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.

Medicare is Still Behind on Telehealth

Medicare has long been criticized for its narrow restrictions on the coverage and reimbursement of telehealth services. A new report to Congress by the US Government Accountability Office (GAO) shows that not much has changed over the years. Mandated by the Medicare Access and CHIP Reauthorization Act, the GAO report noted that Medicare and the US Department of Defense (DoD) trailed the Veterans Affairs (VA) system in their use of telehealth and remote patient monitoring (RPM). On the other hand, the report painted an optimistic picture of Medicare demonstrations and new care delivery models that, it said, might increase the use of telehealth in Medicare. But Gary Capistrant, chief policy

By: Melissa Clark, CCS-P, RT - CEO
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Paper-Based Billing is Ancient History in Healthcare

“Today’s realities are that managing a practice is more complicated than ever…” That’s how an assessment begins on what it takes to successfully run a medical group in 2017 by Triple Tree, a merchant bank focused on healthcare. In a recent report, the bank also looked at the forces driving mergers of specialty groups. Chief among them is the realization by administrators and their physicians that the healthcare business isn’t what they hoped it would be. The mounting pressures are affecting medical groups’ top and bottom lines. The bank’s report suggests that while opting to be part of a larger group might sound attractive to an independent practice, the non-clinical

By: Melissa Clark, CCS-P, RT - CEO
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5 biggest concerns for health execs in 2017

A new set of concerns has emerged among hospital and health system executives, according to The Advisory Board Company’s latest Annual Health Care CEO Survey. The survey, which was completed by 183 C-suite executives between December and January, found the No. 1 concern among health system leaders in 2017 is improving patients’ access to care in ambulatory or outpatient settings. Last year, this concern was ranked No. 6. An entirely new concern — finding innovative ways to lower expenses — came in at second place. The No. 3 concern was boosting market share for outpatient surgical procedures, up from No. 10 in 2016. “This shift in topic rankings reflects a

By: Melissa Clark, CCS-P, RT - CEO
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Self-service data preparation and analytics

Improving claim collection rates is one way to boost revenue cycle performance, and hospitals can achieve this through various means. Frank Moreno, vice president of product marketing at Datawatch, shared the following tip with Becker’s Hospital Review:”Effective revenue cycle management is only attainable when healthcare organizations have a full view of their patient and operational data. Finance departments cannot wait for IT to provide detailed reports, or spend countless hours manually pulling data from EMRs, 835 and 837 remittance and other files.Yet that’s what is happening at organizations across the country every day. Instead, by using self-service data preparation and analytics solutions, finance teams can easily unlock hidden data to

By: Melissa Clark, CCS-P, RT - CEO
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7 things to know about medical coding and billing specialists

Medical coding and billing specialists are an integral part of hospitals’ and health systems’ efforts to optimize revenue cycle management processes. Here are seven things to know about medical coding and billing specialists. 1. Medical coders are tasked with reviewing clinical documentation and designating standard codes using ICD-10 classifications. Medical billers primarily process and make sure claims are sent to payers for reimbursement of services administered by a provider, the American Academy of Professional Coders states. 2. A hospital or a health system may combine the responsibilities of coding and billing into a single department, or may divide coding and billing operations into two separate branches. AAPC states if the

By: Melissa Clark, CCS-P, RT - CEO
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Is Your Small Practice Ready for ICD-10?

It’s 193 days to ICD-10 and to be honest, that’s not much time! It’s time to get your practice ready to use ICD-10, but where do you begin? There’s no question it can be overwhelming! Here’s the steps we recommend to any Providers that ask. Let’s get started. Put One Person in Charge First things first, you need to assign the task of overseeing ICD-10 to someone on your staff. It doesn’t matter whether that person is the biller, a coder, the office manager, or someone else. Their goal is to lead the process, ensure things are on task and on target, and to oversee the details.   Develop a

By: Kathryn Disney-Etienne, CCS-P, RT - Director of Operations
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Demonstrating the Complexity of Care

SCENARIO: So, you are working at a multi-specialty practice that recently employed a urologist. As the Lead Medical Auditor and a member of the Corporate Compliance Team, you begin to worry about the chart audits as you have no members on your team that have worked within this specialty before. Take a deep breath – and remember that the largest volume of claims that the urologist will bill are E&M services. Regardless of the specialty of any medical practice, each will utilize Evaluation and Management (E&M) services in greater volumes than surgical services. Specialty-specific trained medical auditors are well versed in trudging through records to note the disease processes and

Guest Article By: Shannon DeConda
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