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.
Medicare No Longer Filling in Blank Forms
Previously, when claims came in with incorrect ICD-9 medical billing, the Medicare carriers would make the proper corrections and then reimburse. They would correct diagnosis codes and fill in the blanks if they were empty. This was lazy medical billing on the part of the provider. Now Medicare personnel will no longer do that. They now require correct medical billing in order to reimburse for Medicare part B services. If a claim is sent in by a diagnostic center, this center must use the diagnosis code given by the referring physician for medical billing. If, for some reason, the physician does not provide a diagnosis, the personnel at the diagnostic …
Don’t Use Social Security Numbers for Patient Identification
Personal identification numbers have been a big issue in medical billing in the current years. In the past, the use of social security numbers to identify patients in medical billing was completely acceptable. As a matter of fact, this was the norm. Now, with the increased risk of identity theft, the use of social security numbers in medical billing is taboo. An eye opening experience happened in Colorado there was an unfortunate incident with member identification numbers used for medical billing. Kaiser Permanente Colorado made a human error and put the user identification numbers on the mailing label of a member magazine. This meant that anyone handling the magazine had …
Avoid E/M Documentation Errors In Your Medical Billing
Avoid E/M Documentation Errors In Your Medical Billing Some of the most common services a medical billing company charges, in behalf of a physician’s office, are for evaluation and management services. There are common errors and CPT code misuses for these services. Medicare is probably the most common payer today. There are three things a medical billing company must substantiate with documentation before Medicare will pay: medical necessity, CPT code criteria, and services must be rendered and documented in the patient’s records. First, when performing Evaluation and management medical billing for a practice, you must ensure medical necessity. Many times simple documentation errors can disprove medical necessity. The chief complaint …
Getting Medical Necessity Right
Getting Medical Necessity Right Medical necessity is the single most important element in medical billing. Many times medical necessity comes down to the proper CPT code used for medical billing purposes. It used to be that Medicare was the only payer that cared what ICD-9 code was used. Presently, all payers, including insurance companies, are looking for any reason not to pay the bill. ICD-9 codes have become the target. ICD-9 codes range anywhere from a three-digit code to a five-digit code. Obviously, a five digit code is more descriptive then a four digit code. Similarly, a four digit code is more accurate then a three digit code. Very rarely …
Reducing Your Rejections
Rejection hurts. Rejected medical billing claims really hurt. They take time away from your staff because the reason must be found for the rejection, the files must be pulled, the billing must be looked at and the claim must be re-submitted to the carrier. All of this takes valuable time away from your practice and has your staff chasing paperwork when they should be servicing your patients and helping your practice grow. Not to mention, you’re still not getting reimbursed for services performed until that claim is re-submitted, accepted and paid. That’s where the idea for outsourcing your medical billing becomes very appealing. Your medical billing partner will not only …
Outsourcing Your Medical Billing in Florida
If you happen to be a physician in Florida and you’re thinking about outsourcing your medical billing to an outside firm, think about what your practice’s needs are before you jump in and make a choice. The best company for your medical billing may not be the one listed in the yellow pages that is on the next block. With the Internet, secure server technology, and other advances in secure data transmissions, you need only find a company that fits your needs, whether they are 2 or 2,000 miles away. Find out how your claims will be handled. Ask what the process will be for handling rejected claims. The more …
Deciding to Outsource Your Medical Billing
Time again, we hear the biggest challenge in the medical billing outsourcing industry is simply convincing physicians it would be a good idea to outsource their medical billing and coding to a medical billing company. Some physicians have been burned by doing business with medical billing companies that may have very good intentions and promised great results, but simply didn’t have the on the job experience to handle the myriad of unusual circumstances, unexpected situations, and fast moving changes (some coding numbers can change many times in one year, and a wrong coding number means delays in reimbursements) that can occur in this industry. Outsourcing medical billing is a huge …
If You’re Not Outsourcing Your Medical Billing Claims…..
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 …
A Simple Lack of Documentation
One of the biggest reasons for denied claims or missed charges on your medical billing is simply a lack of documentation. It is never intentional, but in these busy days of patients, phones, and crisis du jour, it happens. Some of the important processing points where this can happen with your medical billing are: At the Point-of-Care: This is one of the most common causes for inaccurate or lost billing is that doctors find it difficult to record all patient encounters at the end of the day. It’s hard to recall every single procedure you performed with what patient. Your medical billing partner can consult with you to help you …
More Reasons to Outsource Billing Functions
Outsourcing your medical billing will remove so many of your headaches in your practice with your medical billing. A sobering statistic about family physicians who do their own medical billing is that they can be suffering a loss of 10%-20% of their reimbursements each year simply due to incorrect coding. It’s important for your staff to understand the documentation guidelines especially for E/M (evaluation and management) services. Your practice probably uses about 30 codes for about 95% of your patient visits per day. Make sure your staff is familiar with those codes that apply directly to your office’s procedures and the documentation those medical billing codes require. It can seem …
