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.
Medical Coding – The First Step to Medical Billing
Medical billing and medical coding go hand in hand and can seem very confusing until you learn how they work with each other. Medical coders take the procedures and services performed by doctors, hospitals and clinics and translate those services into a series of assigned medical codes that each carry a revenue amount that will be reimbursed when the form that the medical coder has filled out is completed, documented and submitted for reimbursement by the medical biller. There are codes for every conceivable type of encounter and even codes for having no code for the procedure. Whether it is a test, service, procedure, treatment or ongoing care, the service …
Medical Billing Explained
If you’re researching becoming a medical biller, it is a fantastic career with a great future. Basically a medical biller takes the documentation provided by their client (a doctor or hospital) that has rendered services to a patient and is looking to get reimbursement for those procedures and services from the patient’s insurance company. The medical biller’s job is to submit the claim to the carrier (insurance company) and get their client (the doctor or hospital) a reimbursement. The medical biller will have to make sure the claim is properly coded. This means that each procedure and service has a numerical code assigned to it. Those codes must be logical …
What’s So Great About Electronic Medical Billing Claims?
In short – everything. This is one of the few scenarios where there truly is no downside. Medicare alone receives more than 500 million claims on the average per year and they only accept electronic medical billing claims. Filing your medical billing claims or having them filed electronically by your medical billing partner will cut your turn around time on your reimbursements from an average of 90 days for paper or self filed claims to about 14 days for most claims. That alone should be enough to encourage you to outsource your medical billing. Electronic claims will enable you to create a revenue stream that you can count on and …
Have the Diagnosis In Your Documentation
One of the biggest ways that physicians lost out on reimbursements is through poor documentation. Offices get hectic, notes you intend to make don’t get made and sometimes your medical billing claims get submitted to the carriers for reimbursement without the proper documentation. First and foremost, there must be a diagnosis of the condition or disease for the patient. From that it must extend the services rendered in conjunction with the condition or disease and the medical documentation explaining why the services were performed. Only the physician can state the diagnosis for the patient, even with test results that clearly show for example a patient was diabetic, the person doing …
Avoid Fee Reductions in Your Medical Billing
If you have multiple endoscopic services that were rendered during one surgical session, make sure that you determine if the procedures were all part of a “parent” procedure. If that is the case, you can not bill for different endoscopes, you must put them together as one service or you run the risk of having the carrier impose a fee reduction on your medical billing claim. The parent code must be included in the medical billing and be sure to include your documentation of medical necessity to insure that your medical billing claim gets paid in full and not a reduced reimbursement or worse, an outright rejection. If other endoscopic …
Problem Free Medical Billing
Did you know that you could have absolutely seamless medical billing claims? No more hassles with keeping up with the changes in coding and no more keeping up with the paper chase that a lot of filing medical billing claims has become. All you have to do is outsource your medical billing. Your medical billing partner will take care of the making sure there is a logical flow of billing on your medical billing claims, as well as following up to make sure that you get the maximum reimbursement of all your claims. Many physicians unknowingly give away thousands upon thousands of dollars each year through undercoding their medical billing …
Will Outsourcing Get My Billing Reimbursements Faster?
It doesn’t sound logical. Sending your claims out of your office to someone else would actually speed up the process of getting reimbursed, but letting someone else handle your medical billing and coding really does speed up the process. Think about how often your in-house staff gets interrupted, how often the crisis du jour arises and day to day managing of the office prevents them from filing, double checking accuracy, and following up on your submitted claims. Time is also lost re-submitting claims when they get kicked back for the smallest of errors in coding. As you know, Medicare is extremely strict as far as coding and re-submissions can seriously …
Reporting Observation Medical Billing Claims
You know the basics for reporting observation services in the ED. However, there are some common coding mistakes that can be costing you in the form or partial or rejected services. Don’t worry about the location of the services for observation. Observation is a service and not necessarily a physical place within the ED where the patient can stay. Another way to insure full reimbursement is to make sure that you have a specific written order from the physician for observation. Medical documentation should include time notes from both the doctor and nurses. Avoid using codes 99228-99220 when reporting observation. It is used to determine whether or not a patient …
Correct Multiple Procedure Medical Billing
When multiple procedures are performed, you do not have to append modifier 51 for each group of procedures. The CPT manual designates modifier 51 (Multiple procedures) exempt codes with a “circle with a slash” symbol to the left of the code for the services rendered. There is usually a complete listing of modifier 51 exempt codes in an appendix. The list is “a summary of CPT codes that are exempt from the use of modifier 51 but have NOT been designated as CPT add-on procedures/services,” according to CPT 2006. As an example look up a code in your CPT. Arterial catheterization code 36620 (Arterial catheterization or cannulation for sampling, monitoring …
Using the Proper IV Codes
When you have a medical billing claim using codes for infusion codes 90760 and 90761, which are for Intravenous infusion, hydration; initial, up to one hour and each additional hour, up to 8 hours [list separately in addition to code for primary procedure] respectively are used for physician billing in general according to the new CPT 2006 release. Make sure of these IV codes in your medical billing if they accurately describe the service performed and you will reap the rewards in your reimbursements. Be sure to check out the individual carrier’s policies for paying on these codings and be aware that Medicare has specific requirements to meet prior to …
