Archive for The Month of March, 2006
Archive for the Month of March, 2006
Welcome to the medical billing blog archive for the month of March, 2006.
Here you will find links to every article added to the Outsource Management Group web site during the month of March, 2006.
You can browse this month's archives by clicking the "More" button from any of the excerpts below.
How Your Neighbor’s Cost Report Can Cost Your Medical Billing
If you thought your IPPS (inpatient prospective payment system) has nothing to do with medical billing and reimbursement, then think again. Not only will your 2003 IPPS effect your own medical billing, but now your neighbor’s IPPS will effect your 2007 reimbursement as well. The Centers for Medicare & Medicaid Services announced that they will use the 2003 hospital medical billing index data to figure the 2007 payments. That means that if you were not completely accurate with your IPPS, then your reimbursements in 2007 will be skewed. CMS also announced that they will only calculate one wage per state for hospitals outside of the core-based statistical areas. This means …
Inpatient Medical Billing Consultant Choices Diminish in 2006
For a long time there has been a confusion about when to use inpatient follow-up consultation codes. In 2006, this will no longer be an issue, there will only be one type of inpatient consultation service: initial and subsequent. Follow up inpatient consultation codes will no longer be used in medical billing. The previous method when doing medical billing for inpatient follow up consultation codes was to use 99261-99263 (Follow-up inpatient consultation for an established patient). Unfortunately, physicians and medical billing staff members found it difficult to decide if the care was initial or a follow-up. Those CPT codes were constantly claimed incorrectly. In an effort to increase coding efficiency …
Decertification Could Cost You Big in Medical Billing
Keep accurate medical billing and policy practices to ensure your facility’s success. Certification is a necessity tool if you run a Hospice. If you happened to lose that certification for any reason, you would lose out on a lot of revenue. Just ask VistaCare how much they have lost in medical billing since being decertified in October. VistaCare Inc. is a Hospice care facility that was decertified in the two cities of Indianapolis and Terre Haute in October. Since then, they have attempted to assist over 100 patients without pay. Medical billing has been put on hold while they figure out a solution. The solution to the VistaCare Inc. problem …
How Can Physician Credentialing Benefit Your Practice?
Did you think your medical billing partner only handled your coding and medical billing claims? Another service we provide is physician credentialing. You have a busy practice and your staff is just as busy servicing your patients and answering the phones. You really don’t have time these days to fill out yes another form to get yourself credentialed to do business with yet another insurance carrier. You know from previous experience that getting yourself credentialed to do business with certain carriers can take months as the processing of that paperwork can be a slow process unless you are calling the carrier every few days for a status and if you …
CCR Changes for A New Provider
If you are merging hospitals, your medical billing numbers may change. Provider tax identification numbers are used to identify hospitals and medical practices. When one hospital merges with another hospital, the capital cost-to-charge ratio will change for one or both hospitals in medical billing. The first scenario in medical billing is when two hospitals merge and use one of the hospital’s tax identification number. This means that the other hospital drops their own medical billing number. When this happens, Medicare uses the hospital with the existing tax identification number to figure capital cost-to-charge ratios. The second medical billing scenario is when two hospitals merge and get a new provider number …
Medical Billing Cuts Threaten DME
Medical billing practices may be your only saving grace this year if you own a DME company. CMS payment cuts are on the horizon. In the past, Durable medical equipment companies have dodged these cuts, but now they seem to top the Centers for Medicare & Medicaid Services cut list this year. Your durable medical equipment Medical billing reimbursements may suffer. The Centers for Medicare & Medicaid Services define any grossly excessive payment with a fifteen percent threshold. This amount used in medical billing will now be subjected to the inherent reasonableness cuts. Durable medical equipment companies are the target for the agency this year. The medical billing cuts are …
Medical Billing Fees Charged To Clients
If you’re thinking about outsourcing your medical billing and you aren’t sure how the invoicing part works or how fees are calculated by your medical billing partner, you will find the fees are very reasonable and when you consider the time your staff will be suddenly realizing from not chasing claims, finding documentation and filing and answering appeals, will translate into more dollars for your practice, besides the fact your medical billing claims will be paid within about 2 weeks instead of the 60-90 days range that you are probably experiencing if you are still filing your claims yourself. You will find that most medical billing companies charge a percentage …
Medical Billing Fraud Strikes Again!
Medical billing fraud can take on several forms. Usually healthcare practices are thought to be in place to help you when you are in need. People don’t usually think of healthcare facilities as crooks and liars. Unfortunately, some of them are. The state of Washington has found yet another poor example of healthcare medical billing. Star Physical Therapy was charged with medical billing fraud of over $400,000. The owner of Star Physical Therapy, Nancy Wong was thought to be an upstanding citizen. She was even a member of the Washington State Board of Physical Therapy. Wong, proved us all wrong. She did plead guilty to medical billing fraud in June. …
Medical Billing for High Risk Pap
The medical billing staff members in the OB-GYN office have their work cut out for them. There are so many rules and regulations about procedures specific to this specialty. The Pap smear is one area that can get sticky. Knowing how to correctly do medical billing for a high risk pap smear is an important skill. When you are doing medical billing for a Medicare patient, a high risk pap smear must meet to criteria. First, the patient must have over five sexual partners, or have had sex before she turned 16. Only in these instances can you do medical billing for a high risk, screening pap smear. Many medical …
Medical Billing Reimbursement Increase for Screening Exam
The Welcome to Medicare screening exams offer more medical billing reimbursements for medical practices across the country. Currently, if the primary care physician specifically orders any radiology, those tests are chargeable separate from the exam. Make sure you follow Medicare screening rules to ensure you have proper reimbursement. Typical radiological studies that may be ordered for the Welcome to Medicare exam include a bone mass measurement 76075 (Dual energy x-ray absorptiometry, bone density study, one or more sites; axial skeleton) and a mammogram 76092 ( screening mammography, bilateral two-view film study of each breast). When you use these medical billing current procedural terminology codes, be sure to use the correct …
