Medical Billing Blog with Medical Billing & Coding Info & Articles
Our blog contains news and articles relating to numerous healthcare sectors including revenue cycle management, medical billing, medical coding, ICD, HIPAA, practice management functions and more.
If You’re Not Outsourcing Your Medical Billing Claims…..
Did you know that if you are not outsourcing your medical billing, chances are very good you are throwing away about one third of your revenue from your practice. That’s a lot of money to not be collecting. You could vastly and quickly improve your reimbursement rate and collection of funds owed if you outsource your medical billing. Many practices still submit claims via paper, other practices submit their claims electronically but don’t have time to keep up with the coding and billing changes that can occur, many times as frequently as four times per year. Studies show, practices that outsource their medical billing to a medical billing partner that …
A Simple Lack of Documentation
One of the biggest reasons for denied claims or missed charges on your medical billing is simply a lack of documentation. It is never intentional, but in these busy days of patients, phones, and crisis du jour, it happens. Some of the important processing points where this can happen with your medical billing are: At the Point-of-Care: This is one of the most common causes for inaccurate or lost billing is that doctors find it difficult to record all patient encounters at the end of the day. It’s hard to recall every single procedure you performed with what patient. Your medical billing partner can consult with you to help you …
More Reasons to Outsource Billing Functions
Outsourcing your medical billing will remove so many of your headaches in your practice with your medical billing. A sobering statistic about family physicians who do their own medical billing is that they can be suffering a loss of 10%-20% of their reimbursements each year simply due to incorrect coding. It’s important for your staff to understand the documentation guidelines especially for E/M (evaluation and management) services. Your practice probably uses about 30 codes for about 95% of your patient visits per day. Make sure your staff is familiar with those codes that apply directly to your office’s procedures and the documentation those medical billing codes require. It can seem …
Inaccurate Medical Coding Can Cost You
One of the biggest ways a thriving practice loses money is through inadequate and inaccurate medical coding. Either one is a deadly mistake for your medical billing and can result in the following: Partial payment of your medical billing claim – meaning your staff has to stop whatever they are involved in and pull the patient’s file and note whatever has been paid and then spend time discovering why the rest of the claim was not paid. Sometimes it is an accident on the carrier’s part, but many times it is due to bad coding on the physician’s side of the medical billing. Denial of your claim is another big …
The Best Way to Handle EOB
The goal of any medical billing firm is to receive a correct check and correct explanation of benefits (EOB) from an insurance company. Sometimes this is easier said then done. Many times the EOB goes one place and the check goes another. There are two basic ways this can be handled: The first method is an example of a practice that compiles their own medical billing. In this case, it is beneficial to make sure a check and EOB are sent to the practice. This prevents future problems with remainders owed. It also makes sure the physician gets paid, instead of having a check sent to the patient and hoping …
When to Use 99324 in Your Medical Billing Claims
When doing medical billing for rest home care, there are many common pitfalls. Many coders bill four at home services or nursing home services when rest home care is performed. Incorrect medical billing coding such as this, could get you into trouble. The new medical billing CPT codes for 2006 address specific guidelines to follow for rest home coding. The place of the service is a big issue when dealing with the rest home services. Rest home, or custodial care facility is labeled as a POS 33. This is defined as a facility that provides room, board and other personal assistance services generally on a long-term basis. There is a …
Auditory Rehabilitation Receiving Medical Billing Reimbursement
The Centers for Medicare and Medicaid Services have recently made it known that the reimbursement for procedural code 92626 is going to be seeing increases by a rather large amount. To clarify a little bit further, the reimbursement to providers for such a procedure will come in at approximately four times the amount being received currently. This should make any of the providers of language, speech and hearing much happier when it comes to medical billing. This entire thought of reimbursement may be a lot clearer if it is broken down a bit. For example, the code 92626 which is known for the description of Evaluation of Auditory Rehabilitation Status; …
Tightening the Reigns on Medical Billing Claims
It has recently come to the attention of the Cahaba GBA Regional Home Health Intermediary that it is necessary to tighten the reigns on medical billing claims. Therefore, a study has been underway to try to find out exactly why certain claims have been denied. Through the course of this study, there have been a good number of findings to show that there have been denials of various diagnosis codes within the medical billing process. Further studies by the Cahaba GBA have revealed that a large amount of the denied claims had actually shared the same diagnosis codes. Included in the list of diagnosis codes that are often denied are: …
Medical Billing Modifier 59 Has Been Causing Trouble
Recently, the contractors for the Centers for Medicare and Medicaid Services have been on the lookout for any modifiers that have been used incorrectly. The cause for alarm is that it has recently been shown that even though modifiers are a great asset to medical billing, there are a select few modifiers that are not used in the proper fashion. Of all of the modifiers that have been used incorrectly from time to time, the one that has seemed to have been the most questionable is modifier 59. Now, this is not just any random investigation just because there have been a few problems. Studies by the U.S. Office of …
Getting Rid Of Denial Claims For Well Visits
You should always pay good attention to what payers are perceiving when looking at your medical billing. Even though your practice may view the coding procedures a certain way, it is not always the case that your payer will understand them in the same fashion. It has recently been shown that there is a major discrepancy when it comes to dealing with the billing of the procedure code 96110. The fact is that this procedure code should never be lumped in with well exam codes, except for special circumstances. What can actually happen to cause problems is that the miscommunication between medical billing for your practice and the payers are …
