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.
Avoid Medicare Investigations On Medical Billing
Avoid Medicare Investigations Over Your Medical Billing Sending in medical billing claims to any government organization can be nerve racking, especially when submitting to Medicare. Medicare will do an audit on your claims if you show suspicious charges or activity that does not match your FACP. There is one main thing you can do to prevent this medical billing audit: provide adequate records. The Centers for Medicare & Medicaid Services is very hesitant to pay more administrative costs then you claim on your FACP. This is one organization in which you will probably not make any profit. It is important that your FACP report closely matches the Medicare charges you …
Medicare Paid Out $900 million In False DME Claims
Medicare Paid Out $900 million In False DME Claims Large fraudulent medical billing claims are making the senate the Government Accountability Office antsy. Charles Grassley recently sent a letter to the Centers for Medicare & Medicaid Services with a daunting reality. CMS wasted $900 million dollars in incorrect durable medical equipment in 2004. For the survival of Medicare something has to change. This fraudulent medical billing needs to be taken care of. Apparently the 2004 incorrect medical billing dealt with orthotics, equipment, and prosthetics. It seems that the Centers for Medicare & Medicaid services did not keep a closer eye on their National Supplier Clearinghouse. This contractor’s job was to …
When Medicare Computer Glitches Eat Your Claims
Medical Billing Dilemma – When Medicare Computer Glitches Eat Your Claims Keep your eyes peeled for medical billing mistakes coming from the Centers for Medicare & Medicaid Services. Medicare Part B carriers are changing software systems over to the Multi-Carrier System. Some carriers have already switched to the system, some are in the process of switching, and some will change in the near future. This medical billing switch has created a lot of needless headache for providers. During the Centers for Medicare & Medicaid Services software switch, there have been many medical billing claim errors. Errors that have occurred or could possibly occur in the future include: missing updated codes, …
Using New CPT Codes Depends On Your Practice
Using New CPT Codes Depends On Your Practice Set-Up New pharmacy medical billing codes have raised many questions in the medical world. The use of these new current procedural terminology codes depends on the set-up of your practice and how the pharmacy services are administered. Medical billing constantly changes and these new CPT codes are just one example of that statement. There are three new medical billing codes for medication therapy management services. They are 0115T (Initial face-to-face assessment or intervention with the patient; 1-15 minutes, 0116T (Subsequent face to face assessment or intervention with the patient; 1-15 minutes, and 0117T (Each additional 15 minutes spent face-to-face with the patient; …
How Much Do You Know About Patients PHI?
How Much Do You Know About Patients PHI? In medical billing, PHI is personal patient information that should only be shared with covered entities. It is not only wrong to release a patient’s medical billing PHI to outside sources, but it will 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 called these patients trying to sell them pricey medications. They also tried to convince them that their …
Getting Your Arteriogram Claims Paid
Medical Billing Tips – Getting Your Arteriogram Claims Paid After reading this section, you will be a bilateral renal arteriogram medical billing wiz. There are many code confusions with this surgical procedure. Some payers will not pay a cent if you bill the wrong code combinations. However, doing medical billing for renal arteriograms can be quite simple. There are two codes one should report when doing medical billing for a renal bilateral arteriogram. The current procedural terminology code 36245 should be reported twice. Then the Current Procedural Terminology code 75724-26 should be reported. Do not make the mistake in adding a G0275 to your claim because the renal arteriography already …
Medical Billing Dilemma- Changing Newborn Status
Medical Billing Dilemma – Changing Newborn Status The well-being of newborns can change instantly, which intern, changes their medical billing. Newly born babies are very susceptible to illnesses. Their bodies are not used to functioning outside the uterus. They develop breathing problems, heart conditions, illnesses, skin rashes, etc. Many medical billers have incorrectly coded these evaluations. In order to receive correct reimbursement for newborns, it is important to know how to do medical billing for same-day visits for different diagnoses. When a baby is born, it may be considered a well baby. They physician does an exam and the baby is sent to the nursery. Let’s say that two hours …
Medical Billing For Non-Physician Practitioners
Medical Billing For Non-Physician Practitioners Medical billing policies by non-physician practitioners have recently changed. The Centers for Medicare & Medicaid Services reduced restrictions on what types of providers can bill for medical services. There are now several instances when a CMS and NPP can do medical billing for the services they provide. There are several medical billing scenarios to clarify for non-physician practitioners. First of all, it is perfectly legitimate for a nurse practitioner or a clinical nurse specialist to get reimbursed for services rendered in the skilled nursing facility in which they are employed. If the non-physician practitioner decides to resign their payments to the facility, then the SNF …
CMS To Provide National Provider Training
CMS To Provide National Provider Training There are some medical billing provider changes on the horizon. The Centers for Medicare & Medicaid Services is trying to catch everyone up to speed on the new National provider identifier system. The Centers for Medicare & Medicaid Services believes this provider training with alleviate some of the medical billing confusion once the change takes place. On May 27, 2007, all medical providers and organizations will be required to have a national provider identifier for claims processing. This is for any covered entity recognized by HIPAA. This national provider identifier will replace the current provider number. It is important to note that although the …
Borrowing Provider Numbers Can Bring Big Trouble
Borrowing Provider Numbers Can Bring Big Trouble When performing medical billing, using your own provider number is a requirement. Failure to do so is considered fraud and is not tolerated. Using another provider’s tax identification number for medical billing can cost you big money and even jail time. Fraud costs Americans billions of dollars a year. (yes I said BILLIONS). One of the may variations of medical insurance fraud is using another provider’s Tax identification number. There are several reasons why providers would want to do this. A doctor without a contract with a provider network may want to use a TIN of a provider inside that network. Some people …
