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Welcome to the medical billing blog containing news and articles relating to medical billing, medical coding ICD-10, HIPAA and all practice management functions.

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Currently contains over 1,235 healthcare and medical related entries.

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Cybersecurity Taskforce Issues EHR Security Recommendations

A healthcare industry cybersecurity taskforce recently submitted a report to Congress analyzing and addressing various issues with healthcare security including problems unique to EHR technology. The task force was initially convened in March of 2016 by HHS and consisted of members representing organizations ranging from hospitals to pharmaceutical companies. Throughout the year, taskforce members shared information regarding cybersecurity best practices, trends, threats, and general concerns regarding health IT safety. The task force also posted blogs encouraging the public to submit feedback and present ideas the taskforce could draw from when addressing requirements of the Cybersecurity Act of 2015. Ultimately, the taskforce devised the following six imperatives to increase current levels

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

Configuring a chargemaster for medical services

Configuring a chargemaster for medical services is like constructing a building. The more complex the building (or medical services), the more planning, skill, and manpower needed to do the job. The chargemaster of a primary hospital will be different from a tertiary hospital with more acute specialty services. The volume of services rendered gives an estimate of the volume of chargemaster transactions, while the variety and complexity of services rendered gives an idea of the resources needed. Dedicated training, level of expertise, attention to details, and the skill of the chargemaster team determine a successful outcome. The Basics 1. Know your payers and its policies (i.e. what Medicare Jurisdiction the

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

Incident-to Coding: Physician vs. Non-physician Provider

Question: Our practice needs to make sure that “incident-to” guidelines are being followed? Part of the Medicare guidelines is that the physician must stay involved in the patient’s care, but they don’t give a specific timeframe. If the patient only sees the non-physician provider (NPP) once or twice a year, and only sees the physician every two to three years, would Medicare consider that as the provider staying involved in the patient’s care?   Answer: Once upon a time…   Continue reading this article  

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

View provider enrollment as a critical part of your RCM

Provider enrollment with payers is crucial, as it ensures proper reimbursement for services rendered, according to Patrick Doyle, senior vice president of Newport Credentialing Solutions. Mr. Doyle shared the following tip with Becker’s Hospital Review: “To ensure every collectible dollar is received, provider enrollment must become an integral part of the revenue cycle process. Best practices should include regular payer audits to validate provider participation status, rigorous payer application follow up, monitoring of licenses and expiring documents, Council for Affordable Quality Healthcare re-attestations and re-enrollments. Furthermore, understand your at-risk revenue against your open enrollments. These are charges billed by providers when their enrollment status is in-process. In-process enrollments for payers

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

2018 ICD-10-PCS Code Changes

The U.S. Department of Health & Human Services (HHS) has released the code changes for ICD-10-PCS coding system. ICD-10-PCS codes were adopted under HIPAA for hospital inpatient healthcare settings to use for reporting procedures. Their guidelines help healthcare providers and coders to accurately identify procedures to be reported on healthcare claims. The 2018 updates will reflect services from Oct. 1, 2017 through Sept. 30, 2018, so be sure to update your medical records to account for the changes. There were 75,789 codes in 2017. In 2018, the number jumps to 78,705…   Continue reading this article  

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

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