Billers and Coders Digest
News, Views and more....

Wednesday December 11, 2013 | Edition 1.80

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A monthly update on Billing and Coding Information
Billers & Coders in demand to help decipher altering Medicare & Medicaid reimbursements
In the healthcare industry, every participant is affected by the Medicare & Medicaid programs in some way. With constantly evolving rules & regulations, it becomes difficult for the healthcare provider to manage reimbursements in their faculty.

Industry fact states
More than 50% physicians accepted that they can no longer afford to accept new Medicaid patients because of declining pay
Many practices in various states have stopped accepting Medicare patients because of its dynamic nature of reimbursement
How does altering Medicare & Medicaid reimbursement affects your revenue?
The complex, constantly changing rules & regulations governing Medicare & Medicaid coverage... Read More

Billers & coders analyze the cost-benefit structure to assess profitability
  1. Balance sheet analysis: Understanding your balance sheet with respect to...
  2. Market analysis: One of the main factor in this area is understanding the market...
  3. Analysis of business opportunity: Understanding your business dynamics...
  4. Examining the hassle factor: It is important to determine how you are affected by the new requirements and...
Choosing to opt for Medicare or Medicaid presents a wide range of quantitative and emotional factors affecting the decision. Read More
Billers & Coders help prepare for ICD-10 transition with Dual Coding
As the October 1, 2014 ICD-10 compliance deadline looms, many providers continue to prepare their coders for ICD-10 coding. With ICD-10 coding practices, there always seems a chance of uncertainty. So to combat this uncertainty, healthcare providers are encouraging their coders to join the dual-coding movement. ... Read More
News Feed
1
Around 42 percent of experienced codes make between $30,000 and $40,000, although pay can go as high as $100,000 as per national health information management survey.
2 American Hospital Association estimates about 18% of medical billing and coding positions remain unfilled due to a lack of qualified candidates.
CMS Updates
1 Learn When EHR Payment Adjustment for Medicare Eligible Hospitals Begin Read More
2 Back to School: Identify How ICD-10 Will Affect Your Practice Read More
3 ICD-10: Less Than One Year Out Read More
4 Stay Informed: New and Updated FAQs for the EHR Incentive Programs Read More
Tips from Billing and Coding Experts

Verify patient benefits to avoid unpleasant experience from patients. Also verify the need for a prior authorization for any planned procedures.

Get vital patient info at check-in like patient demographics and copy of insurance card upon arrival to verify patient identification.

Review the documentation at the earliest. Your goal should be to have the claim out the door within 72 hours.

The the best way to resolve an issue with the clearinghouse and the payer is to be friendly with the other side and work as a team.

Be sure to pay attention to the claims received and watch accounts receivable aging reports to monitor all outstanding accounts.

Know your payer contracts as they stipulate things like what procedures are covered and whether prior authorization or referrals are needed.

Make the payers show the money. Make sure to follow up and appeal any claim that has not been payed as expected.

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