Medical Billing: How Training Matters for Coders?


Accurate medical billing is important to achieve sustainable success for your medical practice. When centers lack in training their in-house coders, compliance is threatened.

Below mentioned are the facts that you should know:

  1. According to several reports, up to 85 percent of medical bills contain coding mistakes resulting in $70 billion in estimated losses.
  1. 45 % of claims submitted to Medicare are incorrectly coded.
  1. In 2012, approximately $93 billion was added to Medicare and Medicaid spending as a result of fraud.

Any medical practice that is serious about its improving their profitability starts with its data stream first. Practices lose out on millions of dollars every year because of avoidable medical billing and coding errors. Switching over to an automated system for data input, re-evaluating office regulations to be in compliance with the latest standards, and double checking all outgoing documentation is a good start. However, it is better to hit the problem at its source – during employee training.

Your Staff Is Your Biggest Asset

Like any business, your employees are your biggest asset. Just like any asset, you must take care of your employees in order to benefit from their full potential. For this reason, offering medical coders medical billing training is imperative to operate a successful medical practice. Providing training will let them grow and mold your medical staff to fit the needs of your practice.

Providing your medical billing coders with medical billing training offers the following benefits:

  1. It Helps Builds Morale

Offering medical billing training to your medical coder sends a message that you are invested in their success. It may help them feel valued as an employee and in return increase their productivity.

  1. It Increases Office Productivity

In line with above, offering medical staff training teaches employees new techniques and tools that can make them more efficient at their job. This increased efficiency can increase office productivity which may result in increased profitability.

  1. Risk Management

Training employees in the proper way to handle certain situations, such as sexual harassment or emergency situations may help your practice mitigate risk.

  1. Reduced Turnover

Because your employees feel valued and well equipped with the information and tools necessary to perform their job and perform it well, medical staff training can reduce turnover.

  1. You Portrayed Enhanced Image of Your Medical Practice

Providing training opportunities for your employees can help to fuel your reputation among patients as well as competitors. Patients will benefit from your medical staff training endeavors and since satisfied patients are your most valuable referral source, you may experience an influx of new patients as a result.

Areas where your medical billing coders’ benefits from medical billing training include are:

  1. Technology

This includes EMR/EHR training, training on how to operate medical equipment, or even basic computer skills.

  1. Better Communication

Medical billing training courses helps enhancing the communication to better communicate with patients, clinic staff, and insurance providers.

  1. Problem Solving

Training your staff in critical thinking and problem solving may help them react better in certain situations as well as work better independently, therefore accomplishing more.

  1. Team Collaboration

Teamwork is an important part of operating an efficient medical practice. Offering medical staff training on how to collaborate and better function as a team is imperative.

Posted in Medical Billing, Medical Billing Company, Medical Billing Services, Podiatry Billing, Practice Management, Radiology Billing, Revenue Cycle Management (RCM), Urology Billing | Leave a comment

Reduce Cost and Increase Income for Urologist

Reduce Cost and Increase Income for Urologist.jpg

Health of any business is a result of proper balancing of income and expenses so as it ensures profitability and stability. Market dynamics like competition, pricing, consumer needs and pref­erences, product and service inno­vations, and industry regulations all lead to significant changes in success of a practice.  While the thumb rule to increase practice revenue is to remain focused on billing and collection of all Urology practices, a secret to success also lies in reducing cost incurred by pharmaceuticals, medical supplies and equipment’s etc. Saving on clinical cost can be revolutionary for any Urology revenue cycle.

Inventory Management

As a chief cost reduction strategy, it important to put in place inventory control standard for supplies. The office staff needs to be able to accurately estimate the inventory needs and order only up to the control standard. There needs to be a ban on any wastage expenditure when it comes to inventory to save increasing costs. If there is a competition among vendors to sell the same kind of medication, the practice must research the subject and settle for the least expensive alternative.  Expensive medications need to be turned over quickly so as to keep carrying costs down. Special attention is required for pharmaceutical expiration dates, rotation of stock, and spoilage etc. An effective inventory management program helps to tackle these issues.

Group Purchasing

Group purchasing Organizations or Buying through Associations also helps urology practice to save up on costs. These groups can help your practice in procuring material, supplies, services or even pharmaceuticals at slashed pricing. However, there is a need to closely scrutinize the contract before entering any such associations to make sure there are no underlying boundations like restrictions from buying anywhere else etc.

Tackle No Shows

Every Urologist would admit that missed patient appointments i.e. no shows contribute immensely in hampering the productivity of the clinic and show adverse results in terms of revenues.  The front office staff needs to make it a practice to contact patients in advance of their appointments. This not only reduces no-shows and last minute cancellation rates but also aids in sourcing payments from risky patients.

