Medical Billing Blog with Medical Billing & Coding Info & Articles

Our blog contains news and articles relating to numerous healthcare sectors including revenue cycle management, medical billing, medical coding, ICD, HIPAA, practice management functions and more.

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7 things to know about medical coding and billing specialists

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

By: Melissa C. - OMG, LLC. CEO on March 30, 2017

7 Things Your Governance Agreement Must Include

A governance agreement forms the foundation of how a practice’s board of directors is comprised, how it makes decisions and operates, and how it maintains authority. An effective agreement can get a practice through a partner disagreement, financial crisis, legal issue, or natural disaster. It’s a critical document no matter if your group has two or 200 physicians. Most practice governance agreements fall short on detail. Often they contain just the legal statements about board size and voting that are required to file the organization’s corporate documents. Add strength to yours by making sure it includes these seven essentials…   Continue reading the full article on Physicians Practice  

By: Melissa C. - OMG, LLC. CEO on March 29, 2017

Many EHR Vendors and Providers Block Information Exchange

Half of electronic health record (EHR) vendors and a quarter of hospitals and health systems routinely engage in information blocking that restricts data flow between providers with different EHRs, according to officials of public health information exchanges (HIEs) surveyed by researchers at the University of Michigan. The top motivation for EHR developers was revenue maximization, whereas the hospital systems were mainly motivated by a desire to maintain or enhance their competitive position, the authors state. The study was published online March 7 in the Milbank Quarterly. In a report issued 2 years ago, the Office of the National Coordinator for Health IT (ONC) said there was anecdotal evidence showing that

By: Melissa C. - OMG, LLC. CEO on March 29, 2017

HIPAA Certified: Not So Fast

A healthcare organization is looking for a new electronic medical record, secure messaging application or any other solution. It compares a number of vendors, product features and gets close to choosing one. Just before making the ultimate decision, someone asks, what about HIPAA? As this question enters the discussion, another person says that the chosen product is HIPAA “certified.” Hearing that the product is certified, everyone is satisfied and thinks that HIPAA obligations are all set. Unfortunately, HIPAA “certification” does not settle any issue. The question of certification is one that has been around almost as long as HIPAA itself. From the legal perspective, certification is not even worth the

By: Melissa C. - OMG, LLC. CEO on March 29, 2017

20 stats for EHR adoption rates

Less than a decade ago, nine out of ten doctors in the U.S. updated their patients’ records by hand and stored them in color-coded files. By the end of 2017, approximately 90% of office-based physicians nationwide will be using electronic health records (EHRs). Health records are changing quickly — here’s a snapshot of the current EHR landscape: Support for EHR adoption The annual healthcare spending of the country reached ~$2.9 trillion in 2011. It’s expected to soar to $3.5 trillion by 2015. Medical errors cost $19.5 billion a year, and maybe as much as $1 trillion a year when accounting for lost productivity. Medical errors are the third leading cause of death

By: Melissa C. - OMG, LLC. CEO on March 28, 2017

Demonstrating the Complexity of Care

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

By: Shannon DeConda on February 18, 2017

When to Use Modifier 91

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

By: Melissa C. - OMG, LLC. CEO on January 11, 2017

New Orthopedic Coder Position at OMG

We are hiring again. Outsource Management Group, LLC, is seeking an experienced orthopedic coder to work in our office and closely with our numerous orthopedic clients. This position is to be full-time with all benefits, however,  a part-time position is possible for a candidate that fits perfectly, but is unable to be full-time. This position is to be filled in our office at the address below, if you are unable to work in our office in Bloomington, Indiana, please do not submit a resume for this position. Acceptable candidates possess either 1 or more of the following: 1. Currently holds a coding certification through AHIMA or AAPC 2. Has 2-3

By: Kathryn E, CCS-P - Retired on January 7, 2016

Capitol Hill is paying a lot of attention to ICD-10…

“Capitol Hill is paying a lot of attention to ICD-10 implementation” is a great article by Carl Natale on ICD-10 Watch that talks about a big week in ICD-10 implementation…   Excerpt: “The U.S. House Energy & Commerce Subcommittee on Health, chaired by Rep. Joe Pitts (R-PA), has scheduled a hearing on “Examining ICD-10 Implementation” for 10:15 a.m. Wednesday. There isn’t a list of witnesses yet. But expect representatives from Centers for Medicare and Medicaid Services (CMS), American Health Information Management Association (AHIMA) and American Medical Association (AMA) at least.   There are plans to livestream it at http://energycommerce.house.gov/.   This comes a day after the Coalition for ICD-10 sponsors

By: Melissa's Mentions on February 9, 2015

Our Headquarters Will Be Moving This Month

It’s been a busy few weeks! As our client base and staffing needs continue to grow, Outsource Management Group will be moving its corporate headquarters this month. Over the next couple of weeks our corporate offices will be transitioning from our current location into a new 5,000+ sq ft. headquarters in the same area of Bloomington, Indiana. This move is allowing us to better accommodate the additional staff and equipment needed to continue to provide our current, as well as new clients with our leading medical billing services. Stay tuned for further updates, our new address and updated pictures of our new corporate facilities.

By: OMG, LLC. - Corporate Entries on September 8, 2014