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.

EHR companies refuted claims of violating HIPAA

The EHR Association (EHRA) Executive Committee has fired back at accusations that EHR companies are partially to blame for interoperability problems, claiming health data exchange is progressing quickly. The association published a response to an earlier post on Health Affairs Blog that accused EHR and health IT companies of monetizing the custody of patient protected health information (PHI). Former ONC Chief Privacy Officer Lucia Savage urged the Office of Inspector General (OIG) to enforce provisions of HIPAA prohibiting business associates such as EHR developers from using PHI for business operations. She stated some EHR companies may be leveraging ownership of patient PHI for profit. “Building a revenue stream out of

By: Melissa Clark, CCS-P, RT - CEO
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How to Choose Between Modifiers 25 and 57

When reporting an evaluation and management (E&M) service on the same claim with another service or procedure, you must append either modifier 25 “Significant, separately identifiable evaluation and management service by the same physician or other qualified healthcare professional on the same day of the procedure or other service,” or modifier 57, “Decision for surgery” to the E&M service code. Modifier Identifies Separate Nature of E&M Service A minimal patient evaluation is necessary to determine that a prescribed treatment is appropriate to manage the patient’s condition. For example, if a patient presents for a previously scheduled injection, the provider will briefly evaluate the patient to confirm that the injection remains

By: Melissa Clark, CCS-P, RT - CEO
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Your Medical Billing Team is The Center of Your Business

Over the past three years, I’ve really managed to shift who makes policies, enforces policies, and understand why policies are made. Often times, leaders and managers who lack either training or experience create more and more policies rather than approaching a specific person about their behavior. Typing up a policy seems the least resistant way to handle a problem. But I warn you this is the worst approach to take. When you create policies for this reason, you are stifling and handcuffing your remaining staff, who will most likely end up leaving the company due to so many rules and policies. Let’s be clear here, I love structure and process,

By: Kathryn Etienne, CCS-P, RT - DOO
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You Should Worry about Medical Coding Guidelines Changing

Changes are coming with Evaluation and Management (E&M) coding guidelines. I will use this space to explain why these changes will be both a good thing and a challenge to physicians, particularly those who derive much of their income from office visits. CHANGE IS OVERDUE It has been 20 years since the 1997 E&M guidelines were promulgated. They were confusing to most physicians then and remain confusing today. One study from the Journal of Family Practice showed that physicians are accurate in their E&M coding only 55 percent of the time, yet Mitchell King, MD provided a fascinating follow-up investigation in the Archives of Internal Medicine that showed certified coding

By: Melissa Clark, CCS-P, RT - CEO
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A New Platform for Educating New Doctors on EHR Use

Over the past few years, the Regenstrief Institute and the Indiana University (IU) School of Medicine began to notice a problem. While EHR technology had become ubiquitous in the healthcare industry, medical school curricula had not evolved to reflect this reality. This realization became the impetus for the Regenstrief Institute’s EHR Clinical Learning Platform. “It didn’t start out as this,” Regenstrief research scientist and Assistant Professor of Clinical Medicine at IU School of Medicine Blaine Takesue told EHRIntelligence.com. “It started from a different project here at IU,” he continued. “We’ve had proprietary EHR for decades and we noticed we didn’t do much in the way of direct instruction through the

By: Melissa Clark, CCS-P, RT - CEO
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Inventing New Medical Billing Codes

Are there still medical conditions that have no codes for billing in ICD-10?   Here is a graphic from Physician’s Practice on the subject…     Credit and See the original article at Physician’s Practice

By: Melissa Clark, CCS-P, RT - CEO
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RCM tip: Meetings can enhance AR staff productivity

Meetings with individual accounts receivable staff can be a valuable tool to improve revenue cycle management performance, according to Susan Eilman, senior healthcare consultant at Wellesley, Mass.-based Hayes Management Consulting. Ms. Eilman shared the following tip with Becker’s Hospital Review. “Not every member of your staff performs the same. Employees fall into low, medium and high performance levels and from my experience, holding one-on-one meetings with each accounts receivable staff member allows you to understand what issues they experience daily, provide development tools for them to reach to a higher level, and set goals to enhance productivity. Listening is the best tool to discovering issues you may not have known

By: Melissa Clark, CCS-P, RT - CEO
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Documenting in Your EHR While Focusing on the Patient

Mott Blair, a Wallace, N.C.-based family physician, doesn’t get distracted by the EHR in the patient exam room. That’s because he keeps it in the hallway, right outside the exam room. He uses an old-fashioned clipboard and paper to take notes during patient visits. “I do all my work face-to-face with patients. I maintain that eye contact, and I always listen,” he says. This work flow has been intentional on Blair’s part, since he’s witnessed many physicians “caught up” entering data and not focusing their attention on patients. His patient’s experience starts with a nurse at the practice capturing their vitals, chief complaint, and current medications and documenting those details

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