Important Modern Insights and Research into Pre- and Post-Payment Audits

The relationship between pre-bill and post-bill auditing forms a cohesive integration in the revenue cycle  Pre-bill audits prevent errors, boost efficiencies and safeguard revenue, while post -payment audits provide retrospective insights into navigating payer disputes with evidence based knowledge.  The following developments in technology and innovation have enhanced the effectiveness and efficiency of audits. By […]

Straight-Through Billing

Medical billing complexity and massive volumes of daily claims render manual claims processes incapable of protecting both the provider and the payer from underpayments, overpayments, and billing compliance violations. Straight-Through Billing (STB) addresses complexity and volume processing problems by automating the majority of the claim flow and focusing the billing follow-up specialists on exceptions only. […]

No-Show Risk Management

When patients miss appointments, they interrupt the flow of patient care, impede clinic productivity, and signal an eroding patient loyalty. The rate of no-shows runs at 30% for the average family practice. A missed appointment amounts to missed billing revenue. Worse, if clinicians are part-time or full-time staff rather than contracted, they sit idle on […]

Change Healthcare Outage Updates

Update – May 23, 2024 From Our CEO  Weekly Update: Our electronic claim submission is restored to its full pre-CHC outage capacity.  All claims previously dropped to paper to bypass the Change Healthcare outage have since been submitted electronically as needed. We continue the process of re-establishing ERAs, which will likely take several weeks and […]