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.
Update Your Reporting Method To Medicare
Update Your Reporting Method To Medicare or Face Denials Times are changing when performing electronic medical billing to Medicare. Beginning on August 1, 2005, noncompliant electronic claims billed will be denied. These billed medical claims must be compliant with the Health Insurance Portability and Accountability Act (HIPAA). Currently there is a medical billing contingency plan in effect that does accept these noncompliant claims, but that will soon end. In order to ensure the most efficient payment possible, submitting compliant electronic claims is recommended. Otherwise, the Centers for Medicare & Medicaid Services will send the claim back to you unprocessed and with no payment. To get medically reimbursed for this billing, …
Ready for your Medicare Site Visit?
Securing a Medicare provider number is a priority for any new practice. Properly submitted electronic Medicare claims can turn to cash in 21 days and can help establish a predictable cash flow. Part of the approval process includes a site visit and presentation of “QID’s” such as #14120: DOCUMENTED BILLING PROCEDURES that states “Sound practice management provides for defined billing procedures and reference materials as a component of increased accuracy.” When you engage a billing and coding company make sure the support team you choose is familiar with all Medicare procedures including the all-important site visit and the information required and presented during the visit. A company that is familiar …
Doctor Disciplined – Told to Take Medical Billing Classes
In Texas, a Bastrop physician and an Austin doctor were among the over 60 physicians that were disciplined y the Texas Medical Board. are among the 64 doctors the Texas Medical Board recently disciplined. The Internalist that was disciplined, Dr. Rajeev Gupta, was disciplined because five patients were improperly billed and the radiology equipment was operated by a staff member that was unlicensed. Dr. Gupta was fined $1000 and required to take a course in medical billing. The attorney for Dr. Gupta stated, “We realize there were mistakes, and we’re taking steps to make sure there are no additional mistakes,” said Alex Fuller, an Austin lawyer representing Gupta. “It wasn’t …
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 …
Correctly Reporting Wound Length
When a patient reports to the ED and requires laceration repair, the medical billing claim needs to address the length of the wound in order to be a properly filed claim. If the wound length is either not addressed or addressed incorrectly, the claim may be either denied, rejected or only partially paid. Additional factors can include whether or not there was a separate evaluation and how the service was managed during the encounter. Make sure all of these factors are documented in your medical billing claim. Laceration repairs are very common in the ED, in fact a nationwide survey showed that every one in fifteen patients presenting in the …
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 …
Getting Those "Q" Modifiers Right For Medicare
Remember when medical billing used to be a simple affair of matching the procedure done with a couple of medical billing codes to describe what was done, attaching your documentation and then submitting your medical billing claim for reimbursement? Now we have codes for codes and modifiers and the need to when to bundle and when to not bundle with the goal being fair reimbursement for procedures done. Modifiers cause a lot of confusion for many medical billers. One such confusing modifier that is worth clarifying is Q6. This applies to Medicare medical billing claims only, but in a nutshell when one of your staff physicians takes a leave of …
Switch to Oursourcing Your Medical Billing in 2008!
Outsourcing your medical billing claims to a third party partner may be one of the smartest business moves you make in 2007. You may have had every intention of doing your own medical billing for your practice from the day you opened until the day you retired, however with the never ending changes and nuances in medical billing claims varying from cancelled codes to nonpayment of certain procedures because they simply weren’t reported correctly – there comes a time when you need to look at your revenue flow from your reimbursements and decide it might be time to outsource your medical billing claims. Another reason to outsource is the small …
Don’t Be Baffled By Long Term Care Claims!
Long term care medical billing has it’s own set of nuances that must be followed in order to ensure that you receive proper reimbursements for the services you provide. Since nearly every patient you treat will have a long term history of care – it’s sometimes tempting to skimp on the medical documentation and necessity but since you have no way of knowing who is going to review your claim, you need to handle every claim as a fully individual manner complete with full documentation or you may wind up with partially paid claims or outright denials of your medical billing claims. One important thing to learn is when you …
