Medical billing is a complex process that involves numerous procedures, codes, and rules. One of the essential components of medical billing is understanding what is covered and what is not covered by the insurance company. Non-covered services are those medical procedures, tests, or treatments that are not covered by the patient's insurance plan.

Non-covered services may arise due to various reasons, including but not limited to the following:<... Read more

Medical billing can be a confusing and frustrating process, especially when it comes to out-of-network providers. An out-of-network provider is one that does not have a contract with your insurance company, which means they do not have a set fee schedule for their services. This can result in higher out-of-pocket costs for patients, as well as confusion about what is covered by insurance and what is not.

When you visit an out-of-net... Read more

Medical bills can be incredibly confusing, with different terms and concepts to understand. One term that you may have come across when dealing with healthcare expenses is "out-of-pocket maximum." But what exactly does this mean? And how does it impact your medical billing?

What is Out-of-Pocket Maximum?

The out-of-pocket maximum refers to the maximum amount of m... Read more

Medical billing can be a complex and confusing process, not only for healthcare providers but also for patients. One area that often causes confusion is patient responsibility in medical billing. We will define patient responsibility and explore why it matters.

What is Patient Responsibility in Medical Billing?

Patient responsibility refers to the portion of medical bills that patients are... Read more

Medical billing can be a complex and confusing process, with various terms and concepts that can be difficult to understand. One of these concepts is the Point of Service (POS) in medical billing. We will explain what the Point of Service is, how it works, and why it is important for medical billing.

What is Point of Service (POS)?

The Point of Service refers to the locati... Read more

In the world of medical billing, one term that is frequently used is "prior authorization." This term refers to a process that many insurance companies require before they will cover certain medical treatments or procedures. We will explore what prior authorization is, why it is necessary, and how it affects medical billing.

What is Prior Authorization?

Prior authorization, also ... Read more

Medical billing is a complex process that involves various steps, from patient registration to insurance verification to claim submission and payment collection. One of the key aspects of medical billing is pre-determination, which refers to the process of determining the coverage and payment amount for a medical service before it is provided.

In other words, pre-determination is a way for patients and healthcare providers to know in advance what th... Read more

Medical billing can be a complicated process, and one of the terms that often confuses patients is "pre-existing condition." Simply put, a pre-existing condition is a health issue or illness that you had before you signed up for health insurance coverage. We'll explore what a pre-existing condition is in medical billing, how it can affect your coverage, and what you can do to manage your health care costs.

A pr... Read more