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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Simplify Pregnant Patient Transfer On Your Billing

Simplify Pregnant Patient Transfer On Your Medical Billing Pregnancy medical billing is a fairly straight forward process. That is, unless the patient transfers practices in the middle of her prenatal care. Pregnancy transfers scare many medical billing personnel, however if you can remember three tips, maternity transfers will be a snap. How you do medical billing for a maternity transfer all depends on how many times she was seen in the clinic. If she was seen 1-3 times you always want to code those visits as evaluation and management visits. One thing to keep in mind is that the first antipartum visit is not as straight forward as you may

By: Melissa C. - OMG, LLC. CEO on October 28, 2005

Hospital Discharge – A Commonly Misbilled Service

Medical Billing – A Commonly Misbilled Service Many people believe medical billing can be a pain, but in some instances correct medical billing can bring you additional money. A commonly missbilled service is the professional fee for a hospital discharge. There are many medical billing mistakes made with this service. People bill for the discharge when they are not supposed to, and then don’t bill when they are entitled reimbursement. Medical billing personnel also tend to bill an incorrect CPT code when they do bill for hospital discharge. This hospital discharge medical billing mess needs to get straightened out! First of all, many times physicians should not bill separately for

By: Melissa C. - OMG, LLC. CEO on October 27, 2005

Avoid Medicare Investigations On Medical Billing

Avoid Medicare Investigations Over Your Medical Billing Sending in medical billing claims to any government organization can be nerve racking, especially when submitting to Medicare. Medicare will do an audit on your claims if you show suspicious charges or activity that does not match your FACP. There is one main thing you can do to prevent this medical billing audit: provide adequate records. The Centers for Medicare & Medicaid Services is very hesitant to pay more administrative costs then you claim on your FACP. This is one organization in which you will probably not make any profit. It is important that your FACP report closely matches the Medicare charges you

By: Melissa C. - OMG, LLC. CEO on October 27, 2005

Medicare Paid Out $900 million In False DME Claims

Medicare Paid Out $900 million In False DME Claims Large fraudulent medical billing claims are making the senate the Government Accountability Office antsy. Charles Grassley recently sent a letter to the Centers for Medicare & Medicaid Services with a daunting reality. CMS wasted $900 million dollars in incorrect durable medical equipment in 2004. For the survival of Medicare something has to change. This fraudulent medical billing needs to be taken care of. Apparently the 2004 incorrect medical billing dealt with orthotics, equipment, and prosthetics. It seems that the Centers for Medicare & Medicaid services did not keep a closer eye on their National Supplier Clearinghouse. This contractor’s job was to

By: Melissa C. - OMG, LLC. CEO on October 25, 2005

When Medicare Computer Glitches Eat Your Claims

Medical Billing Dilemma – When Medicare Computer Glitches Eat Your Claims Keep your eyes peeled for medical billing mistakes coming from the Centers for Medicare & Medicaid Services. Medicare Part B carriers are changing software systems over to the Multi-Carrier System. Some carriers have already switched to the system, some are in the process of switching, and some will change in the near future. This medical billing switch has created a lot of needless headache for providers. During the Centers for Medicare & Medicaid Services software switch, there have been many medical billing claim errors. Errors that have occurred or could possibly occur in the future include: missing updated codes,

By: Melissa C. - OMG, LLC. CEO on October 24, 2005

Using New CPT Codes Depends On Your Practice

Using New CPT Codes Depends On Your Practice Set-Up New pharmacy medical billing codes have raised many questions in the medical world. The use of these new current procedural terminology codes depends on the set-up of your practice and how the pharmacy services are administered. Medical billing constantly changes and these new CPT codes are just one example of that statement. There are three new medical billing codes for medication therapy management services. They are 0115T (Initial face-to-face assessment or intervention with the patient; 1-15 minutes, 0116T (Subsequent face to face assessment or intervention with the patient; 1-15 minutes, and 0117T (Each additional 15 minutes spent face-to-face with the patient;

By: Melissa C. - OMG, LLC. CEO on October 24, 2005

How Much Do You Know About Patients PHI?

How Much Do You Know About Patients PHI? In medical billing, PHI is personal patient information that should only be shared with covered entities. It is not only wrong to release a patient’s medical billing PHI to outside sources, but it will ruin your business as well. An example of wrongly shared PHI is at the University of Missouri Health Care. Currently over 800 patients have a class-action lawsuit filed against them. The patients claim their confidential medical billing records were released to a home health provider called Option Care. Option Care apparently called these patients trying to sell them pricey medications. They also tried to convince them that their

By: Melissa C. - OMG, LLC. CEO on October 20, 2005

Getting Your Arteriogram Claims Paid

Medical Billing Tips – Getting Your Arteriogram Claims Paid After reading this section, you will be a bilateral renal arteriogram medical billing wiz. There are many code confusions with this surgical procedure. Some payers will not pay a cent if you bill the wrong code combinations. However, doing medical billing for renal arteriograms can be quite simple. There are two codes one should report when doing medical billing for a renal bilateral arteriogram. The current procedural terminology code 36245 should be reported twice. Then the Current Procedural Terminology code 75724-26 should be reported. Do not make the mistake in adding a G0275 to your claim because the renal arteriography already

By: Melissa C. - OMG, LLC. CEO on October 20, 2005

Medical Billing Dilemma- Changing Newborn Status

Medical Billing Dilemma – Changing Newborn Status The well-being of newborns can change instantly, which intern, changes their medical billing. Newly born babies are very susceptible to illnesses. Their bodies are not used to functioning outside the uterus. They develop breathing problems, heart conditions, illnesses, skin rashes, etc. Many medical billers have incorrectly coded these evaluations. In order to receive correct reimbursement for newborns, it is important to know how to do medical billing for same-day visits for different diagnoses. When a baby is born, it may be considered a well baby. They physician does an exam and the baby is sent to the nursery. Let’s say that two hours

By: Melissa C. - OMG, LLC. CEO on October 19, 2005

Medical Billing For Non-Physician Practitioners

Medical Billing For Non-Physician Practitioners Medical billing policies by non-physician practitioners have recently changed. The Centers for Medicare & Medicaid Services reduced restrictions on what types of providers can bill for medical services. There are now several instances when a CMS and NPP can do medical billing for the services they provide. There are several medical billing scenarios to clarify for non-physician practitioners. First of all, it is perfectly legitimate for a nurse practitioner or a clinical nurse specialist to get reimbursed for services rendered in the skilled nursing facility in which they are employed. If the non-physician practitioner decides to resign their payments to the facility, then the SNF

By: Melissa C. - OMG, LLC. CEO on October 19, 2005