Many will tell that gynecology has benefited from being part of OBGYN as it helps gynecology to operate closely with obstetrics, a natural partner when it comes to pregnancy. But gynecologists may argue that while it may be true from a medical standpoint, when seen from a financial point of view, one can get a […]
Healthcare reforms have not changed the goals and responsibilities for physicians but it has certainly increased medical billing and coding complexities. Significant changes like HIPAA, EMR and ICD-10 have imposed additional responsibilities on small as well as large practices, which has been elaborated further- Reforms in HIPAA have increased privacy requirements. The compulsory implementation of […]
Accurate coding is vital for all medical practices as it is the main source of reimbursement. It not only reduces claim denials and increases revenue; but also plays a significant role in insurance assessments. Coding is an irreversible process that decides whether or not your practice will get paid for the services offered. Error-free coding […]
According to CMS, internal medicine physicians will be enjoying an increase in reimbursement rates this year. However, along with this 2013 has brought in a series of regulatory changes for internists to deal with, which most internal medicine physicians are finding difficult to handle. To be fair, all the changes are not financially negative in […]
Are denials, ignored or lost claims, inaccurate coding and underpayments making it difficult for you to collect the revenue you have earned? Physicians have a busy schedule and with the doctor patient ratio getting disproportionate across the US, handling the task of medical billing and coding has turned into a daunting task. Complexities of coding […]
Amongst the possible reasons for denials, coding inadequacies seem to have a major impact. Because codes quantify and qualify physicians’ medical services for medical reimbursements from payers, any inherent coding error, miscoding, over or under-coding can lead to denials upon found to be incongruent with acceptable coding practices. While a few coding manipulations may happen […]
In 2010, Medicare improper payment amounted to $47.9 billion. Human and Health Services, in 2011, recovered $4.1 billion paid through reimbursements as a result of ‘fraudulent’ or ‘improper’ claims. You may be right if you think you won’t ever be among the fraudulent care practitioners who contributed to these figures because you are scrupulous. But […]
Clinical documentation is a need that threads through the entire lifecycle of an inpatient treatment episode. The clinical documentation specialist checks the documents of a patient before or within 24 to 28 hours of admission to assess various aspects of the patient’s condition, reviews documents every two to three days, during patient stay, to check […]
‘Medical billing’ and ‘Medical coding’ may have sometimes been used interchangeably to mean the act of claiming reimbursement from insurance payers, but essentially they are two separate and specialized jobs. Medical coding precedes medical billing, and it is irreversible. While a medical biller is entrusted with far more task than a coder, it is the […]
While the recent one year extension (from October 1, 2013 to October 1, 2014) in deadline by the U.S. Department of Health and Human Services (HHS) may somewhat have eased the pressure, yet the anxiety still persists among the majority of medical practices in the US. The “anxiety” is about the impact of ICD-10 transition […]
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