All Articles Written by Kathryn Disney-Etienne, CCS-P, RT
All Articles Written by Kathryn Etienne, CCS-P - RETIRED
Welcome to the archived list of all medical billing articles written and previously posted to the site by Kathryn Etienne, CCS-P, retired Director of Operations.
All articles are listed below and categorized by date, newest to oldest. Click any article link below to read the entire article.
Separate Charges for Separate Procedures
Neonatal patients seem to present confusing scenarios for many medical billers. It could be due to the fact the patient is so tiny that many of the procedures seem related to split out but in many cases, claims for neonatal services are incorrectly bundled together. A good case in point would be if a neonatal patient presented with a fever. The physician then did a urine catheterization (51701) and a spinal tap (62270) in the office. In many cases, the medical biller might have bundled these claims together but that would be incorrect as they are two distinctly different procedures even though they were performed at the same visit. Also, …
Thinking About Outsourcing Your Medical Billing?
Outsourcing has become a dirty word in many industries due to the substandard nature of the work that is produced in many niche markets. However, with a little due diligence and making a smart choice with the company that you choose to partner with for your medical billing – it can be a rewarding experience for your practice. A medical billing partner like Outsource Management Group can not only process your medical billing, they also have practice management services that can help you keep tabs on your accounts receivable so you have a steady influx of revenue at all times. Another great feature of outsourcing is that OMG can get …
Rejected Claims Hurt Revenue
In the fast paced world of medical billing, it can be difficult for your staff to keep up with not only a busy practice, patient phone calls, needs that crop up and then the medical billing too. If a member of your staff misses a line item on your medical billing or uses an out of date code, it can directly affect your revenue in the form of a claim that isn’t fully paid or worse a rejected item that requires your staff to pull the file, review the documentation and then resubmit the claim to the carrier. This takes valuable time away from your practice and has your staff …
You’re Coding Modifier 59 Correctly With These Tips
Using a modifier incorrectly can cost you in terms of reimbursements and time. Carriers are closely scrutinizing medical billing claims for incorrect usage of modified 59. There are two main areas that you can concentrate on to avoid getting his with denials or pay backs and insure that you use the modifier correctly. A study of the OIG found a 40% error rate for modifier 59 and you can double check your billing. First of all, in order to use modifier 59 there must be services performed at separate regions. Fifteen percent of the OIG’s audited claims using modifier 59 had procedures that weren’t distinct because “they were performed at …
Can NPP Services Be Reimbursed?
Absolutely, as long as the services meet the minimum criteria and you’re medical billing documentation is ironclad. If you aren’t getting a reimbursement for the services rendered to patients by a nonphysician practitioner (NPP) affiliate with your practice, you’re leaving money on the table for the insurance company that rightfully belongs to your practice. Learn the rules of the carrier and take the time to bill under the NPP provider number and statistics how that over three-fourths of the health plans billed would reimburse at an average rate of 85%. While this isn’t a full reimbursement, it is far better than not receiving anything in return for your services rendered. …
