Medical Billing Blog: Section - Medical Billing

Archive of all Articles in the Medical Billing Section

This is the archive containing links to all articles written in the Medical Billing 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.

Billing and coding for advanced clinical practitioners

Melissa’s Mention…   “A 67-year-old patient with diabetes shows up for her appointment. Her A1C levels are high. She reveals during the visit with the advanced practice clinician that she’s not taking her medication as prescribed. The patient’s physician is doing rounds at the hospital and is, thus, unavailable to consult with the patient in person.   At this point, the practice needs to answer a couple questions:   Can the nurse practitioner (NP) or physician assistant (PA) bill the visit under his/her own national provider identification (NPI) number? Or, is the visit appropriate for “incident to” billing and, thus, billable under the physician who created the patient’s care plan?

By: Melissa Clark, CCS-P, RT - CEO
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Are Health Record Guidelines the Same in Every State?

Health professionals typically know many federal guidelines instruct how to handle patient health records. However, they may not understand whether such guidelines differ from state to state. Getting clarification on that matter is essential, particularly when people move to other places after practicing in one for extended periods of time, or if they work as traveling providers on short-term assignments. Medical Retention Time Frames Vary by Location One of the specifics health providers must comply with during their patient care duties relates to the length of time they keep medical records. The details change based on the state. Furthermore, there are differences in retention time for hospitals versus physicians. Some

By: Melissa Clark, CCS-P, RT - CEO
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RCM tip: Follow all payer billing guidelines

“In today’s healthcare environment, it is more important than ever that healthcare providers follow appropriate billing guidelines for each contract with third-party payers, according to Monte Sandler, executive vice president of revenue cycle management at DocuTAP. “With the various types of contracts urgent care providers are entering into with third- party insurers, it’s extremely important to follow the appropriate billing guidelines for each. For example, clinical guidelines are not necessarily the same as those for billing,” he told Becker’s Hospital Review. “Many contracts require all providers to be individually credentialed, and services to be billed under the rendering provider, whereas some contracts allow all providers to bill for services under

By: Melissa Clark, CCS-P, RT - CEO
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Patients Cannot File HIPAA Lawsuits

A U.S. district court judge in Washington, D.C., on June 15 dismissed a case by a patient who alleged Laboratory Corporation of America, or LabCorp, violated HIPAA, reaffirming the precedent that individual patients cannot file lawsuits for alleged HIPAA violations, according to GovInfoSecurity. Here are five things to know about the case: 1. The district court’s ruling dismissed a lawsuit filed by a patient of Washington, D.C.-based Providence Hospital. According to the lawsuit, the patient underwent laboratory testing from LabCorp during a June 2017 hospital visit. During the visit, the former patient said she was instructed to submit medical information at a computer intake station that was allegedly within eyesight

By: Melissa Clark, CCS-P, RT - CEO
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Five Tips for Better Meetings, Communication is Key

Nearly all practices can benefit from improved communication. In this column, I’ll be sharing some tips for making meetings productive and efficient. Reaching out to groups within your practice can improve morale, invigorate and encourage problem solving, and generally make your work life more pleasant and profitable. 1) Reinforce what is important and solidify culture. Any opportunity to communicate with a group is an opportunity to build a common understanding of the goals and challenges facing the practice. Without this holistic understanding, how can you expect staff to show any initiative beyond their narrow job description? Accordingly, be sure to point out how staff’s activities advance your strategic objectives and

By: Melissa Clark, CCS-P, RT - CEO
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Harnessing Effective EHR Use for Improved Patient Care

Improving EHR use can help reduce physician burnout and strengthen the patient care process. When healthcare providers understand how to best leverage new technologies and are able to adopt and implement an integrated EHR system, both patients and providers will benefit. That has been Kaiser Permanente’s top goal with its EHR safety net programs, looking to reduce errors in the diagnostic process. Kaiser Permanente has developed a total 54 EHR safety net programs, which are collectively called KP SureNet. The programs have helped to close major care gaps over the past few years. Michael Kanter, MD, Medical Director, Quality and Clinical Analysis, Southern California Permanente Medical Group explained to EHRIntelligence.com

By: Melissa Clark, CCS-P, RT - CEO
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3 Key Tips for Ensuring a Smooth EHR Replacement

Physician and nursing dissatisfaction with an EHR system could lead to long-lasting problems within a healthcare organization, such as fueling administrative burnout and patient engagement. Opting for an EHR replacement is not a decision that should be made lightly, and organizations often look toward new options when they begin to encounter certain issues, both technical and cultural. A smooth EHR replacement process is not always guaranteed, and organizations will need to make well-informed decisions throughout the entire implementation process. Each healthcare organization is different, and will have varying requirements when it comes to EHR selection. But considering the needs of physician and nurses, finding an EHR system to meet an

By: Melissa Clark, CCS-P, RT - CEO
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Do you study the competition of your practice?

No matter how new or old your medical practice is, it is important to identify your competitors and evaluate their strategies to determine their strengths and weaknesses relative to those of your own. Understanding the competition is a crucial business activity for any physician owner. Some practices hire professionals to track competitors and assess the competitive landscape on a regular basis. But it doesn’t always have to be a complicated, time-consuming, and expensive process—particularly given the new wealth of data that can be assembled using the internet. By investing even a small amount of time, physician practices of any size can develop a framework for making competitive assessments, gather intelligence

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