background preloader

Articles - Medical Billing and Coding // Medical Outsourcing

Facebook Twitter

Read medical billing and coding articles here at OSI. Articles on medical billing, medical coding, medical billing outsourcing, insurance verification / authorization, search engine optimization.

Screening Mammography Medicare Coverage and Documentation Guidelines - mosoutsource. Screening mammography is a low-dose X-ray examination of a woman’s breasts to detect breast cancer.

Screening Mammography Medicare Coverage and Documentation Guidelines - mosoutsource

This screening is carried out on women who do not have any symptoms of breast disease. Medicare's coverage of screening mammograms was created following the implementation of the Omnibus Budget Reconciliation Act of 1990 (OBRA 1990). Dental Office Accounts Receivable (AR) and the Role of a Front Office Manager. A dental office manager is responsible to ensure that a dentist’s office and various business processes are running smoothly.

Dental Office Accounts Receivable (AR) and the Role of a Front Office Manager

The office manager is responsible for verifying that the office collects from both insurance companies and patients, and is paid for work completed. A good collection ratio is 95% to 99%. The collections from one month to another may vary depending on many factors, but over a 12-month period, the office collects nearly all of what is produced. A dental office manager’s responsibilities may include scheduling and confirming appointments to dental insurance verification, submitting insurance claims, hiring more staff, and more. It is common for the dental office to carry balances on patient accounts. The front office team must have a clear idea on effective methods of collecting old balances as well as daily balances. Effective Methods a Dental Office Manager Could Follow to Maintain a Low AR. Prevalence of HDV Infection in the U.S. – An ICD-10 Analysis. Hepatitis delta is a viral infection that causes the liver to become inflamed.According to the Centers for Disease Control and Prevention, 4.4 million Americans have chronic hepatitis, and 80,000 new infections occur each year.

Prevalence of HDV Infection in the U.S. – An ICD-10 Analysis

The most aggressive form of viral hepatitis, this infection is contagious and can be transmitted through urine, vaginal fluids, semen, blood or by birth (from mother to her newborn). Clinical documentation and medical coding forhepatitis infectionalso requires clear knowledge about the condition.Accurate documentation can be ensured with the support of a medical coding service provider. How the Proposed Trumpcare Plan Could Change Healthcare Coverage. Healthcare providers, business and industry groups, and medical billing companies are keenly watching the health insurance scenario to assess the potential impact of the exit of Obamacare and the entry of the American Healthcare Act (AHCA).

How the Proposed Trumpcare Plan Could Change Healthcare Coverage

The media is full of reports about how these changes will affect healthcare and coverage for different groups. Here is a summary of the main changes that the revisions to coverage could bring:Higher premiums for those who buy individual health insurance: The Trump administration wants to stop federal cost-sharing reduction (CSR) payments which go to low-income people using the Affordable Care Act marketplace and are different from the federal premium subsidies.

Industry and business groups point out that withdrawing CSRs would raise premiums at least 15 percent for everyone who buys individual health insurance.Removes individual mandate: The ACHA eliminates Obamacare’s $695 penalty individuals face for not signing up for coverage. Documenting Work-related Injuries in Chiropractic Medical Billing. Workers are often exposed to different health hazards.

Documenting Work-related Injuries in Chiropractic Medical Billing

Chiropractic care is considered a good option for work-related musculoskeletal conditions including back pain, carpal tunnel syndrome, headache and neck pain. According to a report published by the University of Maryland, more than one million back injuries are sustained in the workplace every year and these injuries account for one in every five injuries and illnesses at the workplace. Chiropractors or chiropractic physicians – practice a hands-on, drug-free approach to health care that includes patient examination, accurate diagnosis and treatment.

CMS’ Guidelines on Chiropractic Medical Billing – A Review. Filling out medical claims forms, documenting claims diagnosis and procedure codes, and sending them to insurance companies for payment are all part of the normal medical billing process for any medical specialty.

CMS’ Guidelines on Chiropractic Medical Billing – A Review

But what makes the chiropractic specialty different? Several reports indicate that CMS continues to deny many chiropractic claims as they do not meet Medicare requirements. The most common reason for denial is insufficient documentation to support the billed services. Chiropractic billing services can help providers avoid denied claims and overpayment recovery with their thorough understanding of Medicare requirements, especially documentation and medical necessity. Follow CMS’ Instructions. Boost Your Practice Reimbursement with Chiropractic Billing Services - mosoutsource.

Appropriate chiropractic billing services are critical for any chiropractor’s office.

