Archive for the Week of December 1, 2006
Archive for the Week of December 1, 2006
Welcome to the medical billing blog archive for the week of December 1, 2006.
Here you will find links to every article added to the Outsource Management Group web site during the week of December 1, 2006.
You can browse this week's archives by clicking the "More" button from any of the excerpts below.
Are You Properly Handling PHI?
In medical billing, PHI is personal patient information that should only be shared with covered entities. It is not only unethical to release a patient’s medical billing PHI to outside sources but it can ruin your business as well. An example of wrongly shared PHI is at the University of Missouri Health Care. Currently over 800 patients have a class-action lawsuit filed against them. The patients claim their confidential medical billing records were released to a home health provider called Option Care. Option Care apparently used the information and contacted the patients trying to sell them pricey medications. They also tried to convince them that their doctor, Dr. Paul King, …
Rejected Claims Hurt Revenue
In the fast paced world of medical billing, it can be difficult for your staff to keep up with not only a busy practice, patient phone calls, needs that crop up and then the medical billing too. If a member of your staff misses a line item on your medical billing or uses an out of date code, it can directly affect your revenue in the form of a claim that isn’t fully paid or worse a rejected item that requires your staff to pull the file, review the documentation and then resubmit the claim to the carrier. This takes valuable time away from your practice and has your staff …
You’re Coding Modifier 59 Correctly With These Tips
Using a modifier incorrectly can cost you in terms of reimbursements and time. Carriers are closely scrutinizing medical billing claims for incorrect usage of modified 59. There are two main areas that you can concentrate on to avoid getting his with denials or pay backs and insure that you use the modifier correctly. A study of the OIG found a 40% error rate for modifier 59 and you can double check your billing. First of all, in order to use modifier 59 there must be services performed at separate regions. Fifteen percent of the OIG’s audited claims using modifier 59 had procedures that weren’t distinct because “they were performed at …
Avoid Reductions By Properly Reporting Modifier 52
Avoid Fee Reductions By Reporting Modifier 52 Properly If it has become a habit to append modifier 52 every time your medical billing has a service that doesn’t exactly meet a CPT code description, you could be unknowingly cutting your compensation on your submitted claims. AMA CPT guidelines state that modifier 52 should be used when the physician partially reduces or eliminates a service or procedure at his own discretion. The CMS guide lines state as follows: “when a procedure/service performed is significantly less than usually required”. What you should do is report the code as usual for the procedure and then append modifier 52 to show that the services …
