Archive for The Month of November, 2007

Archive for the Month of November, 2007

Welcome to the medical billing blog archive for the month of November, 2007.

Here you will find links to every article added to the Outsource Management Group web site during the month of November, 2007.

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

Switch to Oursourcing Your Medical Billing in 2008!

Outsourcing your medical billing claims to a third party partner may be one of the smartest business moves you make in 2007. You may have had every intention of doing your own medical billing for your practice from the day you opened until the day you retired, however with the never ending changes and nuances in medical billing claims varying from cancelled codes to nonpayment of certain procedures because they simply weren’t reported correctly – there comes a time when you need to look at your revenue flow from your reimbursements and decide it might be time to outsource your medical billing claims. Another reason to outsource is the small

By: Melissa Clark, CCS-P, RT - CEO
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Don’t Be Baffled By Long Term Care Claims!

Long term care medical billing has it’s own set of nuances that must be followed in order to ensure that you receive proper reimbursements for the services you provide. Since nearly every patient you treat will have a long term history of care – it’s sometimes tempting to skimp on the medical documentation and necessity but since you have no way of knowing who is going to review your claim, you need to handle every claim as a fully individual manner complete with full documentation or you may wind up with partially paid claims or outright denials of your medical billing claims. One important thing to learn is when you

By: Melissa Clark, CCS-P, RT - CEO
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Before You Code…..

Don’t even crack your code book unless you’ve done the following three things: Number 1 – Make sure that your ICD-9 codes book is from the current billing year. New codes are issued on October 1st of every year. Make that your Medical Billing New Years and put up the previous year’s code book to ensure that you don’t make a mistake and code from the incorrect set of codes. Number 2 – State by reviewing the diagnostic statements and make yourself a side list choosing the conditions you need to code in order to make sure you don’t miss anything when you’re choosing the proper ICD-9 codes. Number 3

By: Melissa Clark, CCS-P, RT - CEO
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Report – HHA’s and Hospices Are Billing Medicare Accurately

A recent report showed that HHA’s (home health agencies) and hospices are billing Medicare on an accurate level according to a report compiled by the CMS’ Comprehensive Error Rate Testing. The report showed that HHAs had a 1.4 percent error rate and hospices a 1.0 percent error rate in the November CERT report, which covers claims from April 2006 to March 2007. DME (durable medical equipment) suppliers had a wide range of error rates broken out by supplier type. The lowest was 0.6 percent for a medical supply company with prosthetic/orthotic personnel certified by an accrediting organization while the highest was a whopping 51 percent for “unknown supplier/provider” where it

By: Melissa Clark, CCS-P, RT - CEO
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Home Care Payments Will Be Getting Close Scrutiny in 2008

On October 17, 2007 – the Senate Finance Committee met to discuss ways to pay for a fix to physician payment rates in 2008 and 2009, according to press reports. The heart of the meeting was to talk about the $30 billion in cuts needed to avert the doc pay cut and make other Medicare changes, and home care once again landed on the chopping block to have many home services radically reduced or have their funding cut all together.Some of the specifics of the home care that were discussed to be directly affected were wheelchair suppliers and oxygen providers are under discussion for reimbursement reductions to pay for the

By: Melissa Clark, CCS-P, RT - CEO
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Emphysema Diagnosis Coding Tips

Want to know why your emphysema claims aren’t being fully reimbursed? Often, the reason is that you’re lacking two things when you submit your claim. You aren’t being detailed enough with your coding and your don’t have enough detailed medical documenation to back up your full diagnostic testing that is required to accurately diagnose emphysema and narrow the degree and type. When you’re compiling the medical billing for an established patient with active emphysema (492.8, Other emphysema) and they present and are complaining of shortness of breath (786.05); the physician provides inhalation treatment, trains the patient on using the nebulizer at home, and provides an expanded problem-focused examination and medical

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