Revenue Cycle Management Healthcare

  Gastroenterology Medical Billing Services Gastroenterology medical billing services involve the submission and management of financial claims for medical services provided by gastroenterologists or gastroenterology practices. Gastroenterology focuses on diagnosing and treating digestive system disorders, including inflammatory bowel disease, liver disease, and gastrointestinal cancers. Billing for these services can be intricate and time-intensive, requiring adherence to various coding and billing regulations. Gastroenterologists and billing professionals must accurately document their services, ensuring correct coding and billing practices to optimize reimbursements. Proper management of underpayments, particularly in endoscopy billing, is crucial for maximizing revenue and often surpasses the capabilities of standard billing software and in-house staff, posing a significant financial risk to gastroenterology practices.  Gastroenterology Coding Gastroenterology coding refer...

  In the complex world of medical billing, payment posting is a critical yet often overlooked component. It plays a pivotal role in the RCM process, serving as the final step where payments are accurately recorded and reconciled against the services provided. Despite its importance, payment posting is riddled with challenges that can significantly impact the financial health of healthcare practices. At QWay, we understand these challenges and have developed a comprehensive approach to optimize payment posting, ensuring our client’s accuracy, efficiency, and financial stability. Learn more insights in the blog below. The Importance of Payment Posting Payment posting is entering payments from insurance companies and patients into the billing system. It’s not just about recording numbers; it’s about ensuring that every transaction is accurately reflected in the practice’s financial records. This step allows healthcare providers to track revenue, identify discrepancies, and ensure that...

  General Surgery Billing General Surgery billing involves submitting claims to insurance companies for medical services provided by general surgeons. These surgeons perform various procedures including operations on the esophagus, stomach, small intestine, large intestine, liver, pancreas, gallbladder, appendix, bile ducts, and thyroid gland. To facilitate timely payment, surgeons and their teams must ensure the correctness of information and coding when billing these services. The proper billing process includes verifying patient details, using precise codes, and sending claims to the appropriate payers. Furthermore, accurate record-keeping is essential to support claims and protect against potential audits or rejections.  General Surgery Coding General Surgery coding involves accurately and precisely assigning codes to medical procedures and services carried out during general surgical operations. These codes are utilized for billing, insurance purposes, and healthcare data...

Endocrinology Billing Endocrinology billing is essential for ensuring prompt and precise reimbursement for medical treatment for patients with hormonal disorders like diabetes, thyroid issues, and growth hormone imbalances. Specialized software and expertise are employed to accurately code and bill for services such as injectables, testing, and treatments. Outsourcing endocrinology billing to experienced professionals like us can help medical practices minimize revenue cycle delays and errors, enabling them to concentrate on patient care.  Endocrinology Coding Endocrinology coding involves selecting the right codes from medical classification systems like ICD-10 codes , CGM codes, and ultrasound evaluation codes. to represent patients’ diagnoses and treatments linked to the endocrine system. This process facilitates precise communication and reimbursement within the healthcare industry, including among providers, payers, and government bodies. Effective endocrinology codi...

   Are you curious about the latest changes in Prior Authorization rules by the CMS? You've come to the right place. The CMS has introduced a new rule to streamline and modernize the prior authorization process, addressing concerns about its impact on access to care. This update is set to revolutionize how healthcare services are obtained and organized, promoting improved efficiency and a more positive patient experience within the healthcare system. Check out this blog to understand the CMS's new Prior Authorization Rules for Healthcare Providers. You can thank me later! What is CMS’s Prior Authorization ? Prior authorization, also known as pre-authorization, is a mandate by health insurance firms to verify the medical necessity of expensive procedures. Physicians or healthcare providers must secure permission before carrying out a range of procedures, tests, medical equipment, and prescription drugs. Failure to obtain appropriate pre-authorization in medical billing could re...