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expert-prior-authorization-support-reduces-denials

Healthcare Outsourcing Outsourcing Prior Authorization Prior-Authorization

How does expert PA support fill the revenue gap made by denials?

Prior authorization (PA) remains one of the most pressing administrative hurdles in physical therapy. Designed to manage costs and confirm the medical necessity of specific treatments, medications, and procedures, this process often results in delays that negatively impact both providers and patients. When approvals are denied, it leads to missed treatments, paperwork backlogs, and lost revenue. A 2023 survey by a leading medical association found that 94% of physicians experienced care delays due to PA, with 1 in 3 reporting

Sophia Wilson

Healthcare Outsourcing Outsourcing

How ICD-10 Affects Healthcare Revenue Cycle Management (RCM)?

The implementation of ICD-10 (International Classification of Diseases, 10th Revision) brought a significant shift in how healthcare providers document diagnoses and procedures. While its main goal was to improve clinical accuracy and health data analytics, ICD-10 has a direct and lasting impact on the revenue cycle management (RCM) process. Understanding how ICD-10 affects RCM is essential for optimizing reimbursement, reducing denials, and ensuring compliance. 1. Greater Coding Specificity Improves Reimbursement Accuracy ICD-10 includes over 70,000 diagnostic codes and 75,000 procedure

Noah Thomas

Medical coders impact revenue cycle management

Healthcare Outsourcing Outsourcing

How Medical Coders Impact Revenue Cycle Management?

Medical coders play a critical role in Revenue Cycle Management (RCM), ensuring that healthcare providers are reimbursed correctly for the services they deliver. Accurate medical coding is essential for proper claim submission, billing, and reimbursement from insurance companies, including Medicaid, Medicare, and private insurers. Medical coders translate healthcare services, diagnoses, and procedures into standardized codes, which directly impact the success of the RCM process. Let’s explore how medical coders influence RCM and contribute to the financial health of healthcare organizations.

Noah Thomas