Medical Billing Blog with Medical Billing & Coding Info & Articles

Welcome to the Medical Billing and Coding Blog

Welcome to the medical billing blog containing news and articles relating to medical billing, medical coding ICD-10, HIPAA and all practice management functions.

Click any of the article links below or browse by section to the right to read articles on a specific subject.

Medicare is Still Behind on Telehealth

Medicare has long been criticized for its narrow restrictions on the coverage and reimbursement of telehealth services. A new report to Congress by the US Government Accountability Office (GAO) shows that not much has changed over the years. Mandated by the Medicare Access and CHIP Reauthorization Act, the GAO report noted that Medicare and the US Department of Defense (DoD) trailed the Veterans Affairs (VA) system in their use of telehealth and remote patient monitoring (RPM). On the other hand, the report painted an optimistic picture of Medicare demonstrations and new care delivery models that, it said, might increase the use of telehealth in Medicare. But Gary Capistrant, chief policy

By: Melissa Clark, CCS-P, RT - CEO
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Paper-Based Billing is Ancient History in Healthcare

“Today’s realities are that managing a practice is more complicated than ever…” That’s how an assessment begins on what it takes to successfully run a medical group in 2017 by Triple Tree, a merchant bank focused on healthcare. In a recent report, the bank also looked at the forces driving mergers of specialty groups. Chief among them is the realization by administrators and their physicians that the healthcare business isn’t what they hoped it would be. The mounting pressures are affecting medical groups’ top and bottom lines. The bank’s report suggests that while opting to be part of a larger group might sound attractive to an independent practice, the non-clinical

By: Melissa Clark, CCS-P, RT - CEO
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New Proposed Rule to Reduce EHR Data Reporting

A new CMS proposed rule contains two provisions intended to reduce hospital eCQM reporting requirements in response to feedback calling for less aggressive EHR data reporting policies. A couple provisions in a new Hospital Inpatient Quality Reporting (IQR) Program rule proposal outline modifications to electronic clinical quality measure (eCQM) reporting requirements and validation processes. In a public document in the Federal Register, CMS proposed reductions to hospital eCQM reporting policies. In the 2017 calendar year reporting period (and 2019 fiscal year payment determination), hospitals would be required to choose six available eCQMs listed in the Hospital IQR Program measure set and offer two chosen calendar year quarters of data…  

By: Melissa Clark, CCS-P, RT - CEO
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14 things to know about medical coding

Medical coders play a crucial role in the revenue cycle process, as they help ensure health systems, hospitals and physicians are properly reimbursed for the services they provide. Here are 14 things to know about medical coding. 1. AAPC describes medical coding as “the transformation of healthcare diagnosis, procedures, medical services and equipment into universal medical alphanumeric codes.” 2. Once medical coding professionals assign a code to a specific healthcare service or procedure, the code is included on an insurance claim, according to AAPC. This code tells the insurer how much it owes for the care and helps determine how much the patient will be billed. 3. Coders use a

By: Melissa Clark, CCS-P, RT - CEO
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The Latest Details on HIPAA Compliance Audits

Deven McGraw, deputy director of the Department of Health and Human Services’ Office for Civil Rights has announced that the department’s plans for initiating onsite audits is currently on hold and will remain so until more than 200 desk audits have been completed. An article over on Data Breach Today gives us great detail on where HIPAA compliance audits stand with their enforcing agency. McGraw informed the HIMSS17 conference in February of the delay. We have decided that it makes a lot more sense to [first] take a look at all we had in the desk audit process and even prepare the overarching report to the public about how those

By: Melissa Clark, CCS-P, RT - CEO
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Is Your Practice Violating HIPAA Regulations?

Corpus Christi Medical Associates (CCMA), a family practice in Corpus Christi, Texas, has always found it difficult to comply with HIPAA’s privacy and security regulations. “We struggle to have enough resources to dedicate to the ever-changing environment,” said J. Stefan Walker, MD, a family medicine physician at CCMA. “There is always something new and regulations are constantly evolving. It’s a moving target, and cyber-liability is probably the greatest risk, added Walker.” Despite this sentiment, Walker was determined not to be one of the practices listed on the “Wall of Shame” webpage maintained by the Office for Civil Rights (OCR) at the U.S. Department of Health & Human Services. Practices are

By: Melissa Clark, CCS-P, RT - CEO
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ICD-11 Beta is available in the trials at WHO

If you are tired of ICD-10, you can go checkout ICD-11 at WHO’s website. ICD-11 Beta is available in the trial stages.     Visit the current version of ICD-11 on the World Health Organization website

By: Melissa Clark, CCS-P, RT - CEO
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