Author: One o Seven RCM

It seems straightforward to run an ambulatory surgery center from the outside: patients come in, procedures go smoothly, and everyone goes home the same day. However, underlying that smooth workflow is a money-making machine that never stops. One missed authorization, a forgotten modifier, or an ambiguous operative note can slow…

In 2025, time-based coding is a critical component of appropriate reimbursement and compliance in medical billing. If you are not capturing the data as such today, this analysis reflects an opportunity: Healthcare professionals across the US are moving toward clock-in/clock-out style documentation to prepare for updated CPT 2025 guidelines and…

In the field of medical billing, the UB-04 claim form is one of the most essential tools for a healthcare facility. Speaking of which, this form is essential because it ensures that hospitals, nursing facilities, rehabilitation centers, and other health providers may file claims for reimbursement with great accuracy. The…

Introduction In the medical billing world, every claim submitted represents a story—the story of accuracy, speed and financial control. This “clean claim rate,” as it’s known in medical billing, is a measure of how many of those stories ultimately win on the first try. It is one of the most…

In the complex world of medical billing, net collection rate is one of the most critical metrics that determines the financial health of a healthcare practice. For any medical provider, managing claims and reimbursements efficiently is not just about getting paid, it’s about knowing how effectively payments are collected in…

Introduction Medical billing is a field that demands precision, knowledge of payer rules, and compliance with regulatory policies. Among the terms that healthcare providers and billing professionals encounter, local coverage determination plays a central role in how claims are processed by Medicare. For practices working with patients covered under federal…

Introduction  For behavioral health and psychotherapy, accurate medical billing is important for timely reimbursement. One of the most commonly used codes in psychotherapy is the 90834 CPT Code, which represents a standard 45-minute psychotherapy session. For providers, understanding CPT 90834, its description, time range, and reimbursement rules is very important,…

Introduction Applied Behavior Analysis (ABA) therapy is one of the most recommended treatments for individuals with autism spectrum disorder and related conditions. In this case the clinical progress is the main goal, financial sustainability plays an important role to keep healthcare practices running smoothly. For healthcare providers, the most challenging…