 41 represents services provided in an ambulance on land. Using the correct POS code is essential for smooth claim processing, preventing errors, and ensuring timely and […]
ICD-10 Codes for Lab Tests: A Complete Guide
Medical billing relies on precision, and ICD-10 codes play a crucial role in ensuring lab tests are correctly documented, coded, and reimbursed by insurance companies. These codes help healthcare providers justify the necessity of medical tests, prevent claim denials, and maintain compliance with insurance policies. Without accurate coding, providers may face financial losses, patients may […]
Top 10 Medical Billing Challenges in General Surgery and How to Solve Them
Medical billing in general surgery is complicated and requires precision. Surgeons handle complex procedures, multiple codes, and frequent insurance rule changes, making the billing process prone to errors. A minor mistake can lead to claim denials, revenue loss, and additional administrative burdens. These challenges not only affect a practice’s financial health but also impact operational […]
CO-45 Denial Code: Meaning, Causes, and How to Fix It
Receiving a CO-45 denial code on an Explanation of Benefits (EOB) can be frustrating and confusing for healthcare providers and medical billing professionals. This code indicates that the insurance company has adjusted the billed amount because it exceeds the contracted rate agreed upon between the provider and the payer. If not handled correctly, it can […]
AI in Medical Billing – Automation, Benefits, and Challenges
Medical billing is one of the most critical processes in the healthcare industry. Accuracy, speed, and efficiency are key to ensuring that healthcare providers receive proper reimbursement and that patients are billed correctly. However, traditional billing methods can be prone to errors, delays, and inefficiencies. Enter AI—a powerful tool that is changing the game in […]
How to Handle Denials in Medical Billing | 6 Steps & Tips
In the complex world of medical billing, handling denials is critical to maintaining smooth revenue flow. Every denied claim represents delayed payment, which impacts healthcare providers financially. Understanding and managing denials can significantly enhance billing efficiency and revenue recovery. In this article, we provide you with expert strategies to handle and prevent denials in medical […]
Modifier 95 in Medical Billing: Complete Guide, Uses & CPT Codes
Medical billing can be complex, especially when dealing with telehealth services. One crucial component of telehealth billing is Modifier 95, which ensures healthcare providers receive proper reimbursement for virtual consultations. In recent years, telehealth services have grown significantly, especially after the COVID-19 pandemic, leading to new billing regulations and requirements. Modifier 95 plays a key […]
POS 11 vs. POS 22 in Medical Billing – Key Differences & Best Practices
When billing for healthcare services, understanding POS 11 vs. POS 22 is crucial for accurate claims and proper reimbursements. These Place of Service (POS) codes determine whether a service is billed under a physician’s office (POS 11) or an outpatient hospital setting (POS 22), impacting reimbursement rates, facility fees, and compliance. Misusing these codes can […]
Complete Guide to Physical Therapy CPT Codes
Physical therapy plays a key role in rehabilitation, helping patients recover from injuries, surgeries, and other physical health issues. However, it’s crucial for healthcare providers to use the correct CPT (Current Procedural Terminology) codes when billing for services. This ensures accurate claims and timely reimbursements. In this guide, we will go over the most common […]