Archive for the Week of July 14, 2006
Archive for the Week of July 14, 2006
Welcome to the medical billing blog archive for the week of July 14, 2006.
Here you will find links to every article added to the Outsource Management Group web site during the week of July 14, 2006.
You can browse this week's archives by clicking the "More" button from any of the excerpts below.
The Importance of Accurate E/M Claims
Medical billing largely depends on the accuracy of the physician’s records. Many times physicians have nothing to do with the medical billing aspect of their practice or facility. This can cause them to be haphazard with their documentation for their patients. It is important to educate physicians about the importance of accurate records to the medical billing department. With rising healthcare costs, carriers are becoming much less lenient on treatments and procedures being covered. They also have become sticklers for accurate medical billing documentation submissions. If there is anything incorrect on a claim, it gets sent back to the provider without payment. There are many evaluation and management claims that …
Separate Billing Equals Better Reimbursements
The Centers for Medicare & Medicaid Services has improved medical billing reimbursement for Medicare patients. Currently, if your practice does medical billing for a Medicare exam on a newly 65 patient, you can also bill for cardiovascular screening tests and diabetes screening tests. The Centers for Medicare & Medicaid Services realizes that separately billing for these screening services may seem incorrect. For this reason they are sending out plenty of medical billing information to explain how to bill for preventative care in the future. For instance, one of the things physicians can bill for separately is diabetes screening tests. As long as one risk factor is established and two of …
Are Your Using the Common Working Files With CMS?
The biggest medical billing problem is getting denied payment for a claim. A service for which many patients are denied is smoking or tobacco-use cessation counseling. Payers have a hard time paying for this service. The patient either has no coverage, or is only allowed a certain amount of counseling sessions for the smoking cessation purpose. What happens if another physician has already done medical billing for these counseling sessions? Chances are, you would not get paid. The centers for Medicare & Medicaid Services have come up with a medical billing solution to let you know how many sessions a patient has already used. Let’s say you know your patient …
Medical Billing for Type A Claims
Many times, one medical billing mistake with a Part A claim can cost thousands of dollars. Proper training can eliminate most of these errors. Consolidated medical billing should be engrained into the heads of your personnel. There are some basic tips you should follow when doing consolidated medical billing. There are several medical billing charges that should be excluded when it is a hospital providing the service to the patient. The Centers for Medicare & Medicaid Services gives this list to exclude: computerized axial tomography scans, ambulatory surgery in the operating room, MRI, cardiac catheterizations, radiation therapy, angiography, emergency room services, venous and lymphatic procedures, and ambulance services related to …
How Secure is Your Patients’ Information?
Medical billing uses some very confidential patient information. It is the responsibility of your medical practice to protect this personal information for your patients’ safety. Making one confidentiality mistake can ruin your practice and your security for a lifetime. Patients trust you with their health, their lives, and their personal medical billing information. If you do not have a trustworthy practice, you will not have any patients. It is a regulation that PHI must not be left unattended or unlocked in or on someone’s desk. Many medical billing personnel will get too comfortable with the people they work with and will leave billing information laying out on their desks. This …
Medicare No Longer Filling in Blank Forms
Previously, when claims came in with incorrect ICD-9 medical billing, the Medicare carriers would make the proper corrections and then reimburse. They would correct diagnosis codes and fill in the blanks if they were empty. This was lazy medical billing on the part of the provider. Now Medicare personnel will no longer do that. They now require correct medical billing in order to reimburse for Medicare part B services. If a claim is sent in by a diagnostic center, this center must use the diagnosis code given by the referring physician for medical billing. If, for some reason, the physician does not provide a diagnosis, the personnel at the diagnostic …
Don’t Use Social Security Numbers for Patient Identification
Personal identification numbers have been a big issue in medical billing in the current years. In the past, the use of social security numbers to identify patients in medical billing was completely acceptable. As a matter of fact, this was the norm. Now, with the increased risk of identity theft, the use of social security numbers in medical billing is taboo. An eye opening experience happened in Colorado there was an unfortunate incident with member identification numbers used for medical billing. Kaiser Permanente Colorado made a human error and put the user identification numbers on the mailing label of a member magazine. This meant that anyone handling the magazine had …
Avoid E/M Documentation Errors In Your Medical Billing
Avoid E/M Documentation Errors In Your Medical Billing Some of the most common services a medical billing company charges, in behalf of a physician’s office, are for evaluation and management services. There are common errors and CPT code misuses for these services. Medicare is probably the most common payer today. There are three things a medical billing company must substantiate with documentation before Medicare will pay: medical necessity, CPT code criteria, and services must be rendered and documented in the patient’s records. First, when performing Evaluation and management medical billing for a practice, you must ensure medical necessity. Many times simple documentation errors can disprove medical necessity. The chief complaint …
Getting Medical Necessity Right
Getting Medical Necessity Right Medical necessity is the single most important element in medical billing. Many times medical necessity comes down to the proper CPT code used for medical billing purposes. It used to be that Medicare was the only payer that cared what ICD-9 code was used. Presently, all payers, including insurance companies, are looking for any reason not to pay the bill. ICD-9 codes have become the target. ICD-9 codes range anywhere from a three-digit code to a five-digit code. Obviously, a five digit code is more descriptive then a four digit code. Similarly, a four digit code is more accurate then a three digit code. Very rarely …
