Medical Billing Blog: Section - General Info
Archive of all Articles in the General Info Section
This is the archive containing links to all articles written in the General Info section of our blog.
Click any of the article links below to read the entire article or browse another section to the right to read articles on another subject.
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 …
Paying For Performance May Improve The Quality of Medical Care
P4P is a revolutionary method of figuring medical billing payments. The Centers for Medicare & Medicaid Services has announced that the method of “paying for performance” works to improve the quality of a patient’s care. The current medical billing demonstration that took place had encouraging results for CMS. The areas in which the pay for performance method has been shown to improve the most care is with pneumonia, hip and knee replacements, and heart care. These improvements of care were shown in the first year of the trial run. Only certain hospitals took part in this medical billing study. In the second year of the trial, the quality of care …
Ohio’s Crackdown on Medical Billing Fraud
Recently, several Ohio home health providers have been caught red handed in medical billing fraud. There is nothing worse than medical billing fraud. It costs the United States citizens billions of dollars each and every year. To prevent this fraud, the state of Ohio created a task force to investigate Medicaid providers. This task force found four separate incidences of medical billing fraud. One of the main cases found was with Community Home Health Services Inc and Kevin Dennis. Apparently, this organization billed Medicaid over $32 million dollars in fraudulent payments between June of 2000 and May of 2005. Kevin Dennis used $650,000 of this fraudulent medical billing for his …
A Light at the End of the Billing Tunnel for Oncologists
For quite a while, medical billing has become much like a nightmare for oncology practices across the country. Cancer treatment can be a very expensive service for patients. Some people can’t afford the Medicare part B drug copay. Oncology practices have been forced to sacrifice their own medical billing to help needy patients. When a patient can’t make a payment, usually the answer is simple, don’t provide them services. However, when it comes to cancer treatment, it is nearly impossible to turn down a patient for drugs. Many oncologists have been waiving the Medicare part B copay for their patients. This means they get less for medical billing reimbursement. MedPAC, …
Limited Outpatient Therapy Medical Billing Payments
In an effort to limit medical billing reimbursement, the Centers for Medicare & Medicaid Services has taken action. Beginning on January 1, 2006, The Centers for Medicare & Medicaid Services will reinstate the outpatient therapy cap. This medical billing change may negatively effect your bottom line, but is the best option in the long run. The new medical billing limits for outpatient therapy will be $1,740 for occupational therapy and $1,740 for physical therapy and speech pathology combined. However, these two caps do not affect any therapy provided through home health care. The reason for this medical billing cap is because of the increase in outpatient therapy charges in the …
Outsourcing Your Medical Billing – Your Practice Depends On It!
Did you know that if you are not outsourcing your medical billing, chances are very good you are throwing away about one third of your revenue from your practice. That’s a lot of money to not be collecting. You could vastly and quickly improve your reimbursement rate and collection of funds owed if you outsource your medical billing. Many practices still submit claims via paper, other practices submit their claims electronically but don’t have time to keep up with the coding and billing changes that can occur, many times as frequently as four times per year. Studies show, practices that outsource their medical billing to a medical billing partner that …
Great Medical Billing News for Physicians
A positive medical billing change is on the horizon for physicians. As of January of 2006, the American Medical Association (AMA) released new care plan oversight CPT codes and definitions. These medical billing changes will expand the flexibility and usage of these old codes. There are three major evaluation and management changes that will occur. The first medical billing change is the introduction of two care plan oversight codes. These new codes are different because they do not require a patient to be under the care of a home health agency, nursing home, or hospice. In 2005, the stipulation in medical billing was that the patent must be in one …
How Can Complete Practice Analysis Benefit Your Practice?
If you’re not outsourcing your medical billing, you’re already behind. You have a busy practice, your staff is pushed to the max with patients and phones and day to day activities. One fantastic way that outsourced medical billing can benefit your practice, besides the convenience of handing your medical billing and/or coding for your practice is through a service called Practice Analysis. It can include handling the medical billing for your office, and receiving the data through electronic or secured network. Processing and submitting your claims. In addition, the coding of your medical billing can be handled through your medical billing partner and can be checked and double checked for …
