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.
Still Unsure About Outsourcing Your Medical Billing?
Still Unsure About Outsourcing Your Medical Billing? A sobering fact that most medical practitioners don’t want to hear is that nearly 25% of all medical practice income is lost due to under coding, missed charges and claims that were missed or not properly reimbursed. That translates to hundreds of millions of dollars lost in revenue annually for the medical profession as a whole. Outsourcing your medical billing will allow your revenue to be collected and you will see a faster turn around on your claims. You could be receiving your reimbursement payments on your medical billing claims in 7-14 days as opposed to the 90-120 days you are probably used …
Outsourcing Your Medicare Medical Billing Claims
Outsourcing Your Medicare Medical Billing Claims In order to participate in Medicare, health care providers must:*Agree to file claims to Medicare on behalf of the patient.*Accept the allowed or approved amount of the claim as payment in full.*Write off any amount not paid by Medicare.*Make an attempt to collect the co-pay amount from the patient.*Accept assignment on all claims. If you are a physician that accepts Medicare patients, you are familiar with the billing and re-imbursement process and you know from filing CMS-1500 forms that it can take weeks for a claim that was manually filed to be handled and reimbursed by Medicare. Outsourcing your medical billing to a vendor …
The Business of Medical Billing For Psychiatric Claims
The Business of Medical Billing For Psychiatric Claims Psychiatric medical billing can be confusing for a lot of people, and many times improperly coded medical billing claims will result in the medial billing getting kicked back. Some standard billing codes for the Psychiatric industry are as follows: The “Initial Psych Eval” causes a lot of confusion. Normally the 45 – 60 minute initial evaluation is billed under CPT code 90801 (whether it is a psychiatrist, psychologist or therapist). Psychiatric testing is another coding nightmare for a lot of people, normally it is billed under CPT code 96100 (regardless of the “type” of test – the CPT code is always the …
What Is ICD-9-CM Coding System?
What Is ICD-9-CM Coding System? It almost sounds like the title to an Ed Wood film, but ICD-9 is actually a very efficient system of coding developed in a collaborative effort between the World Health Organization (WHO) and ten international medical centers, including one in the United States in an effort to streamline reporting of medical procedures. The purpose of this coding system is to promote international compatibility in the collection, classification, processing and presentation of health related statistics. In the United States, this coding system takes on another purpose as the HIPAA-mandated coding system used in medical billing. ICD-9 Clinical Modification (CM) is the system currently used in the …
HIPAA Compliance and Outsourcing Your Medical Billing
HIPAA Compliance and Outsourcing Your Medical Billing The Health Insurance Portability and Accountability Act of 1996 (HIPAA) has had a major impact on health care providers who do business electronically as well as many of their health care business partners. Many changes involve complex computer system modifications. HIPAA compliance requirements have been standardized into 4 main aspects. 1) Electronic transactions and code sets2) Security;3) Unique identifiers; and4) Privacy HIPAA does not require a health care provider to conduct all transactions and medical billing electronically. Rather, if you are going to conduct any one of these business transactions electronically they will need to be done in thestandard secure format outlined under …
Clearinghouse vs. Direct to Carrier Medical Billing Submissions
Clearinghouse vs. Direct to Carrier Medical Billing Submissions When considering which to submit to, there is some pause for thought. Most practices submit paper claims direct to the Carrier as they always have. This is not a very cost effective way to handle claims unless you only submit one claim to one carrier,which isn’t likely. You have a thriving practice with a lot of patients and therefore have a lot of claims with many different carriers. With a clearinghouse, you need only contact one location and submit all your claims for routing and processing. Most medical billing firms use the clearing house method.Furthermore, more carriers don’t allow editing of claims …
Outsourcing Your Medical Billing for Chiropractic Services
Outsourcing Your Medical Billing for Chiropractic Services You have a thriving Chiropractic practice. You have loyal patients who appreciate your services and recommend you to their associates and in turn your practice grows even larger. Soon, your in office staff is spending so much time answering phones and patient’s questions, you find your medical billing is being submitted later and later and your reimbursements are happening slower and slower. Worse, your staff is so busy sometimes they are not coding your medical billing properly, it’s not that they don’t know, it is just that they are so busy there isn’t time to keep up with the fast paced changes in …
Common Medical Billing Problems
Common Medical Billing Problems One of the most common errors in medical billing when it is handled in house at the physician’s office is a completely avoidable one. It’s called Up-coding, Undercoding, and Over-coding. Basically, correctly done coding is when the CPT-4, matches up to the correct ICD-9 or diagnosis. Sounds easy enough until you get into the sheer myriad of services available for medical billing purposes. What you need to be careful of is Up-coding that involves submitting CPT code(s) for a more extensive service or procedure than what was actually performed, or for submitting CPT codes for non-covered or non-chargeable services. Over-coding another biggie that can get your …
Medical Billing – Outsourcing
Medical Billing – Outsourcing To outsource or not to outsource that is the question. Your practice is growing and busy. Your staff is very busy servicing incoming patients, answering busy phone calls, and whatever the crisis du jour might be in your office that day. Life can’t be planned, as a physician you know that more than most. You don’t have time for coding errors, which when you do your own medical billing and coding, unfortunately are a fact of life. Most coding errors are just that, plain old human error. When your staff gets rushed and distracted from what they are doing, and it happens in the most well …
Is DME A Profitable Venture?
Is DME A Profitable Venture? Until recent years, not really. The cost of the products versus having to track claims, find re-imbursements, and keep up with claims status; made DME a very labor intensive venture. With the advent of specialized DME/HME software, secure internet connections, and standardized billing procedures; DME can now be a very profitable venture. In your practice, you will want to be sure that the product(s) you are dispensing are profitable. You need to watch the pricing of the product costs, in some instances, your product costs may be more than the carrier is willing to reimburse you for. When handling for Medicare patients, the process is …
