Being a savvy health care consumer has never been more important. With some people finding health care costs soaring as benefits dwindle, it pays to know how to make your coverage work for you.

Know before you go

It’s not enough to ask if a health care agency takes your health insurance. Your health care [...]]]> By AMY HAMILTON

Being a savvy health care consumer has never been more important. With some people finding health care costs soaring as benefits dwindle, it pays to know how to make your coverage work for you.

Know before you go

It’s not enough to ask if a health care agency takes your health insurance. Your health care professional should be contracted with your insurance network. If you’re operating under a Preferred Provider Organization, or PPO, using a health care professional not on the list is going to cost a lot more of out-of-pocket dollars.

“You need to be very careful and definitely when you call to talk to a doctor ask if they are contracted with your insurance,” said Becky Weaver, office manager of Grand Junction dentist Scott N. Vandusen.

In general, Weaver said, clients are learning to check online or call their insurance companies before scheduling appointments.

However, health care professionals can move in and out of networks. If a health care provider moves out of your network, you’ll need to change medical providers or face paying more for the same services, Weaver said.

“People couldn’t understand why they kept having to pay so much even though they were insured,” she said about the misconception.

Save ER for emergencies

You should always go to a hospital’s emergency room during life-threatening situations; for example, if you believe you’re having a heart attack, experiencing a loss of consciousness, losing large amounts of blood, having seizures or convulsions, or experiencing numbness and paralysis, among numerous other serious conditions. However, not all afflictions require an emergency room visit, which can result in bills that are estimated to cost at least three times that of a primary care doctor’s visit.

“Sometimes you do need to go to the emergency room. In many instances, reasons for you to go to the emergency room could be handled at primary care,” said Kayla Arnesen, marketing director for Rocky Mountain Health Plans. “We have after-hours clinics that are very accommodating.”

Four urgent care facilities listed in Mesa County are: Med-X Urgent Care, 1060 North Ave. Suite N; Docs on Call, 3150 N. 12th St.; Family Health West Urgent Care-After Hours, 551 Kokopelli Blvd., Suite G, Fruita; and UCC of Montrose and Grand Junction, 517 N. First St.

Arnesen said it’s always a good idea to call your primary care doctor first unless your condition is so severe you cannot call.

Pediatricians, for example, typically have someone on call who can answer questions and potentially could save a costly trip to the emergency room. Arnesen called her pediatrician at 2 a.m. for advice when her child had a fever. She was advised to buy an over-the-counter drug.

“A $4 bottle of Benadryl solved the problem,” she said.

Focus on prevention

Many health care policies offer free or reduced-cost preventive services such immunizations, dental cleanings, eye exams and routine screenings such as prostate exams, mammograms, Pap smears, physicals and services for children. But don’t forget periodic screens for blood pressure, blood sugar and cholesterol, as well as testing for colon cancer and HIV.

However, if symptoms arise, it’s best not to try to ride out an illness in the hopes it will disappear, according to Dr. Dale Kliner of the Colorado Urgent Care Association. Waiting to seek treatment can sometimes result in worsening conditions that may require further medical care.

“More patients are being diagnosed with pneumonia after suffering minor conditions such as a cough, indicating that some patients are waiting to seek treatment, when their best interest is to act immediately,” Kliner said in a news release.

Go generic

The first question to ask your doctor after being prescribed a drug is whether it’s available in a generic form.

For customers of Rocky Mountain Health Plans, which make up 60 percent of Mesa County residents, getting a generic prescription can be a cost savings of 50 percent to 80 percent off name-brand drugs, said Kayla Arnesen, marketing director for the insurance company. Arnesen advised that patients first ask their physicians to prescribe a generic form of a drug, which may be easier than attempting to buy a prescription in its generic form once you get to the pharmacy.

“It’s a common misconception,” she said. “If generic drugs are available, they are just as safe as the brand name.”

Check your bills

Any number of mistakes on your medical billing could change the amount paid by your insurer or cause an insurer to reject the claim.

