Medical Billing Outsourcing

Initial EHR Certification Bodies Named

admin — Tue, 31 Aug 2010 13:51:58 +0000

Key step in national initiative toward adoption of electronic health records

The Certification Commission for Health Information Technology (CCHIT), Chicago, Ill. and the Drummond Group Inc. (DGI), Austin, Texas, were named today by the Office of the National Coordinator for Health Information Technology (ONC) as the first technology review bodies that have been authorized to test and certify electronic health record (EHR) systems for compliance with the standards and certification criteria that were issued by the U.S. Department of Health and Human Services earlier this year.

Announcement of these ONC-Authorized Testing and Certification Bodies (ONC-ATCBs) means that EHR vendors can now begin to have their products certified as meeting criteria to support meaningful use, a key step in the national initiative to encourage adoption and effective use of EHRs by America’s health care providers.

“Less than two months following the issuance of final meaningful use rules, we have approved our initial ONC-ATCB certifiers. EHR vendors can begin immediately to get their products certified.” said David Blumenthal, M.D., national coordinator for Health Information Technology. This is a crucial step because it ensures that certified EHR products will be available to support the achievement of the required meaningful use objectives, that these products will be aligned with one another on key standards, and that doctors and hospitals can invest with confidence in these certified systems.”

Applications for additional ONC-ATCBs are also under review.

Certification of EHRs is part of a broad initiative undertaken by Congress and President Obama under the Health Information Technology for Economic and Clinical Health (HITECH) Act, which was part of the American Recovery and Reinvestment Act (ARRA) of 2009. HITECH created new incentive payment programs to help health providers as they transition from paper-based medical records to EHRs. Incentive payments totaling as much as $27 billion may be made under the program. Individual physicians and other eligible professionals can receive up to $44,000 through Medicare and almost $64,000 through Medicaid. Hospitals can receive millions.

To qualify for the incentive payments, providers must not only adopt, but also demonstrate meaningful use of, certified EHR systems. The law envisions that defined meaningful use requirements will help ensure that the patient and provider benefits of EHRs are realized. Initial meaningful use criteria were defined in a final rule issued by the Centers for Medicare & Medicaid Services (CMS) on July 28.

In addition to the CMS rule, ONC also issued standards and certification criteria for EHRs on July 28, aimed at ensuring that EHR systems will support the specific tasks required under meaningful use. Also, through regulations issued on June 24, ONC created a system by which technology review organizations could also qualify as ONC- ATCBs that will certify EHR products as meeting the requirements necessary for meaningful use.

With the initial two ONC-ATCBs now named, EHR vendors can apply to them for certification of their products. By purchasing certified products, providers will have assurance that the products will support achievement of the meaningful use objectives.

“Multiple steps are underway to carry out the intent of Congress in supporting rapid and effective adoption of EHRs throughout our health care system,” Dr. Blumenthal said. “The naming of initial ONC-ATCBs is one important step. Actual certification of multiple vendors’ systems by the ONC-ATCBs is an important next step. CMS is also working to create an online system for providers to register and attest for the EHR incentive programs. The first incentive payments are targeted to be made in May 2011. Meanwhile, ONC is also carrying out new programs of technical assistance and training, especially for smaller hospitals and physician practices.”

Dr. Blumenthal said the Health IT initiative “is on an aggressive schedule to meet the urgent targets set by Congress and the President toward realizing the quality and safety improvements that we can achieve through health information technology.”

To learn more about the ONC-ATCBs named today visit www.cchit.org and www.drummondgroup.com.

For more information about the ONC certification programs visit http://healthit.hhs.gov/certification.

For more information about other HHS Recovery Act Health Information Technology funding and programs, visit http://www.hhs.gov/recovery/programs/index.html#Health.

