RCM Finder Resource Center

Healthcare RCM Blog

Practical guidance on medical billing, coding, compliance and practice growth, written for practice managers and physicians.

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Every guide is reviewed by Awais Afzal, founder of RCM Finder.

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Latest guides

Newest first. Use the page numbers at the bottom to reach every guide.

Illustrated desk with a code book and a claim form linked by an arrow

Medical Billers and Coders: Roles in the Revenue Cycle

Medical billers and coders are two of several roles that move a visit to a paid claim. See who owns each step, where handoffs fail, and how to staff them.
what is credentialing in medical billing

Understanding the Purpose of Provider Credentialing and Its Importance

In today’s complex healthcare landscape, provider credentialing plays a vital role in ensuring quality care and maintaining the trust of patients. This comprehensive article will explore the purpose of provider credentialing, its importance in the healthcare system, and how it can impact medical billing processes. What is Provider Credentialing? Provider credentialing is the systematic process […]

is pain and suffering separate from medical bills

Understanding the Relationship Between Pain, Suffering, and Medical Bills in Personal Injury Cases

Dealing with personal injury cases can be challenging, especially when it comes to understanding the difference between pain and suffering and medical bills. Knowing how these two relate is important for both people looking for compensation and healthcare professionals working in revenue management. This article will break down these ideas in simple terms, using helpful […]

Friendly illustrated biller reviewing a hospital outpatient claim at a checkpoint gate with a green light

Outpatient Code Editor (OCE): What It Is and Who Uses It

The Outpatient Code Editor is a CMS program that edits institutional outpatient claims inside Medicare’s systems. Here is who it applies to, what its results mean and how to respond.
Physical therapy CPT codes

Understanding the Physical therapy of CPT Code

Physical therapy CPT codes: In the ever-evolving landscape of healthcare, accurate billing and coding are paramount for the financial health of medical practices, particularly in physical therapy (PT). CPT codes, or Current Procedural Terminology codes, serve as the backbone of the billing process, ensuring that healthcare providers are reimbursed for the services they deliver. This […]

medicare patient-driven payment model

Understanding the Impact of PDPM on SNF Billing: A Comprehensive Guide

Skilled nursing facilities (SNFs) are pivotal in the American healthcare system, providing essential care and rehabilitation services to individuals recovering from illnesses or surgeries. With the implementation of the Patient-Driven Payment Model (PDPM), the landscape of SNF billing has undergone significant changes. This article aims to break down the complexities of PDPM and its implications […]

Patient signing a one-page notice form while a practice staff member explains the options

Advance Beneficiary Notice (ABN): Form CMS-R-131 Guide for Providers

What an advance beneficiary notice is, when Medicare requires one, how to complete Form CMS-R-131, which GA, GX, GY or GZ modifier applies and how long to keep it.
Billing team member matching a diagnosis card, a procedure card and a supply card to one claim form

CPT, ICD-10 and HCPCS Codes: What Each One Does on a Claim

Three code sets, three jobs. See what CPT, ICD-10 and HCPCS each report, who maintains them, how often they change and how they fit on one claim.
Illustration of two digital charts, one inside a clinic and one linked to several buildings, representing EMR vs EHR

EMR vs EHR: Differences and What They Mean for Billing

What the difference between an EMR and an EHR is, using HealthIT.gov definitions, and why the better billing question is where charges and claims are handled.
asc hospital

Understanding the Difference Between ASC and Hospital Billing Services

Introduction In the healthcare landscape, the billing process is often a critical aspect that can significantly impact the financial health of medical facilities. Understanding the nuances between different billing services is essential for ensuring financial efficiency and compliance. This article will explore the key distinctions between Ambulatory Surgery Center (ASC) billing and hospital billing services. […]

Wheelchair, walker and hospital bed icons in a friendly home living room

HME vs DME Billing: Is There a Real Difference?

HME vs DME billing comes down to the item, the payer, the order and the rental schedule, not the label. Here is what changes your claims.
claim submission process in medical billing

Understanding the Clean Claim Submission Process in Medical Billing

The clean claim submission process is a vital aspect of Revenue Cycle Management (RCM) in the healthcare sector. A seamless claim submission process can significantly impact a healthcare provider’s financial performance, ensuring timely reimbursements and minimizing revenue loss. This article will delve deep into the intricacies of medical billing, breaking down each step of the […]

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