Second-hand Goods

There are a host of companies and practices that go out of business and try to sell their furniture, office and medical equipment online. It’s a cost effective method to purchase these second hand goods and to put them to use. Not only does this allow your practice to be fully equipped but so at a lower pricing altogether.

Cost-Saving Strategies

A direct method of increasing revenues would be to employ certain cost saving strategies at your practice. Telephone services, waste disposal of bio-hazardous substances and other expenses like paid time off, overtime, insurance benefits etc. need to be managed efficiently to save overall costs.

The cost of certain procedures like botulinum toxin preparations for urinary incontinence has been inconsistent in the past. Thus, it requires tracking. In case the rises quarterly, however the payers are charged the same rate for a while, a practice’s revenues might shake. Centers for Medicare & Medicaid Services (CMS) website publishes the necessary data that you need to estimate the cost trends.

Posted in Medical Billing, Medical Billing Company, Medical Billing Services, Practice Management, Revenue Cycle Management (RCM), Urology Billing | Leave a comment

Podiatry Practice Increase Revenue with Outsourced Billing Service


Podiatry billing like every other specialty billing faces its own set of challenges. Unskilled billing staff and inefficient billing practices can work havoc on the RCM process of your practice. Outsourcing the revenue cycle management of a podiatry practice to a medical billing expert can maximize claims payments and keep the practice compliant to governmental regulations. Professional medical billing services try to reach a level of efficiency when it comes to revenue cycle management of podiatry practices because of their exhaustive collection practices, incessant execution of billing tasks, and updated knowledge of prescribed documentation regulations. Here are the reasons why Podiatry Practice Increase Revenue with Outsourced Billing Service:

  • Better Understanding of Podiatry Billing Guidelines.

Centers for Medicare and Medicaid Services are very particular about the prescribed billing guidelines. The team of billing experts are well versed at podiatric procedures and related codes. This helps your podiatry practice to achieve your goal of flawless billing. Do check that the company you shortlist  has certified, professional, and experienced medical coders and billers that can keep your practice compliant with HIPAA and OIG, and in turn help you maximize payments, thus improving revenue streams. You can shortlist a company that already is dealing with podiatry practices, as this ensures that they know what they are doing.

  • Technological Aid

Podiatry medical billers and coders take help of automated technology to reach an overall efficiency of operations. They use customized templates of EHR that are specific to podiatry, as these ensure spec free use of codes native to podiatry procedures. This allows a practitioner to focus on the patient better without fretting about the billing front himself.  Billing teams also preauthorize all patient documents with the insurance providers and maintain records for them to avoid in discrepancies later.

  • Fighting Claims

Podiatry practices lose a significant portion of their annual revenue due to insurance underpayments and are often unable to estimate this loss of revenue correctly. An experienced billing partner checks all the payments received from insurers and matches them with bills filed. This brings to light underpayments, if any. The billing experts then respond to insurer’s queries about claims. They also make appeal for denied claims.  Such timely detection of underpayments also helps in timely claim filing and reimbursements. As rules and claim procedures surrounding Podiatry vary from insurer to insurer, it is a prudent step to seek the help of a podiatry medical billing company. Overtime, the expert would be able to identify the payers which usually write off your claims as underpaid or unpaid. This analysis helps the practice pay attention to the coding and documentation requirements of these insurers and chase collections regularly.

  • Dealing with The Patient

Every practice needs to realize that the overall exercises of bill collection from patients need to be improved. Outsourced Billing companies aid this by providing better customer service and putting in place an interactive interface. A more responsive approach to customer’s queries about billing and other medical practices helps in increasing the revenues in long term.

Services of expert billers in specialty Podiatry billing can help a practice overcome billing challenges easily.

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Will Advanced APM Affect Urology Revenue?


There was a certain cheer in the air from Urologist and other Medicare providers when the Medicare Access and CHIP Reauthorization Act (MACRA) was passed and signed. This ended the terrain of sustainable growth rate (SGR) payment formula. However, what persists today in the world of healthcare is confusion and uncertainty. The Quality Payment Program (QPP) introduced to replace SGR; is a promise of ultimate financial reward to practitioners who improve the quality for care they provide at a reduced cost. In reality though, QPP is a bundle of complexities that makes the derivation of the promised benefits difficult to achieve.

The Quality Payment Program offers a physician a choice of two paths for reimbursement:

The Merit-based Incentive Payment System (MIPS) Alternative payment models (APMs) which are further segregated into -Advanced and Non Advanced kinds.

Experts are of the opinion that for urologists, it’s the Advanced APMs where the benefit lies. However, the difficulty is that right now there are no approved episode-based Advanced APMs for urology. AUA is working on two and LUGPA has submitted one for approval by CMS.

