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.
Inaccurate Medical Coding Can Cost You
One of the biggest ways a thriving practice loses money is through inadequate and inaccurate medical coding. Either one is a deadly mistake for your medical billing and can result in the following: Partial payment of your medical billing claim – meaning your staff has to stop whatever they are involved in and pull the patient’s file and note whatever has been paid and then spend time discovering why the rest of the claim was not paid. Sometimes it is an accident on the carrier’s part, but many times it is due to bad coding on the physician’s side of the medical billing. Denial of your claim is another big …
The Best Way to Handle EOB
The goal of any medical billing firm is to receive a correct check and correct explanation of benefits (EOB) from an insurance company. Sometimes this is easier said then done. Many times the EOB goes one place and the check goes another. There are two basic ways this can be handled: The first method is an example of a practice that compiles their own medical billing. In this case, it is beneficial to make sure a check and EOB are sent to the practice. This prevents future problems with remainders owed. It also makes sure the physician gets paid, instead of having a check sent to the patient and hoping …
When to Use 99324 in Your Medical Billing Claims
When doing medical billing for rest home care, there are many common pitfalls. Many coders bill four at home services or nursing home services when rest home care is performed. Incorrect medical billing coding such as this, could get you into trouble. The new medical billing CPT codes for 2006 address specific guidelines to follow for rest home coding. The place of the service is a big issue when dealing with the rest home services. Rest home, or custodial care facility is labeled as a POS 33. This is defined as a facility that provides room, board and other personal assistance services generally on a long-term basis. There is a …
Auditory Rehabilitation Receiving Medical Billing Reimbursement
The Centers for Medicare and Medicaid Services have recently made it known that the reimbursement for procedural code 92626 is going to be seeing increases by a rather large amount. To clarify a little bit further, the reimbursement to providers for such a procedure will come in at approximately four times the amount being received currently. This should make any of the providers of language, speech and hearing much happier when it comes to medical billing. This entire thought of reimbursement may be a lot clearer if it is broken down a bit. For example, the code 92626 which is known for the description of Evaluation of Auditory Rehabilitation Status; …
Tightening the Reigns on Medical Billing Claims
It has recently come to the attention of the Cahaba GBA Regional Home Health Intermediary that it is necessary to tighten the reigns on medical billing claims. Therefore, a study has been underway to try to find out exactly why certain claims have been denied. Through the course of this study, there have been a good number of findings to show that there have been denials of various diagnosis codes within the medical billing process. Further studies by the Cahaba GBA have revealed that a large amount of the denied claims had actually shared the same diagnosis codes. Included in the list of diagnosis codes that are often denied are: …
Medical Billing Modifier 59 Has Been Causing Trouble
Recently, the contractors for the Centers for Medicare and Medicaid Services have been on the lookout for any modifiers that have been used incorrectly. The cause for alarm is that it has recently been shown that even though modifiers are a great asset to medical billing, there are a select few modifiers that are not used in the proper fashion. Of all of the modifiers that have been used incorrectly from time to time, the one that has seemed to have been the most questionable is modifier 59. Now, this is not just any random investigation just because there have been a few problems. Studies by the U.S. Office of …
Getting Rid Of Denial Claims For Well Visits
You should always pay good attention to what payers are perceiving when looking at your medical billing. Even though your practice may view the coding procedures a certain way, it is not always the case that your payer will understand them in the same fashion. It has recently been shown that there is a major discrepancy when it comes to dealing with the billing of the procedure code 96110. The fact is that this procedure code should never be lumped in with well exam codes, except for special circumstances. What can actually happen to cause problems is that the miscommunication between medical billing for your practice and the payers are …
Always Appeal Your Denied Medical Billing Claim
It is a well known fact that everyone is human and we are all prone to make mistakes from time to time. Often times, your medical billing personnel could end up miscoding an item just because they are not up on all of the latest rules regarding ICD-9-CM or CPT rules. Because of the chances for a miscoded item being so high, it is always important that you know how an appeal can help you when your medical billing claims get denied. You may already know this, but there are a good deal of practices that will actually lose a good deal of money every single year because they do …
Double Check Those Medical Billing Adjustments!
Your staff may be grumbling about the M0175 medical billing adjustments. The Centers for Medicare & Medicaid Services announced that all home health intermediaries are required to post their adjustments however the new adjustments were delayed in posting to the United Government web site and the CMS delayed the implementation of the adjustments. Your medical billing staff needs to check the website frequently to make sure you’re getting all the adjustments that are due, if you miss filing on an adjustment, you are literally throwing away money. If your in-house staff is overworked and having a hard time keeping up with the changes, new codes, deleted codes and the filing …
PHI – Is Yours Safe?
Billing and reimbursements are the life’s blood of any practice. They keep the offices up and running. Without proper claims submissions and payments, there would be no money to run the practice. PHI is a big element when submitting claims. Keeping PHI safe is important for your patients’ safety and the longevity of your practice. PHI information is confidential information that only your patient, you, and covered entities should have access to. This medical billing PHI would include a patient’s social security number, diagnosis, treatment plan, medical history, and other personal and pertinent information. Since the content of your medical billing claims is so sensitive, it is important to always …
