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OSI Blog // Medical Billing and Coding

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OSI Blog: Information on outsourcing medical billing and coding, medical transcription, insurance verification and authorizations, appointment scheduling.

Patient Complaints put Hospital Medical Billing Practices in the Spotlight. Revenue cycle management experts in medical billing companies are well aware of risks of billing errors.

Patient Complaints put Hospital Medical Billing Practices in the Spotlight

Mistakes can cost the healthcare provider a lot of money and headache in addition to destroying their relationship with their patients. Positive Growth Forecast for Global Medical Billing Outsourcing Market. A recent Transparency Market Research (TMR) market report indicates that the global medical billing outsourcing market will see steady expansion during the period 2016-2023.

Positive Growth Forecast for Global Medical Billing Outsourcing Market

Several factors are driving this growth. The healthcare sector is growing rapidly as governments and industry stakeholders strive to ensure effective, efficient, and equitable care. Spending on health care is increasing, driven by aging populations, spread of chronic diseases, increased focus on quality of care, new financial regulations and business, clinical, and operating models, infrastructure improvements, and novel treatments and technologies.

According to the TMR report, these factors are inducing healthcare systems to become more efficient so that they can make the best use of these monetary allocations. This is driving the demand for efficient medical billing services. The TMR market research report identifies the high-impact factors at play in the global medical billing outsourcing market as: How Artificial Intelligence can Improve the Medical Billing Process. New government regulations and payment methodologies, constantly changing medical codes and other reform measures have made the medical billing process prone to errors.

How Artificial Intelligence can Improve the Medical Billing Process

Recent reports say that an estimated 30 to 40 percent of medical bills containing errors. Physician practices and the medical billing companies that serve them need to be alert to medical billing and coding errors, which can lead to losses amounting to thousands of dollars for both providers and patients. The good news is that artificial intelligence (AI) can play an important role in improving healthcare revenue cycle management. Keytruda FDA Approved for Treating Genetically Defective Tumors. Medical billing and coding companies are well aware that oncologists face significant reimbursement challenges with the switch to new models of cancer care delivery such as the Oncology Care Model (OCM) and the Merit-Based Incentive Payment System (MIPS).

Keytruda FDA Approved for Treating Genetically Defective Tumors

However, the major challenge that both healthcare providers and patients face is the cost of cancer drugs. In the seventh annual Trends in Cancer Programs survey conducted by the Association of Community Cancer Centers (ACCC) in 2016, up to 83% of the respondents named the costs of cancer drugs as the top challenge, according to a Modern Medicine Network report. Keytruda (pembrolizumab) by Merck is an expensive drug that is FDA-approved to treat advanced melanoma. The FDA has now cleared Keytruda to treat tumors with a genetic defect. Tips to Improve Revenue in Pain Management Practices. Compared to other medical specialties, pain management practices face certain unique challenges related to increased state and federal regulations.

Tips to Improve Revenue in Pain Management Practices

This has brought about changes in coding and payer reimbursement policies, increasing the relevance of efficient pain management medical billing and coding services. Here are some of the reimbursement issues that providers have to contend with and tips to help pain management practices improve revenue. According to a report in Beckers ASC Review, ICD-10 has made it difficult for physicians to meet the demands of payers and federal regulators for pain management procedures. There are many issues involved: Global Chiropractic Care Market to Grow at a CAGR of 3.67% Chiropractic treatment is a hands-on, drug-free approach to pain management and its importance has increased in recent years with the shift away from opioid prescribing.

Global Chiropractic Care Market to Grow at a CAGR of 3.67%

A recent Research and Markets report titled “Global Chiropractic Care Market 2017-2021” predicts that global chiropractic care market will grow at a CAGR of 3.67% during the period 2017-2021. It can be expected that the demand for chiropractic billing services will also grow during this period. The report, prepared based on an in-depth market analysis with inputs from industry experts, covers the market landscape, its growth prospects in the coming years, and a discussion of the key vendors operating in the market. The key trends identified in the chiropractic care market are as follows: Medical Billing - Meeting Patient Expectations Effectively.