Be sure to check bills carefully for items such as correct account numbers, services administered and that the services were billed to the correct insurance company. Study your benefits booklet to be certain of your coverage.

If you locate a billing mistake, send a certified letter to your insurer and follow up in few weeks to check if it was corrected.

Don’t hesitate to call your doctor or insurance company if you have questions on a bill.

If your insurance company won’t pay for a service you feel is necessary, dispute it.

Above article published on
http://www.gjsentinel.com/hp/content/features/stories/2009/09/01/090109_9a_Health_Five_things.html

Software to help medical practices manage their finances has been around for decades. However, today’s electronic chiropractic billing programs are more accurately called chiropractic practice management software and bears only the most basic resemblance to its older counterparts.

Electronic medical billing software covers a wide [...]]]> By the editors of BuyerZone

Software to help medical practices manage their finances has been around for decades. However, today’s electronic chiropractic billing programs are more accurately called chiropractic practice management software and bears only the most basic resemblance to its older counterparts.

Electronic medical billing software covers a wide range of functions including:

• Tracking patient demographics, visits, and diagnoses;
• Collecting, transmitting, and tracking billing information and insurance payments;
• Managing appointment scheduling; and
• Generating a variety of reports.

In addition, most billing programs will also bring you into compliance with the sections of the Health Insurance Portability and Accountability Act (HIPAA) that specify increased security standards, ANSI billing formats, and more. Note that we say “most” – some software may provide only partial HIPAA compliance. You should quiz vendors carefully about the HIPAA compliance of any software you are evaluating, particularly around electronic billing and security measures.

Wide-ranging benefits

Besides HIPAA compliance, there are several other important benefits to be gained from the right electronic billing software:

• Improved staff productivity – easy-to-use software improves efficiency.
• Increased patient and customer satisfaction – more flexibility in scheduling and better access to personal information.
• Faster payment from insurers – paper claims usually take 30-60 days, electronic claims are usually paid in 10-14 days.
• Fewer errors in billing and insurance.

How to investigate an electronic medical billing program

First, make sure you include the right people in the purchasing process. Physicians, office managers, receptionists, and billing managers will all have different viewpoints and important concerns: taking any major steps towards a purchasing decision without involving every role is likely to lead to problems down the line.

Next, see what practices similar to yours are choosing. Find offices similar to yours in size and specialty and visit their offices to see the software in action. While this may seem like an obvious tactic, it is highly effective.

Try to find software that matches your specialty and office size by asking these types of questions, as they apply to you:

• Does the system handle scheduling quirks unique to your practice?
• Does the system recognize all procedures and diagnosis codes your practice uses?
• Can the system handle multiple offices and multiple doctors?
• Can information be accessed from multiple locations?
• Does it include inventory tracking or the ability to manage several separate accounts?

Of course, the best way to compare ease-of-use is to try it yourself. Many vendors allow you to log in to a sample account or will send you a sample CD to let you try out the software: take advantage of these opportunities. Have all the interested parties from your practice go through their most common activities to get a sense of how easy the software is to use – watching “canned” demos does not give you the same in-depth look at the products.

How to choose the right supplier

A successful medical billing software decision includes not only choosing the right software – but choosing the right supplier. Qualified suppliers will listen to your needs during the sales process, help your office run smoothly during and after the transition, and provide the training and support you require.

Above article published on

http://www.chiroeco.com/chiropractic/news/4423/675/Electronic-Medical-Billing/

Most of the time Claim get decline because of improper medical coding done by medical coders. Without proper medical coding, it is very hard to get claim reimbursement easily. Medical coding is a process of giving special code to verbal description of disease, injuries and procedures. Insurance coding is one of the synonyms.

What are the Benefits of Outsource Medical Coding?

1. Cost Benefit: By outsourcing, you always gain cost benefits. You don’t have to spend on infrastructure, hiring people and purchase of latest technological equipment, if you go with outsourcing of medical coding. This will decrease your cost up to 60%. You can spend this savings to upgrade your main business.

