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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
10 Common Physician RCM Mistakes
If you’re familiar with the beloved sitcom “Seinfeld,” then you have probably seen “The Opposite,” an episode where George Costanza takes it upon himself to do the complete opposite of what he believes is right. The episode serves as the inspiration for Craig Pedersons’ presentation, “Physician Compensation: 10 Common Mistakes (and Four Solutions),” at the Medical Group Management Association (MGMA) Annual Conference in Anaheim, Calif. “I am going to go through case studies and specific examples of financial train wrecks. I’m not trying to tell people what to do, I’m telling them what to avoid. Case studies allow examples to become a lot more real,” says Pederson, a principle consultant …
The Cloud Protects Practices from Mother Nature
Late last week, as Irma devastated Florida’s Atlantic and Gulf coasts, I had the opportunity to speak with one of our medical practices in the area. As I shared my concerns and best wishes with them, they quickly reminded me how valuable it is to have their entire practice’s data securely stored in the cloud—far away from the rain, devastating winds, and storm surge. With the destruction left in the wake of hurricanes Irma and Harvey, it is wonderful to know that cloud technology is helping people worry less and avoid further damage. Here are four disasters modern medical practices across the southern U.S. will sidestep in the storm aftermath: …
Is Your EMR User Friendly?
A common complaint about EMRs is that while they might have technical capability, they might not have real world usability, or be “user friendly”. Thus, you might be able to enter A, B and C; but finding the previous values of A, B and C might be challenging, and seeing the history of A, B and C might not be possible. As I sat in front of one of my medical providers recently, who is a late and reluctant convert to EMRs, he created an on paper list of my previous values as he inefficiently hunted through my now online history. And unless he types them back in in a …
EHR companies refuted claims of violating HIPAA
The EHR Association (EHRA) Executive Committee has fired back at accusations that EHR companies are partially to blame for interoperability problems, claiming health data exchange is progressing quickly. The association published a response to an earlier post on Health Affairs Blog that accused EHR and health IT companies of monetizing the custody of patient protected health information (PHI). Former ONC Chief Privacy Officer Lucia Savage urged the Office of Inspector General (OIG) to enforce provisions of HIPAA prohibiting business associates such as EHR developers from using PHI for business operations. She stated some EHR companies may be leveraging ownership of patient PHI for profit. “Building a revenue stream out of …
How to Choose Between Modifiers 25 and 57
When reporting an evaluation and management (E&M) service on the same claim with another service or procedure, you must append either modifier 25 “Significant, separately identifiable evaluation and management service by the same physician or other qualified healthcare professional on the same day of the procedure or other service,” or modifier 57, “Decision for surgery” to the E&M service code. Modifier Identifies Separate Nature of E&M Service A minimal patient evaluation is necessary to determine that a prescribed treatment is appropriate to manage the patient’s condition. For example, if a patient presents for a previously scheduled injection, the provider will briefly evaluate the patient to confirm that the injection remains …