This news is published on : http://www.hhs.gov/news/press/2010pres/08/20100830d.html

Medical Billing Services – The Best Choice For Your Physician Clinic

admin — Mon, 30 Aug 2010 16:23:43 +0000

Integrating a physician billing company into your physician clinic’s structure isn’t a minor consideration. On the contrary, it’s an important choice, as it comprises an extensive amount of beneficial points, several of which will facilitate the smooth management of your health practice whilst maximizing your profits. Cut down on those pressures and worries and automatically make sure that your business meets all legal rules. If you’re still not sure, let us explain why you should subcontract to a responsible Medical Billing Services. One major advantage of hiring this sort of business is the serious amount of time you will retrieve. Just think of all the minutes wasted, every single day – consider the handling, invoicing and tracking and all of the similar jobs which are part of a health center’s management. Sometimes it distracts your staff handling people who are ill. Giving such responsibilities to a reputable billing service will mean that they handle all of this, as well as various other concerns, including copying, data storage and collection and delivery services. Its remit could additionally include establishing plans for payments, or maybe processing workers’ compensation.

Offloading these tasks will allow your medical employees additional time to concentrate on caring for patients in the best possible way. This could save you a large amount of expense and take all those concerns off your mind. Your employees should have better things to worry about and we should not expect them to know about complex changes within billing industry processes. Reliable Medical Billing Company will concentrate exclusively on this special area. They are the absolute experts in all of these things, including any and all technologies, associated codes and procedures related to physician financial processes. Not only will this help save money, effort and time, it will cut out almost any possibility of your clinic being faced with legal complications.

Attention to detail is extremely important in billing services. However, when you hire the experts, you can stand easy, knowing full well that there are measures in place to catch and amend the stray clumsy errors immediately.

Utilizing specialized this type of company is an intelligent move for medical professionals including doctors, physiotherapists and GPs, and businesses like health centers and clinics. Although, don’t make concerns like costing and size the main aspect of your decision – ensure you locate the best service for your health center.

Source : http://fitnessinfos.net/archives/2010/07/28/medical-billing-services-the-best-choice-for-your-physician-clinic/

Let Medical Professionals Concentrate on Patients’ Needs — Let Physician Billing Services Take on Everything Else!

admin — Tue, 17 Aug 2010 16:20:23 +0000

Thinking about incorporating a medical finance management company into your health clinic’s workings isn’t a small decision to make. It is a serious choice, comprising an extensive number of benefits, many of which will improve the effective management of your health clinic while raising your profits. Cut down on those worries and pressures and make sure that you account for all legal requirements. If you’re still not convinced, let us tell you why you should subcontract to one of these finance management providers.

A most important benefit of utilizing such a company is the serious amount of time it will save you. Just imagine all the effort your members of staff spend, every week — consider the invoicing, tracking and handling and all of the similar jobs that are part of a medical center’s daily life. It accounts for more time than treating patients sometimes!

Trusting a professional finance management service allows someone else to cover all these concerns, as well as various other aspects. These might include collection and delivery services, credit checking and data storage. The finance management service’s duties might additionally cover establishing payment programs, or possibly handling workers’ compensation. Redeploying these responsibilities will enable your employees to focus on what’s important — caring for clients in the best possible way. All of this could cut back your expenses and take all those concerns off your shoulders. Don’t medical professionals have other things to be worried about than billing industry methods? Professional medical billing services will concentrate entirely on this one field. They are the experts in such matters, including regulations, rules and associated codes involved with mandatory physician financial matters. In addition to saving effort, money and time, it will cut down the risk of you confronting legal issues. Accuracy is really important in finance management companies, and when you work in partnership with expert help, you can stand easy, knowing full well that there are measures established to recognize and amend the intermittent unfortunate faults right away. Hiring specialist this type of company is an intelligent financial investment for medical professionals such as dentists, physiotherapists and doctors, and services like infirmaries and clinics. However, factors like costing and size should not totally influence your decision — make sure you seek out the provider who will provide the best results for your financial requirements.

Source : http://talentagency411.com/index.php?s=medical+billing&Submit=Search

Streamlined Medical Billing Could Save Physicians $7 Billion Annually

admin — Wed, 11 Aug 2010 11:00:28 +0000

“I’m at the office late every night taking care of mindless paperwork, just so the insurance companies can deny payment,” a physician colleague told New York Times columnist Pauline W. Chen, MD, for a piece titled, “Fueling the Anger of Doctors.”