Under the MIPS Quality Payment Program, the payment adjustments for the Physician Quality Reporting System (PQRS), the Value-based Payment Modifier, and the Medicare and Medicaid Electronic Health Record Incentive Program will come to a halt on Dec. 31, 2018

The other key components of all these programs will be contained in a single streamlined program in 2019. Through a memo AUA had attempted to explain that in 2019, the MIPS program will make positive or negative adjustments to a physician’s payments. These adjustments would be based on a composite score of their performance in 2017 across four categories:

  • Quality Reporting (will replace PQRS), Improvement Activities
  • Advancing Care Information (replaces Meaningful Use)
  • Cost (replaces Resource Use).

    Physicians qualified to participate in an Advanced APM are exempt from MIPS. They are also eligible for a 5% lump-sum bonus payment on Medicare Part-B services from 2019 through 2024. They will end up receiving higher annual increases in their payments starting in 2026 and onward. However, the urology practitioners that are participants in an Advanced APM must estimate more than nominal financial risk, they need to report quality measures comparable to those adopted under MIPS, and use certified EHR technology. One must also note that only risk-bearing accountable care organizations, patient-centered medical homes, and certain bundled payment models qualify as Advanced APMs. On the other hand, urologists participating in non-Advanced APMs are subject to MIPS. They are not even eligible for the 5% lump-sum bonus payment.

    In the past any patients have been over-treated. They mostly had low-risk disease. The excessive over treatment was prescribed because there has been a lack of understanding that many such patients can be very safely monitored. The over treatment was also due to lack of active surveillance to cut out the cost of care.

The new APM has been submitted to the Physician-Focused Payment Model Technical Advisory Committee. It provides a way for physicians to demonstrate savings to CMS, and includes a care management fee for physicians who follow active surveillance. Urologists face risk only in the case they fail to meet the outcome quality parameters and costs to Medicare increase. This means if costs and outcomes do not meet the goal, then the physician could end up losing on money.

Posted in Medical Billing, Medical Coding, Practice Administration, Practice Management, Revenue Cycle Management (RCM), Urology Billing | Leave a comment

Why OB-GYN Documentation Is Under Scanner?

Why OB/GYN Documentation Is Under Scanner?

In the real world, dealing with medical documentation is a complete nightmarish and OB/GYN documentation is no different. Why? Inaccurate, incomplete documentation process is leading to several hiccups in insurance claims reimbursements OB/GYN.

Discharge summaries and other important information are often not available at the time of coding. Such misleading and incomplete information results into incorrect missed-out coding which in-turn can cause loss in revenue, productivity and profitability creating compliance issues. According to federal and state regulations, patients’ histories and diagnostic and treatment documentation supposed to have completed and submitted within 24 hours, while overall record has to be completed within 30 days, and often DS fall within this time period.

OB/GYN healthcare professionals very well knows the effects of unfinished, delayed or wrong clinical documentation overall affecting the financial bottom line, performance-improvement activities such as review of serious cases, and compliance with federal and state governing laws. Thorough and precise documentation is the basis of all medical coding, billing, and claims submission and follow-ups. With the correct medical and billing coding of OB/GYN services it makes it easy and hassle free in receiving accurate payment which in turn, hinges around quality, precise, and thorough clinical documentation.

It is important that your OB/GYN documentation should be legitimate and complete. How do you know that your documentation work is in line?

A Correct Medical Billing And Coding Will Offers Services Like:

  • Selection of the correct diagnostic, treatment, and re-habitation codes-that describe more accurately “what” and “why” “who” and “where” of the OB/GYN process
  • Consistent with coding guidelines
  • Coding to the highest degree of specificity
  • Linking the ICD-9/10 to the correct CPT-4 on the claim form
  • Linkage and Medical Necessity: ICD-9/ICD-10 codes “justify” the services provided
  • Failure to appropriately link leads to denials and delays of reimbursement claims
  • Avoiding bundled codes
  • Coding only relevant OB/GYN diagnoses
  • Sequencing the OB/GYN diagnoses
  • Correctly understanding the billing requirements of each insurance agency, which varies from agency to agency, as well as with federal and state-specific regulations

To Flourish Your Practice, Below Are Few Critical Things To Watch Out For:

Ensure that your documentation process is in sync with the latest emerging documentation trends, guidelines, and formalities related to OB/GYN. This will boost your coding accuracy, decrease insurance reimbursement claims denials, and safeguard your payments.