Most healthcare providers outsource medical billing and coding to ensure effective revenue cycle management.

Medical Billing - Meeting Patient Expectations Effectively

But what about the patient? It’s important that healthcare organizations provide patients with proper information on billing so that they can make the right medical decisions. Today, patients are assuming greater financial responsibility for their healthcare needs and it’s only fair that well informed about pricing. U.S. Healthcare RCM Industry to be worth USD 38 billion by 2024. Medical billing and coding companies use the latest technologies to develop and implement processes and policies to help physician practices and hospitals stay financially healthy as they treat patients and save lives.

U.S. Healthcare RCM Industry to be worth USD 38 billion by 2024

According to Global Market Insights, Inc., the U.S. healthcare revenue cycle management (HRCM) industry will cross USD 38 billion by 2024. The global healthcare revenue cycle management market is expected to be worth over $100 billion by 2024. Healthcare revenue cycle management involves managing the administrative and clinical tasks related to an entire gamut of financial processes such as medical billing and coding, claims processing and submission, payment collection, and other revenue generation aspects. According to the Global Market Insights report, the HRCM marketwas worth more than USD 39 billion in 2015 and several factors will drive the growth in the global HRCM market in the coming years:

Chiropractic Billing Services. Outsource Strategies International (OSI) is a leading provider of chiropractic billing services in USA.

Chiropractic Billing Services

We specialize in comprehensive revenue cycle management which includes chiropractic coding and AR management for Medicare as well as other commercial and personal injury such as no fault and workers compensation. We understand that chiropractic medical billing has specific rules depending on insurance as well as the state that the services are provided. Our AAPC certified coders are very aware of the individual rules and regulations that needs to be followed to maximize reimbursement.

Lumbar spine disease increases complication risks after THA. In the rapidly evolving landscape of value-driven health care reimbursement, an increasing number of physicians are opting for outsourced medical billing services to stay financially viable.

Lumbar spine disease increases complication risks after THA

Such support is especially critical for providers of orthopedic services as recent Medicare reforms for this field include the evolution of bundled payments with mandatory programs such as Comprehensive Care for Joint Replacement (CJR) and Femur Fracture Treatment (SHFFT) and Merit-based Incentive Payment System (MIPS) pay-for-performance, and readmission penalties. A recent study stresses that orthopedic specialists need to assess factors that warn of good and bad outcomes in patients who undergo total hip arthroplasty (THA) hip replacement.

The researchers found that compared to patients without lumbar spine disease who undergo THA, patients with lumbar spine disease who have THA face a higher risk of complications and may have lower chances for potential improvement. Boost Income & Patient Satisfaction. Success with dental billing depends on the dental practice’s ability to verify insurance benefits before services are provided. Dental insurance verification, when performed correctly, reduces claim denials, boosts practice collections and saves patients time and money. Surveys show that about 75 percent of dental insurance claims denials due to inadequate or absence of insurance verification. Patient registration and insurance eligibility verification are the first steps in health care revenue cycle management. The process of dental claims submission is greatly simplified if you know the insurance company’s rules, patient eligibility and predetermination status, and other vital claims details.

Before dental services are provided, practices need to: Register the patientVerify whether the patient has valid insuranceIf prior approvals are required by the beneficiary’s insurance planPerform pre-authorization or pre-certification, if necessary. M.E.A.T. is at the Heart of HCC Coding and Clinical Documentation. Costly chronic conditions of ICD-10-CM have been classified by CMS into Hierarchical Conditional Categories (HCCs). Patients with HCC conditions require more resources and disease intervention. The Risk Adjustment process identifies patients who are more costly to care for based on the diagnosis codes billed for the patient in the previous review period. Learn the New Guidelines and Codes for OSA Testing. Obstructive sleep apnea (OSA) is a common condition treated by primary care physicians, sleep specialists, surgeons, dentists, mental health professionals, and ear, nose and throat physicians.