This anecdotal frustration is corroborated by a new study published in Health Affairs. Led by Bonnie Blanchfield of Massachusetts General Hospital, a team of researchers analyzed the billing system of a physician’s group affiliated with a large, urban, academic teaching hospital, and found that 12.6 percent of submitted claims are initially rejected. After considerable staff time and effort, 81 percent of these are eventually paid. In some cases, the researchers report, providers miss a chance to collect billed revenue simply because of the initial rejections.

But the scenario could be turned around significantly, they discovered, by standardizing the Medical Billing system. Specifically, by using a single set of payment rules for multiple payers, a single claim form and standard rules of submission, physicians and staff could spend four and five fewer respective weekly hours on this administrative burden. Moreover, the hypothetical model revealed that such standardization could save U.S. physicians and their practices about $7 billion per year.

“The savings from reducing administrative complexity could be translated into decreased costs in general,” the study authors said in a statement. “Mandating a single set of rules, a single claim form, standard rules of submission, and transparent payment adjudication–with corresponding savings to both providers and payers–could provide system wide savings that could translate into better care for Americans.”

Source : http://www.fiercehealthcare.com/story/streamlined-medical-billing-could-save-big-bucks/2010-04-30

Even More Options for Your Medical Billing Career: Third-Party Billing on the Rise

admin — Fri, 30 Jul 2010 15:53:43 +0000

More doctors nationwide are choosing to contract out or outsource their medical billing needs. This means that professionals training today have even more options to build a solid medical billing career! As a medical billing professional, you will typically provide services to specialty physician groups and primary care practices and process Medicare, Medicaid and private health insurance claims – and working with a third-party billing company is no different.

The Department of Health and Human Services defines third party billing companies as “providing a valuable service to providers and suppliers who seek out their help in submitting claims correctly and efficiently. These firms vary greatly, performing a wide variety of services from simply formatting claims for submission to Medicare and private insurance companies to managing the entire ‘business end’ of provider practices.”

In addition to seeing that health care providers get paid for their services, billing professionals who work in a third-party billing setting usually offer a wide range of functions. In fact, in this career, you will perform many of the same extensive duties as an in-house medical biller:

- Manage patient data – demographic and incurred charges
- Prepare insurance claims
- Follow up on unpaid claims
- Post payments
- Bill patients for deductibles and co-insurance
- And more

Third party billing companies have a long and storied history, but larger-sized billing companies did not become more commonplace until the 1980s when it was required that hospital-based physicians’ services be billed separately. Today, according to statistics by the Healthcare Billing and Management Association (HBMA) third party medical billing companies employ nearly 20,000 people nationwide and process more than 17 million claims per month.

Partnering with a third-party Medical Billing Company can help health care providers increase cash flow and productivity, as well as enable them to concentrate on health care services, not on collecting bills. This means that as a medical biller, you have many options to create a solid future in the health care industry. Joining a third party billing company is yet another way to apply your medical billing training and create the medical billing career you’ve always wanted.

Source : http://www.medicalbillingcourses.com/blog/2010/03/even-more-options-for-your-medical.html

The Origin of Medical Coding

admin — Fri, 16 Jul 2010 10:47:52 +0000

What is medical coding and who are medical coders? Well, everyone does know about the importance of accurate medical data while providing quality healthcare service. The professional medical coder is one of the main persons involved in the capturing of this critical and accurate medical data that needs to be delivered in time. Computerization of medical billing process is done only after medically coded details specify all the various processes / procedures/ therapies/ undergone by the patient at the health care provider’s premises.

During medical coding all verbal descriptions of diseases, injuries, and procedures are converted into numeric or alphanumeric designations. How did the medical coding originate? Coding was originally performed to classify mortality (cause of death), data on death certificates, besides being used to classify morbidity and procedural data. Since the early 1970’s, the HCFA (Health Care Financing Administration) has asked the American Medical Association (AMA) to work with physicians of every specialty to determine appropriate definitions for the procedure codes and to try to determine accurate reimbursement amounts for each code. Such type of coding is very useful especially as it helps us today to get easy access to medical records by diagnoses and procedures so that in can be used in,

Hospitals/clinics etc

Research work

Education

The federal government introduced The Medicare Prospective Payment System (PPS) in October, 1983, for better management of medical care. Each patient was classified into a DRG (Diagnosis Related Group) depending on the information from the Medical Record that appears on the bill. Under PPS, hospitals are paid a pre-determined rate for each Medicare admission. Since then there has been a great deal more emphasis placed on medical coding.

