7 No Surprises Act Billing Rules for Private Practices in the USA
What Is the Federal No Surprise Act? The No Surprises Act is a federal law (effective January 1, 2022) designed to protect patients from unexpected medical bills, especially when they unknowingly receive out-of-network care. In simple terms, if your private practice provides services to patients with private health insurance, you can no longer bill patients […]
Timely Filing Limit for Medicare vs. Medicaid vs. Commercial Payers
Healthcare operations involve several moving parts, but one of the most important is submitting the health insurance claim form within the allowed timely filing limits. Missing this window can slow or even stop the flow of reimbursements from insurance payers. As a healthcare provider, your focus is on delivering patient care, but getting reimbursed for […]
NPI vs. Tax ID: What’s the Difference?
When it comes to medical billing, provider identification plays a major role in ensuring accurate claims submission and proper reimbursement. Two of the most important identifiers used in healthcare are the NPI (National Provider Identifier) and the Tax ID (TIN or EIN – Employer Identification Number). While they are often mentioned in the same sentence, […]
Top Cloud Based Medical Billing Software for Small Practices in 2025
Managing a small medical practice comes with its fair share of challenges. Between patient care, insurance claims, and billing, it can feel like there’s always something else demanding your attention. Billing, in particular, is one of the most time-consuming and often frustrating tasks for small practice owners. Effective management of accounts receivables is crucial for […]
New No Surprise Act Policies Brings Relief from Unexpected Medical Bills
Have you ever: These are some of the nightmare scenarios of Surprise Medical Bills, a problem that has burdened millions of Americans. That’s why the No Surprises Act, which came into effect in 2022 by U.S. federal law, is designed to protect patients’ healthcare costs from unforeseen or unexpected medical bills; particularly in emergency situations […]
7 Benefits of Embedded BI in Healthcare
The healthcare sector is a department with ever-evolving changes with new technologies and methodologies to deliver better patient care and streamline administrative operations. One such advancement is healthcare business intelligence with integrated features of analytic tools to analyze data. Healthcare BI helps to improve the efficiency and effectiveness of healthcare services and systems automatically. Embedded […]
The Role of Advanced Analytics in Value-Based Healthcare Systems
Healthcare systems around the globe have seen a shift from a traditional fee-for-service model to a more patient-centric approach for better patient healthcare outcomes, with the Value-Based Healthcare (VBHC) model. This patient outcome-driven model aims to prioritize healthcare quality, as payers reimburse them based on the value and outcomes of that care provided. Payers establish […]
What is E11.42 Diagnosis Code for Type 2 Diabetes Mellitus?
The E11.42 code is for type 2 diabetes mellitus with diabetic polyneuropathy in ICD-10. This code is key for diagnosis, treatment and documentation. What you will learn here: What is the E11.42 Code? E11.42 code is part of the ICD-10 classification system to identify type 2 diabetes mellitus with diabetic polyneuropathy. This is nerve damage […]
A Guide to the 8-Minute Rule: Get Paid Accurately for Every Therapy Session
The 8 minute rule has been a tried and true way to bill therapy sessions accurately since 1999. Simply put, 8 minutes of treatment equals one unit, and we’ve included everything you need to know about the 8 minute rule in this article to help you get your billing done quickly and efficiently. What is […]
Understanding POS 11: A Key to Faster Payments and Fewer Claim Denials
POS 11 means services provided in a physician’s office. It’s essential for accurate billing and optimal reimbursement. Here’s how to use POS 11 correctly, what services it includes and tips to avoid common mistakes. Quick Facts Understanding POS Codes in Medical Billing The Centers for Medicare & Medicaid Services (CMS) assign specific POS codes to […]
