Archive for The Month of September, 2005

Archive for the Month of September, 2005

Welcome to the medical billing blog archive for the month of September, 2005.

Here you will find links to every article added to the Outsource Management Group web site during the month of September, 2005.

You can browse this month's archives by clicking the "More" button from any of the excerpts below.

Clarifying Guidelines For Medical Billing Cardiac Rehab

Clarifying Guidelines For Medical Billing Cardiac Rehab Difference in medical billing manuals have made cardiac rehab claim submission confusing. There are three manuals that give guidance on how to bill for cardiac rehab services. These manuals are the Medicare Coverage Issues Manual, Intermediary Manual, and Hospital Manual. Each on of these manuals gives a different method on how to bill for cardiac rehab. The Office of Inspector General realizes that this has become a major medical billing issue. Recently, an audit was done on thirty four different hospitals. The goals was to see where the consistencies and then confusion lie in billing for medical cardiac rehabilitation. The results were astonishing!

By: Melissa Clark, CCS-P, RT - CEO
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Captain Integrity & The Medical Billing Community

Captain Integrity – Superhero For The Medical Billing Community And More! Medical billing compliance has never been more fun. A brand new compliance program called Captain Integrity is getting some positive attention. Medical billing fraud is wrong and Captain Integrity is here to save the day. With medical billing fraud on the rise, a new compliance brand name was in order. The intention of the Captain Integrity program is to put a positive spin on compliance that all employees will enjoy. Many people look at compliance as a negative thing. Captain Integrity wants to change that. Everyone from office personnel to actual physicians can get involved in this medical billing

By: Melissa Clark, CCS-P, RT - CEO
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California AG Files Fraud Charges Against 39

California AG Files Fraud Charges Against 39 pharmaceutical companies There is big Medical billing news in California. California’s Attorney General, Bill Lockyer, is showing large pharmaceutical companies that they can’t take advantage of his state any longer. Pharmaceutical fraud has plagued California. Inflation of medical billing hurts everyone. On August 25, the medical billing news that swept across California was that the Attorney General filed a lawsuit against 39 large pharmaceutical companies. He claims that they have spent years wrongfully inflating the costs of drugs. The billings for many of these medical drugs were sent to California’s Medicaid (Medi-Cal). Apparently, a smaller pharmacy filed a lawsuit against a few larger

By: Melissa Clark, CCS-P, RT - CEO
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Strong Documentation Gets Your E/M Claims Paid

Strong Documentation Gets Your E/M Medical Billing Claims Paid When billing a medical claim, the diagnosis code is one of the most important elements to prove medical necessity. As soon as a payer gets a claim, it automatically goes through their system and is either paid, denied, or sent to review. Billing with strong documentation to back up medical current procedural terminology codes will get claims paid quicker. Many times with simple evaluation and management visits, the only thing needed in billing a claim is the medical CPT code and the ICD-9 code. When this is the case, it is very important that these codes not only correctly correspond, but

By: Melissa Clark, CCS-P, RT - CEO
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Errors In Drug Testing Claims = Visit From the Feds

Errors In Drug Testing Claims Can Put The Feds At Your Door Any type of medical billing error can raise some eyebrows. There have been so many cases of fraudulent claims, there is no longer room for mistakes. Whether you make an unknowing error in medical billing, or purposefully cheat a payer out of money, the government will come after you with full forces. Recently, on August 25, 2005, an osteopath, Aaron M. Hurowitz was indicted on 80 counts of healthcare fraud. This Georgia osteopath had been involved in fraud and money laundering since 1997. Apparently he cheated Medicaid out of about three million dollars. There were several things he

By: Melissa Clark, CCS-P, RT - CEO
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Outsourcing Your Medical Billing In Texas

Outsourcing Your Medical Billing In Texas Texas is a big State with a lot of people and those people need to see doctors and those doctors need to bill and get reimbursed for those services. This is where outsourcing your medical billing becomes a viable option and good idea. Outsourcing your medical billing will free up your staff and handle your receivables for you. With today’s secured and encrypted information transferring technology, there is no fear of your information not being private and secure. Your records are kept private and in full compliance. Medical billing companies stay up to date on the latest pulse of the medical billing industry and

By: Melissa Clark, CCS-P, RT - CEO
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Choosing Medical Billing and Coding Training

Choosing Medical Billing and Coding Training Medical billing is a complicated process designed for only the most skilled workers. Although training is necessary, certification is not a requirement. However, choosing the right training program with the correct certifications is the key to success in medical billing. First we will take a look at three of the most notable training programs available for medical billing and coding today. The first program is a web-based program called Universal Class. The great thing about Universal Class is the ability to work at your own pace in a non-credit type of atmosphere. The medical billing courses are taught by knowledgeable instructors at affordable prices.

By: Melissa Clark, CCS-P, RT - CEO
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Combining HPI and ROS In Your Medical Billing

Combining HPI and ROS In Your Medical Billing Claims Combining history of present illness and review of systems is possible when doing medical billing. Many medical billers think this practice is breaking a rule or impossible. However, documenting an element once to account for HPI and ROS is perfectly legal. Many times a physician will leave a medical billing company with tons of documentation for a review of systems, but not enough information for the history of present illness. Don’t worry! There is no need to down-code. The CMS states that physicians absolutely do not need to document an element two times just so the person performing medical billing knows

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