What Clean Claim Rate Should a Dermatology Billing Partner Actually Guarantee You?

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Choosing a dermatology billing partner based only on a promised clean claim rate can be misleading. A billing company may tell you that it maintains a 95%, 97%, or even 99% clean claim rate. But before accepting that number, you need to know how the rate is measured, what claims are included, and whether those clean claims are actually being paid correctly . For dermatology practices, this matters because a claim can pass an initial billing check and still face problems related to medical necessity, modifiers, procedure coding, payer policies, or underpayment. A clean claim rate should therefore be viewed as one part of the revenue cycle, not the entire performance picture. What Clean Claim Rate Should a Dermatology Billing Partner Guarantee? A reasonable contract target is 97% or higher , provided the billing partner clearly defines the metric and measures it consistently at the payer level. The percentage itself, however, is only part of the agreement. A dermatology practice should a...
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Unique Challenges of Substance Abuse Billing

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Medical billing on its own can be a complex process, requiring specific expertise. However, substance abuse billing comes with unique challenges even for certified billing and coding experts. Substance abuse billing is one of the major areas with which drug and alcohol addiction treatment centers struggle resulting in lost revenue and delayed payments. Many drug rehabilitation centers and behavioral health organizations are closing their doors due to rapidly changing industry laws, regulations, and payer reimbursement policies. Substance abuse services are provided by: Physicians (medical doctors or doctors of osteopathy); Clinical psychologists; Clinical social workers; Nurse practitioners; Clinical nurse specialists; Physician assistants; and, Certified nurse-midwives. These substance abuse treatment providers are finding it increasingly difficult to get reimbursements from payers.

To get more information about Substance Abuse Billing and its challenges click here: https://bit.ly/3Wh0PWA.
Location: United States

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