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.

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

Published By: Melissa Clark, CCS-P | No Comments

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

Published By: Melissa Clark, CCS-P | No Comments

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

Published By: Melissa Clark, CCS-P | No Comments

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

Published By: Shannon DeConda | No Comments

When to Use Modifier 91

When to use Modifier 91? Modifier 91 is used for the reporting of repeat laboratory tests or of studies that are performed on the same patient on the same day. You will only add Modifier 91 when additional tests results are to be subsequently obtained to the initial administration or the performance of the tests done on the same day. When Not to Use Modifier 91 Modifier 91 is not used when laboratory studies or tests are rerun as a result of equipment or specimen malfunction or error. It is also not used when a test is repeated to confirm the results that the initial test reported. In addition, based

Published By: Melissa Clark, CCS-P | No Comments