Category Archives: Medical Billing

Physicians are being heavily penalized for overbilling! Are you at risk?

Physicians are being heavily penalized for overbilling! Are you at risk?

Oops another Medicare scandal has rocked the healthcare industry! Every now and then a Medicare scandal hits the headline and sends the healthcare industry into, a, frenzy. Ranging from carefully orchestrated scams to genuine mistakes and oversights, Medicare inspections and fines have almost become de-rigeur. Recently a Michigan based gynaecologist was in the news for…

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Revenue Cycle Tips

10 Quick Revenue Cycle Tips

Patient Related: Make sure patient demographics are clean. Verify patient eligibility before every encounter and determine the patient’s financial responsibility. Collect all patient responsibility at the time of visit (copays, deductibles, and balances). Define your financial policy regarding patient payments. Your office policy is critical to ensuring that all patients under-stand their responsibility and that…

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Losing Money on ICD-10

Why You Can’t Afford to Ignore ICD10

Here is a nice follow-up to my ICD-10 Primer article on the impact of ICD-10 from Alok Prasad.  Alok accentuates that when it comes to ICD-10 coding it is essentially an all-or-nothing situation when it comes to revenue cycle management and reimbursement.  Enjoy. You Can’t Afford to Ignore ICD-10 By Alok Prasad, www.revenuexl.com All medical…

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Insurance Billing Rules

Quick Tip – What is the Birthday Rule?

How do you determine whose insurance is primary and whose is secondary when parent both have insurance coverage? The answer to that question is known as “The Birthday Rule”. The Birthday Rule The birthday rule states:  The primary payer is determined by the parent whose birthday falls first within the calendar year. If both parents…

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Black Book Rankings

Black Book Award Winners Showcase Revenue Cycle Cycle & Coding Solutions at 86th AHIMA

The number of outsourced coding and revenue cycle management initiatives have doubled over a years’ time as the number of hospitals confront the challenges of implementing suitable solutions before the 2015 ICD-10 deadline, according to the recently published Black Book™ surveys of hospital technology and physician leaders. This week many of those leaders will gather…

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ICD10

A Primer on How ICD10 Impacts Revenue Cycle

Procedure billing has been much more effective since the introduction of the Current Procedural Terminology (CPT) coding system.  The CPT system was created by the American Medical Association (AMA) and intended to standardize and facilitate medical billing.  CPT consists of a collection of alpha-numerical codes which describe the services and treatments medical groups perform.  They…

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How to properly document wellness visits and physicals

Documenting wellness visits and physicals for Medicare

Coding Medicare physicals and wellness visits per Medical Economics. Renee Dowling Q: Our physicians perform a lot of annual wellness visits (AWVs) and preventive visits for Medicare patients. Can we use the same template for each of these visits? A: Each template needs to be different. If the documentation for your initial or subsequent AWVs…

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