At present assigning of medical codes is the backbone for reimbursement of claims for Medicare patients. Codes are given for diagnoses, services, and procedures provided. Thus healthcare providers today have to comply with different medical coding guidelines.

Source: http://maryanngarth.easyworldwidemall.com/2010/07/06/the-origin-of-medical-coding/

5 Tips to Stay on Top of Your Hospital Bill

admin — Fri, 09 Jul 2010 10:28:09 +0000

The Commonwealth Fund states that in 2007, 72 million Americans either experienced problems paying medical bills or accrued medical debt. Billing errors are often at the root of this problem, creating medical bills that patients can’t afford. Interpreting a hospital bill can be complicated and reviewing it line-by-line can be time-consuming and overwhelming.

It pays off to be informed. There are medical billers, medical coders, doctors and other health care professionals involved in each hospital stay. Miscommunication on any part can lead to mistakes. What can you do? Start by following these tips:

1. Plan ahead if possible – If your hospital stay is planned, make sure you double check your coverage before your hospital stay. This will enable you to verify the cost of any procedures and the amounts that will be covered.

2. Don’t leave the hospital without an itemized bill – Once you’re discharged, it is harder to obtain, so make sure you have it in your hand before you leave.

3. Keep track of everything – It is important for you to know who is treating you and exactly what they are doing. Make sure you ask questions and take names. Note: if you are unable to keep track of this information, have a spouse, family member or friends do it for you.

4. Don’t immediately pay the bill – Make sure you take the time to carefully go over the bill and understand what the charges are for. Once you pay the bill, it will be harder to re-coup your money if there are mistakes.

5. Make the hospital accountable – Don’t let the hospital ignore the erroneous charges and assure you that your insurance company will pay for it. Mistakes are mistakes and the hospital needs to correct errors.

Source: http://www.medicalbillingcourses.com/blog/2009/10/5-tips-to-stay-on-top-of-your-hospital.html

7 Benefits of HIPAA 5010

admin — Fri, 02 Jul 2010 16:12:33 +0000

By, Tom Sullivan

Although HIPAA 5010 essentially serves as the EDI pre-cursor to ICD-10, the new transaction standard also brings a fistful of its own noteworthy advantages.

Let’s face it: HIPAA 4010 is outdated; hence the more than 500 changes in the pending 5010. What’s more, HIPAA 5010 will “offer consistency of processing for payers and clearinghouses,” that 4010 does not, according to Christine Stahlecker, CMS director of medical billing procedures.

CMS, The centers for Medicare and Medicaid Services, in a National Provider Conference call last week outlined seven of the benefits above and beyond that processing consistency foundation. And, so, here they are:

Less ambiguity in the implementation guides
Enhanced usability and usefulness of certain transactions such as referrals and authorizations (X12 and NCPDP)
Improved utility of the NCPDP standards, compliance with Part D requirements
Supports standardization of companion guides across the industry
Supports increased use of EDI between covered entities
Supports e-health initiatives now and in the future
Provides infrastructure on ICD-10 and Present on Admission Indicator

Stahlecker added that to make the transition as seamless as possible, healthcare organizations, if they’ve not already, should soon check in with their vendors to see when the system upgrades will be available.

Even the major software vendors are running late with both HIPAA 5010 and ICD-10 updates, and according to HIMSS most recent readiness survey, only 12 percent of providers have formally begun their HIPAA 5010 projects. All that may become problematic as the Level 1 compliance deadline of January 1, 2011 and the ultimate deadline of one year after that, to the day, draw closer.

“The timeline really brings it home to roost,” Stahlecker added.

For those healthcare organizations that have still not begun, HIMSS has outlined 8 steps for starting the HIPAA 5010 migration.