  • Be acquainted with ICD-10 related Ob-GYN documentation that is needed as diagnosis system changes. Stay up to date on the most timely, relevant, and accurate ob-gyn coding guidance straight.
  • Find your way out of coding tight spots thanks to precise and thorough supporting documentation.
  • Implement the latest coding, compliance, legal and regulatory updates.
  • Documentation and coding principles are intimately linked and affect patient care, reimbursement, and compliance. An understanding of the principles is required for the successful practice of modern-day OB/GYN practice.

The Documentation Of Each Patient Should Include:

  1. Reason for the supposed medical diagnosis, and relevant history, physical examination findings and prior diagnostic test findings, as well as the patient’s progress, response to and changes in treatment, and revision of diagnosis according to the level of service provided.
  2. Assessment, clinical impressions or diagnosis, and identification of risk factors.
  3. Plan for care and the actual time spent plus date and identity of the clinician.
  4. Ensure that the CPT and ICD9/10-CM codes reported on the health insurance claim form or billing statement should be supported by the documentation in the medical record.

How to Boost-Up Your Revenue and Profitability of Your OB/GYN Practice?

It would be a wise and judicious decision for OB/GYN medical practitioners to outsource their documentation and coding worries to a professional medical billing and coding service provider. Having an established name on board for your medical billing and coding will ease out your revenue cycle and other operations. The service providers are specialized in OB/GYN documentation, coding, and billing hence they are familiar with the procedures, treatment and terminologies concerned in OB/GYN services in the USA.

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Impact of Telemedicine on Otolaryngology Practice

Impact of Telemedicine on Otolaryngology Practice

Telemedicine is a significant technological and business trend that is influencing medical practice marketing, patient engagement and revenue. Advances in telemedicine technology have reduced operating costs with substantial savings for all types of organizations that utilize medical professionals in some capacity. As a medical professional, how can you benefit from the increased usage of telemedicine in the workplace today?

Uses of Telemedicine on Otolaryngology

Telemedicine has been used in the field of otolaryngology since the early 1990s. Use has occurred primarily in those situations where there was a remote, isolated population to serve; a shortage or lack of availability of otolaryngologist; or, more recently, backlogs of patients needing otolaryngology care inadequately addressed by the existing delivery system.

Below Mentioned Are Some Of The Significant Impacts:

Improvised Patient Flow

When you find that your schedule is relatively light during the middle of the day, scheduling a number of telemedicine “check-in” appointments during that time can let you connect with patients in quick succession. Fast visits increase the number of patients seen in a day.

It Attracts New Patients

For a busy parent or for a patient who can’t seem to make time for an appointment due to their busy work schedule, Otolaryngology telemedicine allows them to interact with a trained physician more conveniently.

Not only can they minimize the disruption that a doctor’s visit adds to their day, but they are also more likely to address small or early indications of medical problem.

Increases Patient Loyalty

Urgent care Otolaryngology clinics and retail clinics offer convenient in-person options and online video visits through on-demand services are becoming increasingly popular. Patients choose these options because of scheduling flexibility, lower transportation costs, and less time away from work. By offering the option to get care from you via video, your patients get the convenience they want without sacrificing continuity of care.

Reduces Costly Cancellations

While it will never be able to completely eliminate no-shows from a practice, it can help save thousands of dollars by reducing a fraction of patient no-shows.

Improves Revenue

Just because your practice is closed for the day doesn’t mean that you have to stop seeing patients. The use of telemedicine on Otolaryngology practice will allow for after-hours care when it is convenient for both provider and patient.

These are just a few of the ways that telemedicine can transform your practice in ways that are great for you, your patients and the bottom line. These advantages explain why video visits are rapidly moving from new and novel, to a standard method of care.

Overall, the general direction of medicine is seen as favorable to the use of Telemedicine. The aging U.S population means there will be more patients and fewer active physicians, which could mean the need for remote treatment options to cover larger areas of the country. If practices continue to consolidate, Telemedicine may become a viable option in suburban or smaller urban areas. It alleviates patient difficulties in accessing a practice that alone is a good enough reason to implement it.

Posted in EMR / EHR / Health IT, Healthcare Reforms, HIPAA / ACA / ACO, ICD-10 Coding, Medical Billing, Medical Coding, Otolaryngology Billing, Otolaryngology billing & coding, Otolaryngology billing companies, Otolaryngology billing guide, Otolaryngology billing guidelines, Otolaryngology Billing Outsourcing, Otolaryngology billing providers, Otolaryngology Billing Services, Otolaryngology billing vendors, Otolaryngology coding, Otolaryngology coding services, Otolaryngology rcm outsourcing, Practice Administration, Practice Management, Revenue Cycle Management (RCM), Why Outsource Medical Billing Services | Tagged , , , , , , , , | Leave a comment