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.
2004-2024 Celebrating 20 Years of Healthcare RCM Articles
The Blog Currently Contains 1,265+ Healthcare Articles
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 …
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
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 …
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
EHR Data Helps Scientists Detect Heart Failure Earlier
Joint research between IBM Research and Sutter Health led to the development of methods for predicting heart failure using clues imbedded in patient records in Epic EHR technology. Researchers observed the performance of machine learning models designed to detect prediagnostic heart failure in primary care patients using longitudinal data in EpicCare EHRs. “Information that can be gained on populations of patients from longitudinal EHR data can be used to individualize care for a given patient,” Ng et al. stated. “Access to these data in combination with the rapid evolution of modern machine learning and data mining techniques offers a potentially promising means to accelerate discoveries that can be readily translated …