1. Better Accuracy: Accuracy does matter for acceptance of reimbursement claim. Medical coding must be accurate to get clear idea about the process, tests done by patient. If it is not clear to the insurance company, there is always denial from them. So better accuracy will increase acceptance chances of your claim. Through outsource medical coding, you can achieve better accuracy.

1. Certified Coding Specialist: It is very hard to find certified coding specialist. You have to setup full infrastructure with enough equipment before hiring any coding professional. If you want to hire experienced certified coder, it will cost you a lot. It is wise decision that outsourcing of coding work and gets benefit of certified coding specialists at low cost.

1. Quality Audit: This feature makes your medical coding more accurate. Quality audit will increase the accuracy of coding. Through this type of services you get more accurate and speedy coding services. Your chance of getting compensation from insurance is near to 100%.

1. More Clean Claims: With the help of professional coder and quality audit you get cleaner claims. It becomes very easy to get the reimbursement from the insurance company. Through outsource medical coding; you get access of latest technology, trained coders, quality controller and proper environment for coding. All this helps you for clearing the claims cleanly.

1. Transparent Methodology: Most of the medical coding company offers transparent methodology. This type of services increases the trust of client for particular company. It also increases the reputation in the market.

There is always disadvantage of data theft while outsourcing but you can always come out of that by checking the reputation of firm in the market.

Above article published on

http://www.articledashboard.com/Article/What-are-the-Benefits-of-Outsource-Medical-Coding-/930644

The increased productivity in billing can be [...]]]> Electronic medical billing makes life easier and collections more successful in a medical practice. Questions about medical bills can be answered before the bill becomes past due because of quicker response times. Complicated payment procedure for insurance companies will no longer overwhelm a billing office.

The increased productivity in billing can be directly linked to the different kinds of medical billing software. Client server (CS) and application service providers (ASP) make up two types. Management of a client server requires configuration, back up, restoration, and upgrades after it is initially installed. In addition it consists of a central server and terminals linked to a local network. For these reasons client servers are usually more expensive.

Application service providers assure the latest in technology. The central server is located with the vendor, and data is exchanged via the internet. This minimizes time needed for troubleshooting and downtime. Electronic medical billing training can also be conducted online. The vendor is responsible for managing the technology, recovery, restoration, installations, and upgrades.

Post-payment audits by insurance investigators are less frequent with electronic medical billing. Increased cash flows come with more accurate and easy billing. Cost and productivity savings, including fewer clerical errors reduced office workload, and improved coding come with electronic billing. And electronic billing software offers benefits such as compliance requirements, financial and work flow controls, and accurate procedure coding for patients.

Many medical offices choose application service providers instead of local client servers because IT staff and equipment expenses aren’t necessary. Yet further reasons for choosing application service providers are because of greater flexibility. The lack of equipment to install means the system is faster to implement, and the training of necessary personnel can be done online.

Electronic medical billing makes the billing process accurate and less susceptible to penalties. Built-in compliance protection prevents electronic billing software from committing fraudulent billing or coding practices or issuing duplicate bills. Federal and state enforcement agencies have brought legal action against medical billing offices. For this reason the compliance protection feature is crucial in the event that a post-payment audit triggers suspicion and causes a penalty to be accessed. Proper billing procedures and post payment audits are much easier.

Since technology often becomes outdated every three years the replacement costs of a client server needs to be considered. There are tax advantages to purchasing the client server equipment, but these may be offset by the reduced front end cash flow. An application service provider will charge a monthly service fee, but this is small compared to the sizable upfront investment needed to purchase a client server.

Electronic medical billing is a cost effective way to increase cash flow and guarantee billing compliance. Once you have decided on electronic billing, the next step is to choose which methods best suits your office. Both client servers and application service providers are a great way to get electronic billing onto your office

Above article published on

http://ezinearticles.com/?Electronic-Medical-Billing-Save-
Money-by-Improving-Office-Procedures&id=2421041