This chronic breathing disorder is diagnosed through an in-lab sleep study or a home sleep apnea test. The American Academy of Sleep Medicine (AASM) has released a new guideline for OSA testing. While outsourcing medical billing and coding can ensure error-free claim submission for optimal reimbursement, sleep medicine specialists need to be aware of the new clinical practice recommendations for the diagnosis of OSA in adults.

Characterized by repetitive episodes of complete or partial upper airway obstruction during sleep, OSA affects an estimated 30 million adults in the U.S. Untreated sleep apnea poses an increased risk of various health problems, including hypertension and cardiovascular disease and quality diagnostic methods are necessary to achieve optimal health for improved sleep. Avoid Improper Claim Submission with Chiropractic Billing Services. Several audits of the claims submitted for chiropractic services have found inappropriate payments. According to a recent report, the Centers for Medicare and Medicaid are continuing to deny chiropractic claims because they fail to meet Medicare requirements.

Proposed Changes to Medicaid could affect Physician Reimbursement. Medicaid covers 74 million Americans and of the 20 million Americans who gained coverage under the Affordable Care Act (ACA), about half were through Medicaid expansion. With an in-depth understanding of the complex Medicaid system and its rules for various states, medical billing and coding companies help physicians create proper claims and bill correctly for patients covered under this government program. However, the Republican government’s proposed changes to funding Medicaid could have a significant impact on state spending, enrollment in the program, and physician reimbursement.

The Medicaid budget multiplied under Obamacare as more people got coverage. The Republicans believe that the federal government’s current spending on the program is unsustainable and put forward a bill to change this. Medicaid reimbursement methods depend on a variety of factors which differ among states, though several criteria are fairly standard. Chiropractic Medical Billing for Medicare Claims-Key Points to Note.

The Practice of Balance Billing - What Physicians Need to Know. The practice of surprise medical billing or balance billing has received widespread attention in recent times. The media is full of reports about angry and frustrated patients who receive surprise bills in their mailbox after their treatment, usually emergency medical care and operations. Avoid Medical Billing Practices that lead to Medical Debt. According to a recent study by the federal Consumer Financial Protection Bureau, medical debt is the top reason consumers report being contacted by a collection agency. Obesity can cause Severe Liver Disease over time.

Is Your Medical Practice prepared for HCC Coding? Latest CMS Announcements on Meeting Meaningful Use Requirements. Insurance Authorization Services for Prior Authorization. The relevance of having efficient insurance authorization services is evident from a recent report in Medpage Today which says that prior authorization is a major “pain point” for most healthcare providers. Based on the recent annual meeting of the Healthcare Information and Management Systems Society (HIMSS), the report cites a senior official of the American Medical Association (AMA) as saying that a recent survey had revealed that its members found prior authorization a time consuming process and one that delays patient care. U.S. ICD-10 Market to Rise at an Outstanding CAGR By 2026. Medical Coding and Billing for Advance Care Planning. According to the Population Reference Bureau, the number of Americans ages 65 and older would more than double from 46 million in 2016 to over 98 million by 2060, and the share of the 65 plus age group in the total population will rise to nearly 24% from 15%.

This indicates the significance of advance care planning (ACP), one of the important services offered by family physicians. Insurance eligibility verification. In the changing health insurance scenario, verifying patients’ coverage is more critical than ever before. Medical Billing Outsourcing. Medical Coding Company. Hernia Repair - Code it Right to Maximize Reimbursement. Traumatic Brain Injury May Have Long-lasting Impact on Children. Insurance Authorization Service. Medical Document Scanning. Customized Review Services. Medical Data Entry Services. Medical Website Design. Website Development Services. Coding Outsourcing Companies. Medical Billing Services. Medical Transcription Outsourcing - 30% to 40% Savings. Medical Appointment Scheduling. Insurance Verification - Get a Free Trial Now. Healthcare Outsourcing Services.

