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 Billing Improvements with RNs
Medical Billing Improvements with RNs Not only are nurses important to your patient’s healthcare, but they also help your medical billing reimbursement bottom line. Some say the key to unnecessary hospital deaths is increased registered nurse care. Although there would be increased hours for the nurses, it would not mean more medical billing cost to you. Extra nurse hours would mean improved medical billing reimbursement for your hospital. Recently a study done shows that a nurse care could reduce patient deaths by 6700 per year. Not only would patient deaths decrees per year, but the number of hospital days would decrease by 4 million as well. You may think that …
Illegal Immigrant Medical Billing No Longer Allowed
Illegal Immigrant Medical Billing No Longer Allowed A recent medical billing study in New York State has created some fuss regarding immigrant health care. Many people believe illegal immigrants should not be covered for health care. However, many states, New York included, cover immigrants for emergency care. Medical billing for this emergency care is another story. Recently there was a review of medical billing claims from January, 2001-September, 2004. This review found that $14 million each year were spent on ancillary care instead of emergency care. To correct this problem, care such as physical therapy and speech therapy will no longer be eligible for medical billing reimbursement. Ancillary care is …
Perfect Disease Management Medical Billing Myth
Perfect Disease Management Medical Billing Myth Medical billing for disease management is not working for many insurance companies. Disease management has been a trend in the recent years. However, model programs are being shut down all over the country. Lack of interest is the downfall of these disease management programs. Medical billing and revenue for the year will fail due to disease management closings. A model disease management program, HeartPartners will be closing ten months early. The payer, PacifiCare Health Systems, cannot take any more medical billing loss. They were severely short on beneficiaries. They anticipated 15,000 beneficiaries, however only 3750 people actually enrolled in the program. Disease management is …
Selective Debridement Medical Billing Reimbursement Doubtful
Selective Debridement Medical Billing Reimbursement Doubtful Lately debridement medical billing has brought up many questions in the healthcare industry. The medical billing CPT codes 97597-97598 can usually not be used by every provider. The American medical association Recently released these new Current Procedural Terminology codes. Interpretation of these two medical billing codes varies from payer to payer. When the American Medical Association first released the codes 97597-97598 there was a lot of confusion. Shortly after that release the Centers for Medicare and Medicaid Services offered an explanation of the medical billing codes. 97597 (Removal of devitalized tissue from wounds, selective, debridement, without anesthesia, with or without topical applications, wound assessment, …
Using Cross-Subsidizing in Medical Billing Could Lead to Denials
Using Cross-Subsidizing in Medical Billing Could Lead to Denials Using your medical billing to cross subsidize lesser expensive services with more profitable services could lead to denials. Some hospitals are already feeling the pain. A revamp in hospitals’ medical billing chargemaster may be in order to correct this reimbursement problem. In the coming months the Centers for Medicare and Medicaid services will be doing a more detailed look at your hospital claims. If you happen to be cross subsidizing the more profitable services for the less profitable services, this may lead to non payments. This will change the medical billing scene forever. Unfortunately if insurance companies quit paying your medical …
Medical Billing Changes at Blues
Medical Billing Changes at Blues In an effort to reduce medical billing expenditures, Blue Cross Blue Shield is implementing a couple programs. Each one of these programs improves the healthcare and well being of its members. They also reduce medical billing reimbursement costs to Blue Cross Blue Shield. Your practice does everything to raise medical billing reimbursement, Blue Cross Blue Shield does everything in its power to lower reimbursement. One of the ways Blue Cross Blue Shield is lowering medical billing expenditures is in Kansas City. There is a pilot program where members/patients can use the Internet to contact Physicians and asked medical questions. This is not intended for emergency …
Medical Billing Modifier 56 Pitfall
Medical Billing Modifier 56 Pitfall Using modifier 56 in a medical billing preoperative consult can be used by a specialist or even a primary care physician. Many people believe specialists are only allowed to perform consultations. This is incorrect thinking. If done correctly medical billing reimbursement is allowed for family care practice consultations. There are two main situations in which a family care physician would perform a consultation in medical billing. The first, and the most common scenario, is when a surgeon requests that a family practice physician examines their patient prior to surgery. They would do this to make sure the patient is healthy enough to undergo the specific …
Surefire Medical Billing Tips for Modifier 25
Surefire Medical Billing Tips for Modifier 25 Modifier 25 is a medical billing code used to indicate extra work for a medical service or procedure. Soon, the American Medical Association (AMA) will explain in more detail the correct way to use this modifier. Before then, there are three simple steps you can use to learn how to correctly use the medical billing modifier 25. The first medical billing step to correctly use modifier 25 is to only report the most significant services provided during the visit. When reporting an Evaluation and management exam, it is very difficult to perform a service that is separately billable. Most things are covered under …
Changes To Your CCR
If you have a New Provider Number you can expect Changes To Your CCR Your CCR or cost to charge ratio will still be used with the surviving provider number if your hospital merges with another one. Your Medicare fiscal intermediary will continue to use the old CCR instead of a new one if there is a merger. However, If Medicare issues the hospitals a new provider number after a merger then there will be a different outcome. In the event of a new provider number your Medicare fiscal intermediary will use the average CCR for the state because according to them a new provider number means that there has …
Medical Billing Expanded for Cardiac Rehab
Medical Billing Expanded for Cardiac Rehab Cardiac rehabilitation staff members have great medical billing news coming their way. The Centers for Medicare and Medicaid Services expanded coverage for cardiac rehab this past December. The medical billing element for cardiac rehabilitation will be much less strict when it comes to requirements. Last year, the requirements in order to get medical billing reimbursement for cardiac rehab were strict. You had to have a heart attack, angina, or coronary artery bypass surgery. The Centers for Medicare and Medicaid Services now realizes that this type of care does not prevent any problem from occurring. It was merely reactive treatment. In December of 2005, the …
