Medical Billing Blog with Medical Billing & Coding Info & Articles
Welcome to the Medical Billing and Coding Blog
Welcome to the medical billing blog containing news and articles relating to medical billing, medical coding, ICD, HIPAA and practice management functions.
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The Blog Currently Contains 1,265+ Healthcare Articles
Medicare No Longer Filling in Blank Forms
Previously, when claims came in with incorrect ICD-9 medical billing, the Medicare carriers would make the proper corrections and then reimburse. They would correct diagnosis codes and fill in the blanks if they were empty. This was lazy medical billing on the part of the provider. Now Medicare personnel will no longer do that. They now require correct medical billing in order to reimburse for Medicare part B services. If a claim is sent in by a diagnostic center, this center must use the diagnosis code given by the referring physician for medical billing. If, for some reason, the physician does not provide a diagnosis, the personnel at the diagnostic …
Don’t Use Social Security Numbers for Patient Identification
Personal identification numbers have been a big issue in medical billing in the current years. In the past, the use of social security numbers to identify patients in medical billing was completely acceptable. As a matter of fact, this was the norm. Now, with the increased risk of identity theft, the use of social security numbers in medical billing is taboo. An eye opening experience happened in Colorado there was an unfortunate incident with member identification numbers used for medical billing. Kaiser Permanente Colorado made a human error and put the user identification numbers on the mailing label of a member magazine. This meant that anyone handling the magazine had …
Avoid E/M Documentation Errors In Your Medical Billing
Avoid E/M Documentation Errors In Your Medical Billing Some of the most common services a medical billing company charges, in behalf of a physician’s office, are for evaluation and management services. There are common errors and CPT code misuses for these services. Medicare is probably the most common payer today. There are three things a medical billing company must substantiate with documentation before Medicare will pay: medical necessity, CPT code criteria, and services must be rendered and documented in the patient’s records. First, when performing Evaluation and management medical billing for a practice, you must ensure medical necessity. Many times simple documentation errors can disprove medical necessity. The chief complaint …
Getting Medical Necessity Right
Getting Medical Necessity Right Medical necessity is the single most important element in medical billing. Many times medical necessity comes down to the proper CPT code used for medical billing purposes. It used to be that Medicare was the only payer that cared what ICD-9 code was used. Presently, all payers, including insurance companies, are looking for any reason not to pay the bill. ICD-9 codes have become the target. ICD-9 codes range anywhere from a three-digit code to a five-digit code. Obviously, a five digit code is more descriptive then a four digit code. Similarly, a four digit code is more accurate then a three digit code. Very rarely …
Reducing Your Rejections
Rejection hurts. Rejected medical billing claims really hurt. They take time away from your staff because the reason must be found for the rejection, the files must be pulled, the billing must be looked at and the claim must be re-submitted to the carrier. All of this takes valuable time away from your practice and has your staff chasing paperwork when they should be servicing your patients and helping your practice grow. Not to mention, you’re still not getting reimbursed for services performed until that claim is re-submitted, accepted and paid. That’s where the idea for outsourcing your medical billing becomes very appealing. Your medical billing partner will not only …