Documenting Tonsillitis with Specific ICD-10 Medical Codes. Steer Clear of Audit Risks with Proper E/M Documentation. Influenza Vaccine Coding in 2017 - Key Points to Note. Report: Telemedicine improves Patient Care in Family Practices. Survey: Most Physicians not in Favor of Affordable Care Act Repeal. Top Challenges Physicians Could Face in 2017. U.S. ICD-10 Market Trends for the Period of 2016-2026. Cash Flow and Reimbursement, the Top Physician Challenges in 2017.

Maximize Reimbursement for Care Coordination Services. Proactive Strategies to Optimize Medical Coding and Billing in 2017. Contract Coding Companies. RADV Audit Services for Compliance with CMS Contract Requirements. Study Reveals Greater Use of Chiropractic Services by Veterans. CRNAs Exclusion from New VA Policy Impact Anesthesia Medical Billing. Anesthesiology ICD-10 Clinical Documentation Tips. Outsourcing Medical Billing can help Radiologists Stay Ahead of the Curve. Glaucoma Documentation - Use the Latest ICD-10 Codes. Increase Revenue by Reporting Non-Medicare Patients Consultations. Learn About the 2017 CDT Codes Eligible for Medical Cross Coding. Making the Medical Billing Outsourcing Decision – Points to Consider - mosoutsource. Tips to Improve the Charge Capture Process in a Medical Practice. Medical Billing Outsourcing – Reduce Overhead Costs and Increase Practice Efficiency by Outsource Strategies. Study: Prenatal Exposure to Industrial Chemicals Increases Autism Risk.

Dental Medical Billing - Know the 2017 CDT Code Updates. Obamacare 2017 – Is Your Medical Practice Ready for the Changes? Improved Documentation for Drug-related Disorders with ICD-10 Codes. Get Set for Physical Therapy Code Changes in 2017. Dental Medical Coding – Essentials of Reporting Code D4381. AAFP Congress of Delegates highlights Preauthorization Concerns.

Medical Fraud Take Down by DoJ – What Physicians Need to Know. Ensure Proper Medical Record Documentation for RADV Compliance. Commonly Used ICD-10 Diagnostic Codes for Chiropractic Office. Medicare Consult Denials – Key Clarifications. How Physicians can Prepare for MACRA. September Is Peripheral Artery Disease Awareness Month. Global Medical Billing Outsourcing Market - Trends and Forecasts. October 1, 2016 Ends ICD-10 “Flexibilities”, Accuracy Crucial. Iron Deficiency – One Third of Pregnant Women at Risk, Says Study. Study: Creative Nurse-driven Protocols Could Address ER Crowding. Reduce Dental Claim Denials with Dental Insurance Verification. CDC Apps for Physicians, Patients and the General Public. Post-operative Complications - Code it with ICD-10. Good Documentation Practices Critical for Pneumonia Coding. Obamacare under a Cloud as Top Carriers Back Out.

AHA Upbeat about Growth in Patient Access to EHR. Key Issues in Medical Practice Revenue Cycle Management. Rio Olympics 2016 – French Gymnast Sustains Horrific Leg Injury. Physician Practice Setting can Improve Reimbursement for RTs. Insights on Automated Medical Appointment Scheduling. Medical Specialties with Complex Coding Challenges under ICD-10. Coding ‘Episode of Care’ – the 7th Character in ICD-10-CM. Reduce Your Practice’s Denial Rate with Best Practices. Tips to Collect Patient Payments and Boost Practice Revenue. Resolve the Complexities of Chiropractic Billing with Outsourcing. Incomplete Colonoscopy - Know the Latest Medical Billing Updates. Downcoding - Definition, Impact and Prevention Tips. ICD-10 Coding for Hip Fractures. Resolving Challenges with ICD-10 Orthopedic Injury Coding.

How ICD-10 Impacts Chiropractic Coding.