MBC Medical Billing and Coding Blogs

Revenue Cycle Management – Prescription for Optimum Medical Claim Realization

“Despite such volatile environment, physicians have to find means to realize their each and every dollar owed them as their very sustenance and growth hinges on efficient reimbursement of medical bills” Unlike other professional services that realize their professional fees instantly, without having to rely on a third party (insurance carriers), physicians have to go […]

Under-Coding: Financial Repercussions and Solutions

Under-coding can be defined as the procedure of medical coding where the codes do not reflect the full extent of the treatment provided to a patient. This can usually happen due to many reasons but the most common are errors or misreading of codes or because of the misconception that the chances of insurers paying […]

Appealing Denied Insurance Claims: An Overview

The process of appealing a denied insurance claim is complicated but can be effective if done correctly since there are numerous reasons for claims to be denied by an insurance company. The payer or insurance company receives thousands of claims everyday and the claim can be quickly denied if there has been an error in […]

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Are You Prepared to Deal with Patient Information Breach?

‘The readily available sources for implementing security-rich technology platforms should not only make your search easier but also ensure Patient Privacy Compliance by sage-guarding critical information against undesirable proliferation, and sharing information only at the behest of patients’ Although there have been sporadic incidents of patient privacy breach, yet, the recent episode reported in a […]

Combating Healthcare Fraud and Abuse – A Challenging Task for Providers

The inherent nature of Health Insurance is such that it is highly susceptible to fraud and abuse by unscrupulous healthcare providers and beneficiaries. Consequently, there has been an unbridled rate of fraud and abuse amounting to billions of dollars – a reliable statistics puts it around 300 billion dollars, and still counting. Whereas, primarily, it […]

Small Practices: Adapting to the Challenges of Healthcare Reforms for Better Revenue

The major challenges faced by physicians who run a small practice or clinics that have less than four or five physicians are expanding exponentially. Many physicians find themselves worrying and spending time on administrative processes and interacting with payers rather than spending some quality time with their patients. The recent health reforms including the HITECH […]

Standards of Ethical Medical coding: Part 1

Coding is one of the core functions of healthcare providers and, due to the complex regulatory requirements impinging upon the health information coding process, coding professionals are frequently faced with ethical challenges. There are stringent medical Billing guidelines in place for the entire gamut of coding practices which include issues such as the privacy of […]

CPT Category II Code Updates by AMA

The American Medical Association (AMA) has released an update of CPT Category II code list, which will first appear in CPT 2012, with an implementation date of 1st Jan, 2011. The CPT Category II codes are supplemental tracking codes that can be used for performance measurement. The use of tracking codes for performance measurement will […]

Increasing Demand for Certified Coders in Healthcare

The year 2010 has set a premium on the coding professionals, registering a rise in their average salaries. And as expected, the salaries for certified medical coders are higher as compared to the non certified ones. According to a salary survey of nearly 12000 coding professionals, the average salaries for credentialed coding professionals have increased […]

Decoding Common Billing Blunders & Devising Ways To Quell Them

The growing incidence of delays, denials, audits, and resubmission of physicians’ medical bill claims is reason enough to have a relook at the way physicians’ services are billed and coded. In a medical insurance environment, characterized by stringent billing and coding compliance, inherent billing and coding errors are easy to catch. Further, lack of knowledge […]

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