Medical Billing Blog: Section - Medical Billing
Archive of all Articles in the Medical Billing Section
This is the archive containing links to all articles written in the Medical Billing 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.
“Today’s realities are that managing a practice is more complicated than ever…” That’s how an assessment begins on what it takes to successfully run a medical group in 2017 by Triple Tree, a merchant bank focused on healthcare. In a recent report, the bank also looked at the forces driving mergers of specialty groups. Chief among them is the realization by administrators and their physicians that the healthcare business isn’t what they hoped it would be. The mounting pressures are affecting medical groups’ top and bottom lines. The bank’s report suggests that while opting to be part of a larger group might sound attractive to an independent practice, the non-clinical …
Published By: Melissa C. - OMG, LLC. CEO |
A new set of concerns has emerged among hospital and health system executives, according to The Advisory Board Company’s latest Annual Health Care CEO Survey. The survey, which was completed by 183 C-suite executives between December and January, found the No. 1 concern among health system leaders in 2017 is improving patients’ access to care in ambulatory or outpatient settings. Last year, this concern was ranked No. 6. An entirely new concern — finding innovative ways to lower expenses — came in at second place. The No. 3 concern was boosting market share for outpatient surgical procedures, up from No. 10 in 2016. “This shift in topic rankings reflects a …
Published By: Melissa C. - OMG, LLC. CEO |
Improving claim collection rates is one way to boost revenue cycle performance, and hospitals can achieve this through various means. Frank Moreno, vice president of product marketing at Datawatch, shared the following tip with Becker’s Hospital Review:”Effective revenue cycle management is only attainable when healthcare organizations have a full view of their patient and operational data. Finance departments cannot wait for IT to provide detailed reports, or spend countless hours manually pulling data from EMRs, 835 and 837 remittance and other files.Yet that’s what is happening at organizations across the country every day. Instead, by using self-service data preparation and analytics solutions, finance teams can easily unlock hidden data to …
Published By: Melissa C. - OMG, LLC. CEO |
Medical coding and billing specialists are an integral part of hospitals’ and health systems’ efforts to optimize revenue cycle management processes. Here are seven things to know about medical coding and billing specialists. 1. Medical coders are tasked with reviewing clinical documentation and designating standard codes using ICD-10 classifications. Medical billers primarily process and make sure claims are sent to payers for reimbursement of services administered by a provider, the American Academy of Professional Coders states. 2. A hospital or a health system may combine the responsibilities of coding and billing into a single department, or may divide coding and billing operations into two separate branches. AAPC states if the …
Published By: Melissa C. - OMG, LLC. CEO |
SCENARIO: So, you are working at a multi-specialty practice that recently employed a urologist. As the Lead Medical Auditor and a member of the Corporate Compliance Team, you begin to worry about the chart audits as you have no members on your team that have worked within this specialty before. Take a deep breath – and remember that the largest volume of claims that the urologist will bill are E&M services. Regardless of the specialty of any medical practice, each will utilize Evaluation and Management (E&M) services in greater volumes than surgical services. Specialty-specific trained medical auditors are well versed in trudging through records to note the disease processes and …
Published By: Shannon DeConda |
When to use Modifier 91? Modifier 91 is used for the reporting of repeat laboratory tests or of studies that are performed on the same patient on the same day. You will only add Modifier 91 when additional tests results are to be subsequently obtained to the initial administration or the performance of the tests done on the same day. When Not to Use Modifier 91 Modifier 91 is not used when laboratory studies or tests are rerun as a result of equipment or specimen malfunction or error. It is also not used when a test is repeated to confirm the results that the initial test reported. In addition, based …
Published By: Melissa C. - OMG, LLC. CEO |
It’s 193 days to ICD-10 and to be honest, that’s not much time! It’s time to get your practice ready to use ICD-10, but where do you begin? There’s no question it can be overwhelming! Here’s the steps we recommend to any Providers that ask. Let’s get started. Put One Person in Charge First things first, you need to assign the task of overseeing ICD-10 to someone on your staff. It doesn’t matter whether that person is the biller, a coder, the office manager, or someone else. Their goal is to lead the process, ensure things are on task and on target, and to oversee the details. Develop a …
Published By: Kathryn E, CCS-P - Retired |
It can be difficult deciding whether to outsource your medical billing or not. With ICD-10 coming in October, There are many benefits of outsourcing your revenue cycle functions. Let’s take a look at 7 of those benefits. #1 Economy of Scale A billing service will distribute their expenses through their complete client base, which provide an economy of scale. They are able to operate with lowers costs than what a single practice can and those savings are passed on to their clients, making them very competitive. A billing service is able to afford to hire top-notch staff so you are able to pay less and get more. #2 …
Published By: Melissa C. - OMG, LLC. CEO |
January has brought upon the EHR (electronic health records) Stage 2 incentive programs start for physician and medical practices. However, there is a great deal of concern that those doctors who can meet Stage 1 requirements will not be able to meet the Stage 2, because their EHRs are not up to standard and neither are the vendors that they deal with. There are 2200 products and almost 1400 EHR certifications for Stage 1, but only 75 products and 21 EHR certifications for stage 2. Around 90 percent of the vendors are expected to not be ready for stage 2. Stage 2 is the second step of meaningful use for …
Published By: Melissa C. - OMG, LLC. CEO |
Is ICD-10 going to provoke a level of healthcare insanity? The opinions of a coder. ICD-10 or International Classification of Diseases is designed to create a system where there is compatibility throughout the nation relating to data collection, processing and classification of disease, as well as presenting mortality statistics. The ICD-9 has been revised and as a result, we now have the ICD-10, a whopping three volumes of alphanumeric categories. Some chapters have been changed and rearranged and some conditions have been regrouped from ICD-9. In fact, there is almost double the number of categories from ICD-9 to ICD-10. ICD-10 opponents say that ICD-10 has gone too far, that it …
Published By: Melissa C. - OMG, LLC. CEO |
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