Medical Billing Blog: Section - Medical Coding

Archive of all Articles in the Medical Coding Section

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

The growing importance of patient collections

Patient collections have grown in importance in the healthcare industry for several reasons. Here are some key factors contributing to the increased emphasis on patient collections: Rise in High-Deductible Health Plans (HDHPs): The prevalence of high-deductible health plans has increased, shifting a larger portion of healthcare costs onto patients. As a result, providers need to focus on collecting payments directly from patients to cover these higher deductibles. Increased Patient Financial Responsibility: Patients now bear a greater financial responsibility for their healthcare expenses. This includes co-payments, coinsurance, and deductibles. Effective patient collections are crucial for healthcare providers to recover these out-of-pocket costs. Changing Reimbursement Models: The shift from fee-for-service to value-based

Published By: Melissa C. - OMG, LLC. CEO | No Comments

What is physician insurance credentialing?

Physician insurance credentialing, also known as provider credentialing or insurance credentialing, is the process by which healthcare providers, including physicians, nurse practitioners, and other healthcare professionals, become approved participants in insurance networks or panels. Being credentialed with insurance companies is essential for healthcare providers to receive reimbursement for services rendered to patients covered by those insurers.   Here’s an overview of the process: Application Submission: Healthcare providers submit a credentialing application to insurance companies or third-party payers. This application typically includes detailed information about the provider’s education, training, work history, licensure, certifications, malpractice history, and more. Verification of Credentials: Insurance companies or credentialing organizations verify the information provided by the

Published By: Melissa C. - OMG, LLC. CEO | No Comments

5 Most Important Aspects of Medical Billing: Melissa’s Mention

Here is an excerpt from an interesting article that has been mentioned by Melissa:   “Medical billing is a process where you pay your provider for their services. When we say you, we mean that this is the process where your insurance carrier and you pay the service provider or hospital you were in for deductible charges. Now when you know this let’s put ourselves in the position of a medical institution, clinic, or practice that has to bill for their work. Believe it or not, sometimes it is very hard to do this and these businesses have their work cut out for them when it comes to charging their

Published By: Melissa C. - OMG, LLC. CEO | No Comments

ICD-11: What it is, When it is Coming and How it Will Differ from ICD-10

ICD (International Classification of Diseases) is a universally accepted ranking system used by the WHO (World Health Organization) for categorizing physical and mental illnesses. ICD-11 is the eleventh edition of this categorization system. For about two decades, there have been no development or publishing of an update or revision to the ICD. The official presentation of ICD-11 at the World Health Assembly took place in May 2019 following its release on June 18, 2018. Member states are expected to adopt it as the official reporting system starting on January 1, 2022. However, it is still unknown when the U.S. Healthcare system will be ready to adopt it for use. ICD-11

Published By: Melissa C. - OMG, LLC. CEO | No Comments

The Importance of A/R and Outstanding Medical Claims

Accounts receivable (A/R) management is an integral part of the medical billing process and it is crucial for the financial stability and success of healthcare facilities and medical practitioners. Accounts receivable is referred to as the sum of money owed to the medical practitioner or healthcare provider for the service provided, but not yet paid. The medical services that are rendered by physicians, nursing homes, therapists, laboratory technicians, and hospitals are continuously increasing. An efficient insurance model assists a medical practice in recovering overdue payments from insurance carriers easily and on time. This is when a diligent A/R employee, or department is important, they assist the healthcare provider in being

Published By: Melissa C. - OMG, LLC. CEO | No Comments

EHR Satisfaction and Ease of Use

If you are a healthcare worker in any field, you are probably aware of the HITECH Act.  This Act was the inception of the electronic medical record (EHR), and meaningful use.  Meaningful use was the proposal from CMS and ONC.  The idea was to have the electronic medical record have interoperable capabilities throughout the United States (cdc.gov 2019).  We know now that is not in effect.   The introduction of the HITECH Act was to demonstrate to the reader that the front line healthcare worker (Physician, Nurse, Physician Assistant, Certified Nurse Assistant, etc.), are the workers that are the most impacted by the use of the electronic medical record.  If

Published By: Michelle Bottone | No Comments

Telemedicine and Coding for Remote Blood Pressure Monitoring

Telemedicine has grown rapidly because it allows the remote delivery of healthcare services during the pandemic. Telemedicine tends to lower healthcare costs, expand the patient database, and offer flexible working conditions for physicians and health care providers. It reduces physical office hours and saves overhead costs, like payroll for hourly employees, utilities, and other various expenses associated with an office being open. Remote Patient Monitoring is a key component of Telemedicine. It allows the physician and the patient’s care team to get real-time data thereby enabling communication without an in-person appointment. The Center for Medicare and Medicaid Service (CMS) introduced new Current Procedural Terminology codes for Remote Patient Monitoring (RPM)

Published By: Melissa C. - OMG, LLC. CEO | No Comments

Medical Billing vs Medical Coding, What’s the Difference?

Medical coding and medical billing are two of the reimbursement systems within the healthcare organization. The professionals who perform these tasks are known as medical coders and medical billers, respectively. The work of medical coders and medical billers is to analyze medical treatments received by patients while at a healthcare facility to coordinate payments from insurance companies and patients. In this article, we will discuss the difference between medical coding and medical billing. However, it is important to have a brief understanding of what medical coding and medical billing entail. What is Medical Coding? Medical coding is a way of converting healthcare diagnosis, procedures, medical services, and equipment into universal

Published By: Kathryn E, CCS-P - Retired | No Comments

Flu Season is Nearly Upon Us… Medical Coding for Influenza Vaccine

Since Flu season is rapidly approaching, we decided to take a look at the medical codes that are utilized for billing of vaccine shots.   First of all, what exactly is the Flu? Flu is short for Influenza, which is a contagious respiratory disease caused by the Influenza virus. Influenza virus infects the nose, throat, and in a rare condition the lungs. The symptoms can be mild to severe. The most common influenza symptoms include high fever, sore throat, headache, coughing, runny nose, muscle and joint pain, and fatigue (body weakness). This virus generally occurs during the winter months. Influenza is a serious health condition that can lead to pneumonia.

Published By: Melissa C. - OMG, LLC. CEO | No Comments

COVID-19 and the Family Practice Provider

Since the outbreak of the Covid-19 pandemic, the economic system has certainly been negatively affected. As covid-19 continues its exponential growth across the world, it has taken a financial hit on all businesses, including the health care systems. The Coronavirus outbreak affects Schools, Universities, Cinemas, Concert halls, Theaters, Pubs, Restaurant, Shopping malls and other small businesses. Many People have lost their jobs and shops have closed down as a result of this pandemic. Many people find themselves in isolation with their family or being completely alone. Many People are lonely, afraid and depressed. This novel Coronavirus has been a source of catastrophic social and economic crisis. People now make use

Published By: Melissa C. - OMG, LLC. CEO | No Comments