Tag Archives | medical billing

Medical Billing Codes Do Not Address Full Scope of Primary Care

Current Procedural Terminology (CPT) codes used for medical billing did not account for all the care provided by primary care physicians in about 60.3 percent of visits, a recent Journal of the American Board of Family Medicine study showed. The observational analysis of over 980 family physician-patient ambulatory visits revealed that CPT codes used for […]

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Hospitals, Systems Spend $39B Annually on Regulatory Compliance

Hospitals, health systems, and post-acute care providers spend almost $39 billion annually on administrative tasks related to regulatory compliance, the American Hospital Association (AHA) reported. “As a result of this extraordinary burden, providers are struggling to balance the administrative activities necessary to comply with regulatory requirements against the clinical, operational and financial activities necessary to […]

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CMS Proposes 1.9% Increase in 2018 ASC Pay, Adding Total Joint Replacements

CMS released a proposed rule that would update the Hospital Outpatient Prospective Payment System and the Ambulatory Surgical Center Payment System. Here’s what you should know about the ASC-related changes: 1. CMS is proposing to increase payment rates by 1.9 percent to ASCs that are meeting quality reporting requirements. CMS based the increase on the […]

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ICD-10 Gets Down to Specifics, and Attention to Detail Directly Affects Finances

This year, getting reimbursed is all about making sure the codes reflects the actual care given. For ICD-10 changes this year, the devil’s in the details. When ICD-10 was first implemented on Oct. 1, 2015, it was a nail-biting flip of the switch and then a sigh of relief when denials didn’t mount up as […]

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Patient Safety Jeopardized by EHR Downtime, JAMIA Says

Downtime events in hospitals that shut down the functionality of the electronic health record can result in serious patient safety risks, according to a recently published study in the Journal of the American Medical Informatics Association. In fact, over the three-year analyzation period of a large health system in the Mid-Atlantic, 76 incidents were reported […]

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Surprise Medical Bills: Why They Occur And What To Do

Imagine going on Amazon, buying an Electronic Spin the Bottle Game for its listed price of $32.92, receiving the product (sparing the arduous effort required to spin the bottle) and then several weeks later receiving an additional bill for $600. As indicated in a recent study, that’s basically what’s happening in heathcare…quite frequently. Not spin-the-bottle, […]

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11 Ways To Save Money on Medical Expenses

My health insurance plan jumped 24 percent this fall and dropped in quality of coverage. I’m not alone. Rising health insurance costs across the nation have many people worried. A recent 50-state poll released by the Partnership to Fight Chronic Disease revealed that 77 percent of consumers have experienced difficulty using their health insurance in […]

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Medical billing for dental offices and the 2017 CDT updates: What you need to know

Do you bill medical insurance for medically necessary dental procedures performed in your office? If you do, it’s important to understand the changes to the CDT codes for 2017. When you find yourself using some of these new codes, it might be a sign that you should consider billing medical insurance for a specific procedure. […]

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4 Medical Billing Issues Affecting Healthcare Revenue Cycle

Addressing these four common medical billing challenges can have a positive impact on the healthcare revenue cycle. Medical billing is the backbone of healthcare revenue cycle management, but many providers experience significant challenges with efficiently and accurately billing patients and payers for services they perform. Top four medical billing challenges impacting healthcare revenue cycle. The […]

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How Physicians Can Improve Coding And Increase Revenue

Reimbursement for evaluation and management (EM) services is often the most challenging for primary care physicians and their billing staff. The most common EM codes are based on location, patient status, and level of service. A good understanding of the opportunities, and a review of common errors found in audits, will help your practice obtain […]

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Louisiana Leads The Nation In Medicare Overbilling

Louisiana posted the highest rate of Medicare being overbilled for services in the nation in 2015, with providers charging an estimated $1.25 billion more than they should have, according to a federal report.

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One Vaccine Code Fits All?

Someone recently asked me an interesting question I had not thought about previously – hence the impetus to write this article. The question was “why code immunization to Z23 in ICD-10-CM?”

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How Provider Interaction Reduces Claims Reimbursement Waste

Unreliable provider communication leaves patients vulnerable to expensive and potentially harmful medical errors, delays the medical billing process, and distorts quality of care.

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Payers Take Forgiving Stance in Accepting ICD-10 Claims

How lenient are major health insurers willing to be when it comes to accepting providers’ ICD-10 claims? Humana and UnitedHealthcare are giving latitude in the specificity of the new codes, at least for now.

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RheumNow: ABCs of the New ICD-10 Codes

The ABC’s of the New ICD-10 Codes

Unless you’ve been living in a cave, you are probably aware that come Oct. 1, 2015, the old ICD-9 coding system will be completely replaced with a “newer version”: ICD-10. The purpose of this newer system is to modernize coding — recognizing that since the last update in 1979, the number and precision of diagnoses […]

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Six Training Tips for a Successful ICD-10 Implementation

In just a few short weeks, the landmark ICD-10 transition that has been anticipated and delayed countless times will arrive on Oct. 1, 2015.

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