Source: http://www.healthcareitnews.com/blog/7-benefits-hipaa-5010

Electronic Medical Billing Software To Help Streamline The Work Flow Of Medical Offices

admin — Mon, 21 Jun 2010 09:28:11 +0000

By, Harry T Selent

There is no denying technology from creeping and seeping into our daily lives. Everyday, better and more powerful systems are being put in place to help streamline and automate business processes. Medical practices are no exception. To run a medical practice properly, the right medical billing software has to be installed. Let’s take a closer look at this issue. First, let’s assume that there is no proper billing software in place. What do you think will happen? Of course, there must be some sort of method to help deal with the billing issues. The traditional way, is to do everything manually. Send invoices manually, track payments manually, submit claims manually, and so on. Now this is all fine if the medical practice stays small. But there are other concerns. Sometimes, it is not up to the practice whether to stay small or not. A medical practice is also a business. And like all businesses, it is not immune to market changes. For example, if the practice runs into cash flow problems, it may go under. This is rare and unlikely, but it does happen. From a purely business point of view, the practice has to grow in order to survive. When similar medical practices start to adopt technological systems to help streamline processes, they are actually reducing their operational costs. In other words, they are able to enjoy better margins. With better margins, they enjoy more profits, and can afford to invest more money back into improving and growing their practice. Eventually, those who refuse to grow will not be able to compete. It does sound a little bleak for those who have been procrastinating. But it is the truth, and it’s how reality works. Businesses that fail to evolve, improve and grow will be eliminated. Just take medical billing software as an example. When a medical practice refuses to install a reliable billing system, the business cannot scale. That is mainly because the staff will be too caught up with manual billing processes. If there is any attempt to grow the practice, the current system will eventually collapse under the weight of heightened pressure. And then everything goes back to square one. The features of medical billing software are important because they help to automate many manual tasks. Thus, the business can scale without having to worry about additional pressure. For example, you can submit claims quicker using the Visual Claim Editor (available for Medical Claim Billing Software). You can also manage and schedule appointments and revenue. Other features include prescription writing, custom report writing, medical and financial alerts, and more. In addition, the software also helps graphical representations of what is happening within the practice. For instance, line, bar, and pie charting is available. Using such graphs, the practice owner can easily spot trends and make better business decisions.

Source: http://www.reducemydebtnow.com/electronic-medical-billing-software-to-help-streamline-the-work-flow-of-medical-offices.html

Billing Dental Procedures as Medical Expenses? It’s A Growing Trend in Medical Billing

admin — Wed, 09 Jun 2010 12:14:04 +0000

As documentation linking oral health and overall health of the human body continues to build, more and more dental practices are recognizing the value of filing medical claims for many of their procedures. While this knowledge leads to more opportunities for filing claims with medical carriers, it also requires dental practices to learn how to do it.

Incorporating medical billing in dental practices has turned out to be a win-win situation for everyone. Patients are going forward with treatment, doctors are being paid, and satisfied patients are eagerly referring their friends and family. No doubt, a dental office will enjoy the rewards that come from happy, patients, profit stability, and a team that will receive compliments on a daily basis.

Here is a current list of some dental procedures that can be filed with medical carriers:

Trauma procedures
Medically necessary oral surgical, laser, and periodontal procedures
Medically necessary implant, endodontic, and prosthodontist procedures
Appliances to treat sleep apnea
Screening to detect oral cancer
Medically necessary exams and x-rays, including CT scans, associated with any of the procedures listed above

In fact, staff members at dental offices have been amazed at the number of cases that meet the criteria for filing a medical claim. While some similarities exist between preparing a dental claim and a medical claim, such as patient demographics and insurance demographic sections, there are also some significant differences, such as in coding systems. For instance, medical carriers ask for more than just a procedure code, which is all that is required by dental carriers. Medical carriers also require the reason (which is the patient’s diagnosis) why the particular procedure was done. Therefore, medical necessity is probably the most important element of successful dental-medical cross coding.

Dental practices that choose to implement a dental-medical cross-coding system will undoubtedly experience a positive impact on their day-to-day operation. Patients will certainly appreciate the fact that you are willing to help them obtain medical benefits and word of mouth is one of the most effective marketing tools that exists in any service business.

Source: http://www.medicalbillingcourses.com/blog/2010/02/billing-dental-procedures-as-medical.html