Boost Your Practice Reimbursement with Chiropractic Billing Services - mosoutsource

Chiropractic care has gained much popularity in recent years, as it helps reduce expensive medical testing, unnecessary surgical interventions and accompanying hospital admissions. Several reports highlight the fact that the demand for chiropractic care is increasing with more and more people relying on this non-surgical treatment approach. According to the Illinois Chiropractic Society, around 6 percent of the general population utilizes chiropractic.Technavio’s latest market research report predicts that the global chiropractic care market will grow at a CAGR of nearly 4% during 2017-2021. The increasing older population is the major factor behind the market’s growth. Physician-Dentist Teamwork Essential for Optimal Patient Care. A medical billing company knows the importance of billing medically necessary dental services to medical plans.

Physician-Dentist Teamwork Essential for Optimal Patient Care

Billing patients' medical benefits plan will ease the financial burden on patients and safeguard their annual dental insurance benefits. By ensuring the right diagnosis and procedures codes, companies providing efficient dental billing services help providers maximize reimbursement and minimize denials. Today, with many studies suggesting a link between physical and oral health, it has become evident that physician-dentist teamwork is necessary to promote optimal patient care.

Strategies to Improve Accounts Receivable (AR) Management - mosoutsource. Accounts receivable (AR) management is an essential component of the services provided by medical billing and coding companies.

Strategies to Improve Accounts Receivable (AR) Management - mosoutsource

In a medical practice, AR constitutes the sum of patients’ open accounts and the amounts due from insurance companies. The problem with AR is that the older bills become, the more difficult they are to collect. In fact, the financial success of a healthcare practice depends on having highly efficient AR and claims denial management processes in place. The following AR management strategies can improve a medical practice’s efficiency and bottom line: Gather all patient information when the patient schedules the office visit: Appointment scheduling is the initial point of contact between a patient and the practice. Documenting Food Allergies – Use the Right ICD-10 Codes - mosoutsource. Just like any other specialty, allergy and sleep medicine medical billing requires the use of the right diagnosis codes to ensure timely reimbursement for physicians.Food allergies occur when the immune system overreacts to substances in the food consumed, causing an allergic reaction.Most common in babies and children, allergy to foods can appear at any age.

Documenting Food Allergies – Use the Right ICD-10 Codes - mosoutsource

According to the American College of Allergy, Asthma &Immunology, more than 50 million Americans have an allergy of some kind. Other Relevant Statistics The Centers for Disease Control and Prevention (CDC) - Food allergies are estimated to affect 4 to 6 percent of children and 4 percent of adults.Food Allergy Research & Education (FARE) - This potentially deadly disease affects 1 in every 13 children (under 18 years of age) in the U.S.Every 3 minutes, a food allergy reaction sends someone to the emergency department. Make the Most of ICD-10 coding changes in 2017. Ever since the ICD-10 flexibilities ended on October 1, 2016, physicians have sought to submit claims with clinical documentation that reflects as much specificity as possible. Medical coding companies have worked to educate physicians about the level of granularity required for ICD-10. However, as a report in Medical Economics notes, it is likely that physicians will continue to experience the impact of the ICD-10 transition in 2017 in the form of payer requests, denials, and the new code set’s influence on value-based care.

Ensuring Accurate HCC Coding and Documentation. In 1997, the Centers for Medicare and Medicaid Services (CMS) mandated the Risk Adjustment and Hierarchical Condition Category coding or HCC coding payment model. Today, the HCC methodology plays a critical role in the dynamic insurance benefits and reimbursement scenario. The model assigns a risk factor score to individuals diagnosed with a serious or chronic illness based on their health conditions and demographics.

Accurate HCC coding and proper documentation to capture the full complexity of a patient’s condition will result in higher reimbursement. How the Risk Adjustment Model works. Key Performance Indicators to Watch in Revenue Cycle Management - mosoutsource. The process of revenue cycle management (RCM) in a healthcare practice covers keeping track of claims, collecting payments, and tackling denied claims. The aim is to improve cash flow. However, this is not easy in today’s dynamic environment of federal and state regulations, changing codes, electronic health records, Meaningful Use. That’s why most physician practices are choosing to outsource the RCM to experts. Consumerism - the New Buzzword in Healthcare Revenue Cycle Management - mosoutsource. Medical billing companies provide revenue cycle management (RCM) solutions for healthcare facilities and organizations of all sizes. RCM covers a whole gamut of billing functions from patient registration and insurance verification to coding, charge entry, insurance follow-up, and payment posting.

Now, there’s a new buzzword that providers need to contend with – consumerism. Experts are saying that for RCM success, healthcare providers need a robust strategy to enhance consumer or patient engagement and satisfaction. Key Medical Billing and Coding Considerations for Hospitalists - mosoutsource. Hospital medicine is the fastest growing medical specialty in the U.S., with more than 48,000 practitioners working as hospitalists. A hospitalist may work only in a hospital, only in a post-acute care (PAC) setting, or in both types of facilities. Hospitalists face many medical billing and coding complexities that can lead to reimbursement issues. In 2016, Centers for Medicare & Medicaid Services (CMS) approved a dedicated specialty billing code for hospitalists.

