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.
Are Your Medical Billing Claims Being Denied?
Are Your Medical Billing Claims Being Denied? If you’re a physician and your medical claims are being denied, are you getting reasons why or are you simply eating the charges as a consequence of doing business? In the realm of things, some claims will be denied legitimately, but far fewer medical billing claims than you think will be denied in this manner if you outsource your billing. If you are still doing your own coding and billing, this is the number one reason for claims being denied by the carrier. Most practices are too busy to keep up with the coding changes that can happen many times in one year. …
Outsourcing Your Medical Billing Claims for DME
Outsourcing Your Medical Billing Claims for DME Medical billing for durable medical equipment (DME) is one of those sticky situations for a lot of medical billing companies. Many times the DME must be preapproved and noted as such on the initial medical billing or your practice may or not get reimbursed. A lot of DME claims that go unfairly unpaid to a lot of practices because there is a definite learned criteria for submitting and getting these types of medical billing claims paid. As you are well aware, Medicare claims for DME (both primary and secondary claims) can involve extremely time consuming and manual filing process for most medical billing …
The First Part of Medical Billing: Medical Coding
The First Part of Medical Billing: Medical Coding Many people think medical coding and medical billing are the same thing, as you in the industry know, they are part of the same process but are very different. Medical coding is where it begins, the services are rendered and the standardized insurance codes that correspond to that service are recorded on a medical billing form. The codes can be changed/added to/or removed many times in one year and if an outdated code is used, it can cause your medical billing claim to be rejected. If incorrect coding or under/over coding is used, you can be setting yourself up for an audit. …
Pre-certifications In Medical Billing
Pre-certifications In Medical Billing In many cases, a rejected claim by a carrier is due to the pre-certification requirements not being met. Many times, procedures will need to be pre-certified by the carrier prior to services being rendered or the carrier simply will not honor the medical billing claim when it is filed. One way to cut down on your claim rejections, is to have your staff document when they call for a pre-cert when a patient needs a procedure performed.Have your staff fill out a pre-cert form and call about the procedure for the patient and get the date,time, phone number and extension and full name of whomever gave …
Outsourcing Your Medical Billing In Utah
Outsourcing Your Medical Billing In Utah If you’re a physician in Utah and you’re thinking about outsourcing your medical billing, you’re making a very wise decision. With the advent of the internet, electronic claims submissions, and secure port to port transmissions, you are no longer only able to use a local Utah medical billing company. In fact, the best vendor for your practice may not even be located in your State! Find out what services your medical billing partner can provide for your offices. Finding the right fit for your practice will go miles towards making you happy with outsourcing your medical billing. Your staff will reap big benefits too. …
Medical Billing and Revenue Codes
Medical Billing and Revenue Codes Not all medical billing is generated from physician’s services. Sometimes services are rendered to patients and the medical billing created from those procedures need to be submitted to the various insurance carriers, but they also need three things: a price, a procedure code, and a revenue code. Revenue codes indicate to the type of service that you are billing for; revenue codes are 3-digit codes, and those revenue codes must match up with specific procedure codes to designate what services were rendered. For instance, if you are using a 360 revenue code, you’re stating that the services rendered were performed in the operating room, and …
Safety Send Endorsed by AMBA
Safety Send Endorsed by AMBA The American Medical Billing Association (AMBA) has selected Safety Send as the Endorsed Product for Their Members to use for HIPAA Compliance. Safety Send is designed for all levels of medical billing. According to Cyndee Weston, President of AMBA, “We are excited to have found SafetySend as a very affordable solution for our members to comply with the HIPAA security rule. AMBA was formed and is targeted toward providing assistance for small and home based professional medical billers with similar needs, interests and goals. Our members are looking for an affordable and reasonable answer to compliance, both for their practices and for their physician practices.” …
What Is The Electronic Claims Submission Process?
What Is The Electronic Claims Submission Process? The reason many physicians don’t outsource their medical billing is that they are unsure of how the Electronic Claims Submission process works. Understanding exactly what happens when the medical billing is sent from your office to the time you are re-reimbursed for your claims will show you how smart making the decision to outsource a lot easier. Your claims are transmitted to the medical billing company via electronic submission or plain old paper medical billing forms. At the medical billing firm, your electronic submissions are received and your paper claims are entered and double checked for errors and then transmitted in batch orders …
Medical Billing Outsourcing For Specialists
Medical Billing Outsourcing For Specialists Specialists have special problems when they need to outsource their medical billing. They need to find a vendor that understands their procedures and can accurately pick the correct coding in case the physician merely checks a main procedure performed. This knowledge by the medical billing firm will insure that claims are not under or partially paid when reimbursed and save the Specialist a lot of legwork having to pull files and re-read procedures to see what was actually done. Outsourcing your medical billing to a firm that can handle your specialty claims will take a lot off your mind and improve your cash flow. Did …
One Diagnosis Code
One Diagnosis Code? A situation that happens frequently in the medical billing industry is when a physician sees a patient, puts one diagnosis code on the form, yet multiple services were rendered. As detailed as medical coding is, in many cases, one code won’t cover the range of services the physician may have performed for the patient and portions of the claim will get rejected. Meaning the physician will only receive a partial reimbursement and the claim will have to be recoded covering the additional services originally not coded and the entire process can snarl up the repayment process for the practice. Most medical billing companies have a series of …
