Can You Bill Before Credentialing Is Complete? What Providers Need to Know
A new provider signs the offer on a Friday. HR schedules orientation, the front desk books patients for week two, and the credentialing file goes out to the payers that same week. Payroll starts right away. Revenue usually doesn’t, and the question follows almost immediately: can you bill before credentialing is complete? That stretch, between […]
How to Handle Retroactive Billing and Overcome Payer Retroactive Credentialing Limits
What happens when a provider starts seeing patients before their payer credentialing is finalized? Can those claims still be billed? What if the payer approves the provider months later but refuses to use the original start date? And if claims have already been denied, is there still a way to recover that revenue? These situations […]
DME Revenue Cycle Management: Guide for Providers
Why are DME claims denied after the equipment has already been delivered? Are missing documents, incorrect HCPCS codes, prior authorization issues, or proof-of-delivery problems slowing down reimbursement? DME revenue cycle management covers the full process from patient and insurance verification to the order, medical necessity review, authorization, HCPCS coding, delivery documentation, claim submission, payment posting, […]
How to Streamline Referrals and Prior Authorizations in eClinicalWorks
A referral may be entered correctly yet remain pending due to lack of clinical documentation, an insurance requirement, or a delayed follow-up. Prior authorization can create similar problems, especially when staff must verify payer rules, submit documentation, track responses, and confirm approval before the scheduled service. A well-organized eClinicalWorks workflow can give referral and authorization […]
eClinicalWorks ERA and EOB Payment Posting Guide: Process, Errors & Best Practices
Are insurance payments being posted correctly in eClinicalWorks? A payment can reach the practice successfully while the claim balance is still wrong if the remittance, adjustment, and patient responsibility are not posted correctly. An ERA, or Electronic Remittance Advice, explains how a health plan adjudicated a claim and provides payment and adjustment information. An EOB, […]
Virtual vs. In-Person Medical Scribes: Which Is Right for Your Practice?
Why choose a virtual scribe when an in-person medical scribe can work beside the provider? The wrong choice can increase documentation delays, staffing costs, EHR workload, and communication gaps. When comparing virtual and in-person medical scribes, healthcare providers can choose the approach that is appropriate to their daily tasks. Virtual medical scribe services can reduce […]
How Virtual Medical Scribes Cut Burnout and Save 2 Hours a Day on EHR Documentation
A patient visit may end in 20 minutes, but the physician’s work often does not. Completing EHR notes, reviewing charts, and closing documentation after clinic hours can create “pajama time” and add to administrative fatigue. This raises a practical question: Can virtual medical scribes actually give physicians two hours back each day? A JAMA multisite […]
eClinicalWorks Claim Scrubbing: Process, Errors & Best Practices
Why do some claims get rejected even when the billing information appears complete? What does an eClinicalWorks claim scrubber actually check before a claim is submitted? These are common questions for medical billing teams managing claims in eClinicalWorks. eClinicalWorks claim scrubbing reviews claims for potential billing, coding, patient, insurance, provider, and submission errors before they […]
8 Minute Billing Rule: The Complete Guide for Physical Therapy
The 8 minute billing rule decides how many units you can bill for time‑based therapy services under Medicare. Get it right, and your claims pay cleanly. Get it wrong, and you face denials, take‑backs, or compliance risk. This guide explains the 8 minute rule for physical therapy billing, how to calculate units step by step, […]
CPT Code 95886: The Definitive Billing & Documentation Guide
If you bill neurology or electrodiagnostic services, you must master cpt code 95886. Used correctly, it supports clean payment for complex EMG/NCS studies. Used incorrectly, it leads to denials, recoupments, and audits. This guide explains what CPT code 95886 is, how to pair it with nerve conduction studies, how many units you can report per […]