New Mammography Medical Coding Changes in 2017. Strategies to Optimize Revenue Cycle Management in 2017. According to a survey by McKinsey & Company, revenue cycle inefficiencies accounted for about $400 billion or 15 percent of $2.7 trillion spent on healthcare in 2013. These figures have most likely increased since then, leading more and more providers to rely on physician billing companies to address claim denials and improve their bottom line. Here are some reliable strategies that can help physicians optimize revenue cycle management in 2017:Proper clinical documentation: One of the best ways to improve revenue integrity is by maintaining complete and accurate clinical documentation.

How Physicians’ Practices can Manage Claims Denial Effectively. Denials are the bane of every medical practice. Ensure Effective AR Management with Medical Billing and Coding. The Accounts Receivable (A/R) summary, which provides an account of uncollected claims, is one of the most heavily utilized in medical practice financial management. Medical billing and coding outsourcing helps reduce the average number of days that it takes a practice to collect payments that are due. Experienced companies use proven methods to help physicians avoid the problem of too many unpaid claims. They help maintain the financial health of your business by keeping the number of days in A/R as low as possible.

Factors that Increase Days in A/R A/R is a key indicator of a practice’s ability to collect timely payments. Substance Abuse Medical Billing and Reimbursement Concerns by Outsource Strategies. Choosing the Right Revenue Cycle Management Service Provider. Making the right decisions about revenue cycle management (RCM) is critical for any healthcare organization. Female Physicians have Better Patient Outcomes earn less but than Male Physicians - mosoutsource. Diagnostic Radiology Coding – Tips to Ensure Clean Claims. Documentation Challenges with HCC Coding. The Centers for Medicare and Medicaid Services (CMS) has mandated the Hierarchical Condition Categories (HCC) as the basis for reimbursement for Medicare Advantage (MA) plans.

High Deductible Health Plans – Strategies to Maximize Patient Collections. Anesthesiology Medical Billing – Learn the Top 10 ICD-10 Codes. Medical Coding Outsourcing Supports Clinical Documentation Improvement and ICD-10 Compliance by Outsource Strategies. Outsourcing Medical Billing and Coding Can Maximize Cardiology Practice Reimbursement - mosoutsource. Boost Practice Revenue and Save Time with Patient Insurance Verification by Outsource Strategies. Common ICD-10 Coding Errors that Medical Practices Should Take Care to Avoid. Reliable Strategies to Increase Patient Collections. Avoid Medical Billing Errors with Medical Billing Outsourcing - mosoutsource. Four Reasons why Outsourcing Medical Billing and Coding is a Practical Option. Managing Risk Adjustment Challenges – Tips for Physicians and Payers - mosoutsource. Outsource Strategies's Articles. Are Radiologists Responsible for Determining Medical Necessity? Outsourcing Can Help Maintain Compliance in Medical Practices.

Medical Billing Outsourcing – Key Considerations beyond Claim Submission. Medical Coding for Operative Reports. Home Sleep Apnea Testing – Why Reliable Medical Billing and Coding Services are Crucial. Professional Medical Coding and Billing Services – Get Paid Promptly and Correctly. Optimize Revenue Cycle Operations to Improve Claims Management and Reimbursement by Outsource Strategies.

Insurance Eligibility Verification Process in Physician Practices. Outsource Patient Appointment Scheduling – Increase Patient Satisfaction and Practice Revenue. Capture ICD-10 Specificity with Expert Medical Coding Services. Medical Billing Alert – Take Measure to Avoid Charges of Fraud. Understanding Chiropractic Billing.

Save Time and Focus on Patient-driven Healthcare Education with Endocrinology Medical Billing Services. Avoid Common Documentation Challenges – Choose the Right Medical Coding Company. Increase Revenue with Better Management of Unpaid Claims. The Ins and Outs of Insurance Verification and Authorization. Avoid Duplicate Claims with Appropriate Medical Coding. Common Dental-Medical Coding Systems can Improve Care and Reimbursement in Dental Practices. Medical Coding Services Could Help: Medical Articles. How Inpatient Coding Can Indirectly Affect Your Financial Health.

Tips for Addressing Unexpected Revenue Drop Following ICD-10 Transition. ICD-10-PCS Codes - Definition, Use and Importance. How to Keep a Medical Practice Running Efficiently. Medical Coding for Digestive Disorders in ICD-10-CM. How ICD-10 Impacts Prior Authorizations.