Medical Billing Blog: Section - Outsourcing
Archive of all Articles in the Outsourcing Section
This is the archive containing links to all articles written in the Outsourcing 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.
October Updates Are In Effect!
If you haven’t already, make sure that your staff is using the updated CPT codes that were released in October 2008. Not doing so can lead to kick backs that will require more staff hours to research, redo and resubmit and if this happens on a number of claims it can seriously affect your reimbursements and in turn – slow your revenue flow to a mere trickle. One way to avoid this dilemma is to outsource your medical billing and yes, there are some horror stories out there about outsource companies that threw away patient billing, had lax attitudes towards billing submissions and wound up costing the physician a lot …
Switch to Oursourcing Your Medical Billing in 2008!
Outsourcing your medical billing claims to a third party partner may be one of the smartest business moves you make in 2007. You may have had every intention of doing your own medical billing for your practice from the day you opened until the day you retired, however with the never ending changes and nuances in medical billing claims varying from cancelled codes to nonpayment of certain procedures because they simply weren’t reported correctly – there comes a time when you need to look at your revenue flow from your reimbursements and decide it might be time to outsource your medical billing claims. Another reason to outsource is the small …
Don’t Be Baffled By Long Term Care Claims!
Long term care medical billing has it’s own set of nuances that must be followed in order to ensure that you receive proper reimbursements for the services you provide. Since nearly every patient you treat will have a long term history of care – it’s sometimes tempting to skimp on the medical documentation and necessity but since you have no way of knowing who is going to review your claim, you need to handle every claim as a fully individual manner complete with full documentation or you may wind up with partially paid claims or outright denials of your medical billing claims. One important thing to learn is when you …
Report – HHA’s and Hospices Are Billing Medicare Accurately
A recent report showed that HHA’s (home health agencies) and hospices are billing Medicare on an accurate level according to a report compiled by the CMS’ Comprehensive Error Rate Testing. The report showed that HHAs had a 1.4 percent error rate and hospices a 1.0 percent error rate in the November CERT report, which covers claims from April 2006 to March 2007. DME (durable medical equipment) suppliers had a wide range of error rates broken out by supplier type. The lowest was 0.6 percent for a medical supply company with prosthetic/orthotic personnel certified by an accrediting organization while the highest was a whopping 51 percent for “unknown supplier/provider” where it …
Home Care Payments Will Be Getting Close Scrutiny in 2008
On October 17, 2007 – the Senate Finance Committee met to discuss ways to pay for a fix to physician payment rates in 2008 and 2009, according to press reports. The heart of the meeting was to talk about the $30 billion in cuts needed to avert the doc pay cut and make other Medicare changes, and home care once again landed on the chopping block to have many home services radically reduced or have their funding cut all together.Some of the specifics of the home care that were discussed to be directly affected were wheelchair suppliers and oxygen providers are under discussion for reimbursement reductions to pay for the …
Emphysema Diagnosis Coding Tips
Want to know why your emphysema claims aren’t being fully reimbursed? Often, the reason is that you’re lacking two things when you submit your claim. You aren’t being detailed enough with your coding and your don’t have enough detailed medical documenation to back up your full diagnostic testing that is required to accurately diagnose emphysema and narrow the degree and type. When you’re compiling the medical billing for an established patient with active emphysema (492.8, Other emphysema) and they present and are complaining of shortness of breath (786.05); the physician provides inhalation treatment, trains the patient on using the nebulizer at home, and provides an expanded problem-focused examination and medical …
Common Varicose Vein Treatments
As more research is done regarding the relationship between varicose veins, blood clots and other complications; more and more patients are having the simple surgery and as a result there has been confusion about exactly how to code this procedure to get the fairest reimbursement for this service. Once you know the basics for setting it up – it’s easy! A good example would be if a patient with varicose veins in her left lower leg presents to the ED and is stating she has severe pain in her leg. One of the veins is clearly bleeding so the doctor will use a standard suture ligation to stem the bleeding …
Do You Know the Three "R’s" of Consulting Reimbursements?
Since consultation requirements have increased in the last year as far as criteria for getting them reimbursed in your medical billing claims, there are some criteria you must be certain that your claims meet in order to justify using codes 99241-99255. It used to be simple and medical billing consultant merely had to meet the three “R’s” in order to justify medical billing claims for consultations. However the criteria for what does and does not constitute a consultation has changed and in order to make sure that your medical billing claims are paid, you need to reacquaint yourself with the three R’s of medical billing for consultations. The three R’s …
Definity Still Definitely a Problem in 2007
The injectable contract agent named Perflutren better known as Definity has caused a lot of confusion as many providers are billing the incorrect code and Medicare and most other large payors switched the code for this service in late 2005 and 2 years later it’s still showing up on medical billing and causing numerous delays and rejections on medical billing reimbursements. If you’re a service provider that is still billing A9700, you could face delays in getting paid–or even denials on your medical billing claims. If the carrier approves the main echocardiography procedure, then it will usually approve the use of Definity as contrast. If you are not sure of …
Wound Closure Medical Billing -Dermabond or Stitches?
When a wound needs closing and a tissue adhesive is used the medical billing coding can be different than when sutures or stitches are used. There are specific guidelines for medical billing when tissue adhesives are used. All adhesives including Dermabond have their own unique way of being reported on medical billing. Consult with Medicare or the carrier to ensure that you are meeting those guidelines prior to submitting your medical billing. There are five basic guidelines that Medicare requires in order to reimburse for this service and many carriers follow the same criteria for laceration closures utilizing Dermabond. You should report G0168 for Medicare patients only; the CPT code …
