Revenue Cycle

The Ohio Behavioral Health Redesign has transformed how agencies submit claims, get reimbursed, and manage compliance with Medicaid. While the goal is to improve care coordination and streamline processes, the reality for behavioral health organizations has been more complexity, new payer IDs, and increased denial risk. Etactics has guided providers through every phase of the redesign—helping them simplify billing, reduce rejections, and stay focused on patient care instead of paperwork.

Today, we will get into exactly what claim scrubbing software is. As well as how they help improve cash flow, and what to look for when choosing the right solution for your company! Let's take a look together.

In this blog, we’ll explore how LTC pharmacies support residents, staff, and facilities across the long-term care spectrum.

For billing teams, knowing how to prevent and resolve CO 59 denials is key to effective denial management and maintaining smooth revenue cycle management. So let’s jump into it!

In this blog we are going to break down what “out-of-network” really means, the cost implications, and how to make informed decisions when choosing a provider. 

In this blog, we will walk through the most common reasons claims get denied, and the best practices your team can implement to prevent them and protect your revenue cycle.

In this blog we look at the basics of EDI X12. We will touch on what EDI is in general and how X12 fits into the broader EDI landscape. As well as what constitutes a standard X12 message, what interchange envelopes do, and the importance of functional groups and transaction sets.