Archive for the Week of October 1, 2005
Archive for the Week of October 1, 2005
Welcome to the medical billing blog archive for the week of October 1, 2005.
Here you will find links to every article added to the Outsource Management Group web site during the week of October 1, 2005.
You can browse this week's archives by clicking the "More" button from any of the excerpts below.
Medical Billing And Second Observation Day Coding
Medical Billing And Second Observation Day Coding Eventually, when you’ve done enough medical billing, you will run across the scenario when a patient is in the hospital on a three day stay, a common belief among medical billers is that the a “middle” day of observation should be billed on the medical billing form as an Outpatient Visit (99212-99215). Many Carriers and Medicare will not reimburse a middle day visit coded in this fashion. Even with documentation for the middle day visit included on the medical billing form. The AMA’s position on the medical coding for this situation is that you report the middle/second day of a three day stay …
Clarifying Guidelines For Medical Billing Cardiac Rehab
Clarifying Guidelines For Medical Billing Cardiac Rehab Difference in medical billing manuals have made cardiac rehab claim submission confusing. There are three manuals that give guidance on how to bill for cardiac rehab services. These manuals are the Medicare Coverage Issues Manual, Intermediary Manual, and Hospital Manual. Each on of these manuals gives a different method on how to bill for cardiac rehab. The Office of Inspector General realizes that this has become a major medical billing issue. Recently, an audit was done on thirty four different hospitals. The goals was to see where the consistencies and then confusion lie in billing for medical cardiac rehabilitation. The results were astonishing! …
Captain Integrity & The Medical Billing Community
Captain Integrity – Superhero For The Medical Billing Community And More! Medical billing compliance has never been more fun. A brand new compliance program called Captain Integrity is getting some positive attention. Medical billing fraud is wrong and Captain Integrity is here to save the day. With medical billing fraud on the rise, a new compliance brand name was in order. The intention of the Captain Integrity program is to put a positive spin on compliance that all employees will enjoy. Many people look at compliance as a negative thing. Captain Integrity wants to change that. Everyone from office personnel to actual physicians can get involved in this medical billing …
California AG Files Fraud Charges Against 39
California AG Files Fraud Charges Against 39 pharmaceutical companies There is big Medical billing news in California. California’s Attorney General, Bill Lockyer, is showing large pharmaceutical companies that they can’t take advantage of his state any longer. Pharmaceutical fraud has plagued California. Inflation of medical billing hurts everyone. On August 25, the medical billing news that swept across California was that the Attorney General filed a lawsuit against 39 large pharmaceutical companies. He claims that they have spent years wrongfully inflating the costs of drugs. The billings for many of these medical drugs were sent to California’s Medicaid (Medi-Cal). Apparently, a smaller pharmacy filed a lawsuit against a few larger …
Strong Documentation Gets Your E/M Claims Paid
Strong Documentation Gets Your E/M Medical Billing Claims Paid When billing a medical claim, the diagnosis code is one of the most important elements to prove medical necessity. As soon as a payer gets a claim, it automatically goes through their system and is either paid, denied, or sent to review. Billing with strong documentation to back up medical current procedural terminology codes will get claims paid quicker. Many times with simple evaluation and management visits, the only thing needed in billing a claim is the medical CPT code and the ICD-9 code. When this is the case, it is very important that these codes not only correctly correspond, but …
Errors In Drug Testing Claims = Visit From the Feds
Errors In Drug Testing Claims Can Put The Feds At Your Door Any type of medical billing error can raise some eyebrows. There have been so many cases of fraudulent claims, there is no longer room for mistakes. Whether you make an unknowing error in medical billing, or purposefully cheat a payer out of money, the government will come after you with full forces. Recently, on August 25, 2005, an osteopath, Aaron M. Hurowitz was indicted on 80 counts of healthcare fraud. This Georgia osteopath had been involved in fraud and money laundering since 1997. Apparently he cheated Medicaid out of about three million dollars. There were several things he …
