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How Long Does Prior Authorization Take & How Staffingly Speeds It Up?
The healthcare landscape can be daunting, especially when it comes to understanding insurance requirements like prior authorizations. These are formal approvals that insurance companies often require before they agree to cover certain medications, treatments, or procedures particularly those with lower-cost alternatives. While the intent behind prior authorizations is to manage costs and ensure medical necessity, the process itself can introduce delays and challenges for both patients and healthcare providers. It involves multiple steps, from identifying which services require prior approval
Sophia Wilson
How Non-Compliance with Payer-Specific Rules Affects Healthcare Billing and Reimbursement?
In the world of healthcare billing, accuracy is everything. Without it, providers risk facing significant financial losses, delayed reimbursements, or even penalties. According to surveys, the U.S. healthcare system loses a staggering $935 million each week due to inaccurate billing, and many of these losses are linked to under coding, upcoding, and non-compliance with payer-specific rules. But what happens when your medical coding doesn’t meet the specific guidelines set by each payer? In this article, we’ll explore how non-compliance with
Emma Davis
CPT Coding for New Procedures and Technology in Healthcare
When it comes to medical procedures and technologies, having the correct coding is crucial. Not only does it streamline the billing and reimbursement process, but it also ensures accurate tracking of services and procedures. This is where CPT codes come in, providing healthcare professionals with a standardized system for reporting and managing medical procedures. In this article, we’ll discuss the importance of CPT codes, how they’re created and updated, and how Staffingly can support you with accurate medical coding services
Venkata Ramarao Sanka
What Patients Need to Know About High-Deductible or Cost-Sharing Plans?
High-deductible and cost-sharing health insurance plans have become increasingly common, shifting more financial responsibility onto patients. While these plans often feature lower monthly premiums, they require patients to meet a substantial deductible or pay significant cost-sharing amounts before the insurer contributes toward covered services. This structure can lead to confusion and unexpected financial burdens if patients are not fully aware of their obligations. Challenge In this scenario, the patient is technically covered by insurance but remains responsible for full payment
Noah Thomas
Understanding Coverage Limitations and Plan Exclusions in Health Insurance
Health insurance is designed to provide financial protection for patients, but not all medical procedures, providers, or locations are covered under every plan. Coverage limitations or plan exclusions occur when a patient’s insurance plan does not include a specific service, provider, or facility, leaving patients responsible for some or all of the costs. Understanding these exclusions is crucial for both healthcare providers and patients to avoid unexpected bills and ensure informed decision-making. Challenge A common challenge in healthcare administration arises
Noah Thomas
5 Reasons Every Small Practice Should Consider a Virtual Medical Assistant
Dr. Kim runs a small primary care clinic in a suburban neighborhood. She loves her patients, but between managing phone calls, juggling appointments, verifying insurance, and keeping up with documentation, her day often stretches late into the evening. One day, she brings in a Virtual Medical Assistant (VMA)—a remote professional who handles all those non-clinical headaches. Suddenly, Dr. Kim’s evenings are hers again, her patients feel more cared for, and her front desk staff can finally breathe. This isn’t just
William Brown
HMO vs. PPO vs. EPO: Understanding Plan Types in Eligibility Checks
Maria, a front-desk coordinator, is on her third call of the morning with an insurance company. A patient is waiting for confirmation on whether their specialist visit is covered. The patient’s plan says “EPO,” but Maria isn’t sure if it works like a PPO or an HMO. Meanwhile, the waiting room is filling up. Phones are ringing. Frustration builds.Sound familiar? Insurance plan types—HMO, PPO, and EPO—are more than just acronyms. They directly impact eligibility checks, referrals, and reimbursement. If you
William Brown
Mastering Digital HealthCare with Strategic Outsourcing
Digital healthcare is a fast-evolving, multidisciplinary field that merges digital technologies with healthcare services. It leverages information and communication technologies (ICTs) to transform how care is delivered, accessed, and experienced. The ecosystem includes mobile health (mHealth) apps, telemedicine platforms, electronic health records (EHRs), health information systems (HIS), enterprise resource planning (ERP), and customer relationship management (CRM) tools. Additionally, the field integrates advanced technologies such as big data analytics, genomics, and artificial intelligence (AI). The primary objectives are to improve service
Sophia Wilson
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Recent Posts
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Virtual Medical Assistants
Insurance Verification
Prior Authorization (AI)
Medical Scribing (AI)
Telemedicine Services
Medical Data Entry
Medical Coding
Revenue Cycle Management
