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Humana Diagnostic Testing of Influenza

Humana Claims Payment Policy Subject: Laboratory – Diagnostic Testing of Influenza Medicare Advantage Payment Policy As a Medicare Advantage plan,...

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Humana Z-Code Billing for Molecular Diagnostic Testing

Humana Claims Payment Policy Subject: Z-Code Billing for Molecular Diagnostic Testing Medicare Advantage Plan Palmetto Region The Molecular Diagnostic Services...

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Important Update: Changes to TRICARE East Region Claims Processing

Ashley Fernando, RCM Operations Manager, Experity What is TRICARE? TRICARE is the health care program for uniformed service members, retirees,...

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Setting Up Insurance Companies for Real-Time Eligibility (RTE) in Experity with Waystar Integration

Delilah Greve, Lead Systems Integrity Specialist, Experity Real-Time Eligibility (RTE) in Experity, powered by Waystar, allows practices to instantly verify...

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Importance of Setting Up Accurate Fee Schedules

Laura Gilsdorf, Director RCM Operations, Experity Setting up accurate fee schedules is crucial for healthcare providers and their patients. Fee...

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Ensuring Accurate Registration and Billing for Managed Medicare, Medicaid, and IPA Patients

Jen Johnson, RCM Operations Manager Senior, Experity Front desk employees play a crucial role in ensuring a smooth registration process...

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The Importance of Lockbox and Bank Access for Payment Posting at Experity

Elyce Braun, RCM Operations Manager, Experity At Experity, we know that efficient payment posting is key to maintaining a healthy...

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May Industry Notes: CPT Code Changes

The AMA recently made changes to CPT codes effective March 31, 2025. The following may affect urgent care centers. Code...

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May Industry Notes: PLA Code Changes July 1, 2025

PLA codes, 0240U and 0241U, will be deleted by the AMA with an effective date of July 1, 2025. CPT...

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Credentialing: The Gatekeeper of Healthcare Access and Reimbursement

In the healthcare ecosystem, credentialing is more than a bureaucratic hurdle — it's the linchpin of successful revenue cycle management,...

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Navigating Payer Reviews and Medical Decision-Making: A Critical Guide for Urgent Care Clinics

Urgent care operators face increasing challenges from payer reviews, a situation exacerbated by ongoing confusion around coding guidelines and proper...

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