Archive for The Month of March, 2006

Archive for the Month of March, 2006

Welcome to the medical billing blog archive for the month of March, 2006.

Here you will find links to every article added to the Outsource Management Group web site during the month of March, 2006.

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

How Your Neighbor’s Cost Report Can Cost Your Medical Billing

If you thought your IPPS (inpatient prospective payment system) has nothing to do with medical billing and reimbursement, then think again. Not only will your 2003 IPPS effect your own medical billing, but now your neighbor’s IPPS will effect your 2007 reimbursement as well. The Centers for Medicare & Medicaid Services announced that they will use the 2003 hospital medical billing index data to figure the 2007 payments. That means that if you were not completely accurate with your IPPS, then your reimbursements in 2007 will be skewed. CMS also announced that they will only calculate one wage per state for hospitals outside of the core-based statistical areas. This means

By: Melissa Clark, CCS-P, RT - CEO
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Inpatient Medical Billing Consultant Choices Diminish in 2006

For a long time there has been a confusion about when to use inpatient follow-up consultation codes. In 2006, this will no longer be an issue, there will only be one type of inpatient consultation service: initial and subsequent. Follow up inpatient consultation codes will no longer be used in medical billing. The previous method when doing medical billing for inpatient follow up consultation codes was to use 99261-99263 (Follow-up inpatient consultation for an established patient). Unfortunately, physicians and medical billing staff members found it difficult to decide if the care was initial or a follow-up. Those CPT codes were constantly claimed incorrectly. In an effort to increase coding efficiency

By: Melissa Clark, CCS-P, RT - CEO
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Decertification Could Cost You Big in Medical Billing

Keep accurate medical billing and policy practices to ensure your facility’s success. Certification is a necessity tool if you run a Hospice. If you happened to lose that certification for any reason, you would lose out on a lot of revenue. Just ask VistaCare how much they have lost in medical billing since being decertified in October. VistaCare Inc. is a Hospice care facility that was decertified in the two cities of Indianapolis and Terre Haute in October. Since then, they have attempted to assist over 100 patients without pay. Medical billing has been put on hold while they figure out a solution. The solution to the VistaCare Inc. problem

By: Melissa Clark, CCS-P, RT - CEO
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How Can Physician Credentialing Benefit Your Practice?

Did you think your medical billing partner only handled your coding and medical billing claims? Another service we provide is physician credentialing. You have a busy practice and your staff is just as busy servicing your patients and answering the phones. You really don’t have time these days to fill out yes another form to get yourself credentialed to do business with yet another insurance carrier. You know from previous experience that getting yourself credentialed to do business with certain carriers can take months as the processing of that paperwork can be a slow process unless you are calling the carrier every few days for a status and if you

By: Melissa Clark, CCS-P, RT - CEO
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CCR Changes for A New Provider

If you are merging hospitals, your medical billing numbers may change. Provider tax identification numbers are used to identify hospitals and medical practices. When one hospital merges with another hospital, the capital cost-to-charge ratio will change for one or both hospitals in medical billing. The first scenario in medical billing is when two hospitals merge and use one of the hospital’s tax identification number. This means that the other hospital drops their own medical billing number. When this happens, Medicare uses the hospital with the existing tax identification number to figure capital cost-to-charge ratios. The second medical billing scenario is when two hospitals merge and get a new provider number

By: Melissa Clark, CCS-P, RT - CEO
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Medical Billing Cuts Threaten DME

Medical billing practices may be your only saving grace this year if you own a DME company. CMS payment cuts are on the horizon. In the past, Durable medical equipment companies have dodged these cuts, but now they seem to top the Centers for Medicare & Medicaid Services cut list this year. Your durable medical equipment Medical billing reimbursements may suffer. The Centers for Medicare & Medicaid Services define any grossly excessive payment with a fifteen percent threshold. This amount used in medical billing will now be subjected to the inherent reasonableness cuts. Durable medical equipment companies are the target for the agency this year. The medical billing cuts are

By: Melissa Clark, CCS-P, RT - CEO
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Medical Billing Fees Charged To Clients

If you’re thinking about outsourcing your medical billing and you aren’t sure how the invoicing part works or how fees are calculated by your medical billing partner, you will find the fees are very reasonable and when you consider the time your staff will be suddenly realizing from not chasing claims, finding documentation and filing and answering appeals, will translate into more dollars for your practice, besides the fact your medical billing claims will be paid within about 2 weeks instead of the 60-90 days range that you are probably experiencing if you are still filing your claims yourself. You will find that most medical billing companies charge a percentage

By: Melissa Clark, CCS-P, RT - CEO
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Medical Billing Fraud Strikes Again!

Medical billing fraud can take on several forms. Usually healthcare practices are thought to be in place to help you when you are in need. People don’t usually think of healthcare facilities as crooks and liars. Unfortunately, some of them are. The state of Washington has found yet another poor example of healthcare medical billing. Star Physical Therapy was charged with medical billing fraud of over $400,000. The owner of Star Physical Therapy, Nancy Wong was thought to be an upstanding citizen. She was even a member of the Washington State Board of Physical Therapy. Wong, proved us all wrong. She did plead guilty to medical billing fraud in June.

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