Medical Billing Blog with Medical Billing & Coding Info & Articles
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Welcome to the medical billing blog containing news and articles relating to medical billing, medical coding, ICD, HIPAA and practice management functions.
2004-2024 Celebrating 20 Years of Healthcare RCM Articles
The Blog Currently Contains 1,265+ Healthcare Articles
Medicare Contracting Changes
When billing to Medicare, expect some medical reimbursement delays in the upcoming years. The Centers for Medicare & Medicaid Services is currently reforming contractor workload for medical billing claims that come in. The speedy implementation of this medical billing reform may lead to reimbursement delays and errors. Congress mandated that the Centers for Medicare & Medicaid Services reform their contracting system. This needs to be completed by October of 2011. However, since estimates of huge savings have been made, the Centers for Medicare & Medicaid Services wants to speed up this medical billing contractor reform. Their goal is to have it completed by 2009, which is two years earlier. This …
Do Not Use Social Security Numbers To Identify Patients
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. Recently 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 access to the medical …
Handling Denials Due to Limitations of Service
Getting a medical billing claim denied is one of the biggest problems you can have with your billing. One tricky medical billing claim that many practices get denied for is the service for counseling patients that smoke or seeking to quit smoking and received counseling for doing so. Many payers outright reject any claim that has anything to do with tobacco, including counseling for the stoppage of its use. The patients either have zero coverage for this service or they get a limited number of counseling visits and those are normally less than full reimbursements. If the patient has already seen another physician regarding these services, you will have just …
The Trouble with Disease Management Medical Billing
Medical billing for disease management is not working for many insurance companies. Disease management has been a trend in the recent years. However, model programs are being shut down all over the country. Lack of interest is the downfall of these disease management programs. Medical billing and revenue for the year will fall due to disease management closings. A model disease management program, HeartPartners will be closing ten months early. The payer, PacifiCare Health Systems, cannot take any more medical billing loss. They were severely short on beneficiaries. They anticipated 15,000 beneficiaries, however only 3750 people actually enrolled in the program. Disease management is intended to educate patients about their …
Getting the Best Reimbursements for Injection Medical Billing Claims
If an ED physician performs an injection, infusion or hydration on a patient, there is a way to secure maximum reimbursements for your medical billing claims by looking for additional claims for separate evaluation and management services on the op report to secure all of your deserved reimbursement on these claims, the reason is anytime there is a separately identifiable and significant E/M service is provided, you can charge for both the E/M and the injection/infusion/hydration codes. The use of modifier 25 will make the claims payable with almost all carriers but there must be medical documentation to back it up to ensure reimbursement. .A good example of this would …
