Medical Billing Blog: Section - Consulting
Archive of all Articles in the Consulting Section
This is the archive containing links to all articles written in the Consulting section of our blog.
Click any of the article links below to read the entire article or browse another section to the right to read articles on another subject.
Empowering Patients: The Role of Advocacy in Healthcare Billing
Medical billing can be a labyrinthine process, often leaving patients feeling overwhelmed and confused. From deciphering complex codes to negotiating with insurance companies, the journey through medical billing can be as challenging as the medical treatment itself. However, in this maze of paperwork and jargon, patient advocacy emerges as a guiding light, helping individuals understand and navigate their medical bills with confidence and clarity. Understanding the Complexity Medical billing is notorious for its complexity. It involves a myriad of stakeholders, including healthcare providers, insurance companies, and government agencies. Each entity has its own set of rules, codes, and procedures, making the billing process intricate and opaque for patients. One of …
Return on Investment in Healthcare
Professor William A. Hyman has a good article on ROI over at Hitech Answers… “The usual meaning of Return on Investment (ROI) in purely financial transactions is how much money do you get back for the amount of money you put in. It is usually desirable for the amount returned to exceed the amount invested, thus achieving a positive ROI. In healthcare this concept requires modification because of who may receive the benefit and whether or not that benefit is monetary. Here our concern is usually investments in IT, although there are many other possibilities such as medical devices. In some hospital “investments” there can be an internal positive return …
Cybersecurity Taskforce Issues EHR Security Recommendations
A healthcare industry cybersecurity taskforce recently submitted a report to Congress analyzing and addressing various issues with healthcare security including problems unique to EHR technology. The task force was initially convened in March of 2016 by HHS and consisted of members representing organizations ranging from hospitals to pharmaceutical companies. Throughout the year, taskforce members shared information regarding cybersecurity best practices, trends, threats, and general concerns regarding health IT safety. The task force also posted blogs encouraging the public to submit feedback and present ideas the taskforce could draw from when addressing requirements of the Cybersecurity Act of 2015. Ultimately, the taskforce devised the following six imperatives to increase current levels …
Medical Billing for 92552 And You
Medical Billing for 92552 And You Performing medical billing for current procedural terminology code 92552 can be difficult to distinguish from 92551. These hearing tests are similar, but there are slight differences. When billing for these medical hearing tests, it is important to match chart notes with CPT codes. The medical billing CPT code 92552 means pure tone audiometry; air only. This is a hearing test that a physician uses when testing the limits of intensity for each frequency heard. This means, for each pitch, high or low, the physician sees what the patient can hear at the lowest intensity possible. When doing medical billing for this procedure, one must …
Outsourcing a Dirty Word toYou?
The word “outsourcing” has become a dirty word for many physicians that have been burned by medical billing companies that either outsourced their claims to medical billing companies that use neither secure networks nor adhere to HIPAA regulation in order to maximize their profits; or the outsourcing company just turned out to not be reliable and it wound up costing the practice money to utilize their services. Don’t let a bad experience keep you from partnering with a legitimate medical billing company that can not only help you get your reimbursements faster but also realize great profits by maximizing every single medical billing claim that is filed to make sure …
October Updates Are In Effect!
If you haven’t already, make sure that your staff is using the updated CPT codes that were released in October 2008. Not doing so can lead to kick backs that will require more staff hours to research, redo and resubmit and if this happens on a number of claims it can seriously affect your reimbursements and in turn – slow your revenue flow to a mere trickle. One way to avoid this dilemma is to outsource your medical billing and yes, there are some horror stories out there about outsource companies that threw away patient billing, had lax attitudes towards billing submissions and wound up costing the physician a lot …
Tips for Getting Maximum Reimbursements for Ulcer Claims
Often, patients who are confined to beds for long periods of time develop pressure ulcers. They are painful and need to be treated as quickly as possible as infections can set up within them that can be life threatening when the patient is already in a weakened condition. When a service is performed for a patient such as treatment of a pressure ulcer on an area of the body such as the lower back, the usual manner of treatment is to remove any devitalized tissue from the ulcer using a water jet and forceps. The area is then covered to allow it to not be rubbed on so the skin …
Do You Know the Three "R’s" of Consulting Reimbursements?
Since consultation requirements have increased in the last year as far as criteria for getting them reimbursed in your medical billing claims, there are some criteria you must be certain that your claims meet in order to justify using codes 99241-99255. It used to be simple and medical billing consultant merely had to meet the three “R’s” in order to justify medical billing claims for consultations. However the criteria for what does and does not constitute a consultation has changed and in order to make sure that your medical billing claims are paid, you need to reacquaint yourself with the three R’s of medical billing for consultations. The three R’s …
Definity Still Definitely a Problem in 2007
The injectable contract agent named Perflutren better known as Definity has caused a lot of confusion as many providers are billing the incorrect code and Medicare and most other large payors switched the code for this service in late 2005 and 2 years later it’s still showing up on medical billing and causing numerous delays and rejections on medical billing reimbursements. If you’re a service provider that is still billing A9700, you could face delays in getting paid–or even denials on your medical billing claims. If the carrier approves the main echocardiography procedure, then it will usually approve the use of Definity as contrast. If you are not sure of …
Wound Closure Medical Billing -Dermabond or Stitches?
When a wound needs closing and a tissue adhesive is used the medical billing coding can be different than when sutures or stitches are used. There are specific guidelines for medical billing when tissue adhesives are used. All adhesives including Dermabond have their own unique way of being reported on medical billing. Consult with Medicare or the carrier to ensure that you are meeting those guidelines prior to submitting your medical billing. There are five basic guidelines that Medicare requires in order to reimburse for this service and many carriers follow the same criteria for laceration closures utilizing Dermabond. You should report G0168 for Medicare patients only; the CPT code …
