As a Professional Medical Biller, I RARELY send ANYTHING in via paper!
It is imperative that you ally with a prominent software company that is AHEAD of today's technological and processing standards. The one that I chose to partner with is DAQBilling owned by Antek Healthware out of MD.
They offer an ASP, thin client model with mulit-server backup every hour of every day, so my data is never in jeopardy.
This article focus is on PAPER claims and the tips that go along with processing medical claims on paper.
Tips to Avoid Privacy Breaches
Protect the health information of recipients during the paper claim billing process.
It is important to protect the health information of recipients. Providers can help in this regard in the paper claim billing process. Accuracy, completeness and clarity of the form are important to ensure that the information is read correctly. Forms can be misread if information is illegible. Illegible information may be corrected manually, which results in a delay of timely processing of claims and also presents the chance of a privacy breach. To avoid protected health information being sent to the wrong providers, thus resulting in health care privacy breaches, please adhere to the following guidelines when submitting paper billing forms:
Avoid printing claim forms using a dot matrix printer. Dot matrix print is not clear and may be misread by the OCR equipment. Laser printers are strongly recommended.
Frequently change the ink cartridges on the printer to avoid light ink. Light printing is not legible and may be misread by the OCR equipment.
Use black film-type or high-quality ribbons. Ribbons should be changed regularly to ensure that a clear, distinct character is printed. The OCR equipment may misread blurred or light printing.
Whenever possible, type all information. Use 10-point font or larger (not to exceed the size of the field). The OCR equipment can only scan typed or computer-printed forms. Do not use script or italic font.
Handwritten forms should be printed neatly and accurately using black ballpoint pen only. All requirements pertaining to typed forms, such as entering data within the text space, apply to handwritten forms.
Type only in areas of the form designated as fields. Be sure the data falls completely within the text space and is properly aligned.
Verify that the billing provider number and beneficiary identification numbers are correct.
Furthermore, providers are encouraged to explore the many benefits of electronic claims submission, funds transfer, remittance and other business transactions. These electronic transactions expedite processing, minimize errors and streamline business office operation. Recent enhancements have expanded the types of electronic services available to the provider community.
Tuesday, July 31, 2007
Thursday, July 26, 2007
Medical Billing - The Almighty Combo!! Yes, it's ALL YOU NEED!
Tell me...
DO YOU Want to start off in the RIGHT FOOT in becoming a Medical Billing Business Owner?
All you need are FOUR pieces.
Ready??
1. Buy the full course (or better yet, the Success Package) at www.MedicalBillingCourse.com
2. Buy DAQBilling software
3. Buy the Mediccal Billing Business Manual and become an active member of The Medical Billing Foundation by visiting www.MedicalBillingFoundation.com
4. Excercise commitment, determination, and NETWORK!
All together, you will have a turn-key business package for WAY LESS THAN $10,000! In what other industry could you completely open your business for that little of an investment??? NONE!
Look at trying to buy a franchise - it's IMPOSSIBLE.
DO YOU Want to start off in the RIGHT FOOT in becoming a Medical Billing Business Owner?
All you need are FOUR pieces.
Ready??
1. Buy the full course (or better yet, the Success Package) at www.MedicalBillingCourse.com
2. Buy DAQBilling software
3. Buy the Mediccal Billing Business Manual and become an active member of The Medical Billing Foundation by visiting www.MedicalBillingFoundation.com
4. Excercise commitment, determination, and NETWORK!
All together, you will have a turn-key business package for WAY LESS THAN $10,000! In what other industry could you completely open your business for that little of an investment??? NONE!
Look at trying to buy a franchise - it's IMPOSSIBLE.
Friday, July 13, 2007
Reduce Your Medical Billing Firm's Claims Rejection Rate!
IMPORTANT TO KNOW... Stay on top of current and changing requirements to reduce your Medical Billing Firm's claims rejection rate!
Treatment may be covered for one condition but not covered for another. For example, arthodesis may be covered for a dislocation but not covered for an anomaly. Remember, the pairing of the condition with the treatment determines which line the service is on.
Reasons For Denied or Returned Claims:
A Clean Claim means a claim that has no defect, impropriety, lack of any required substantiating documentation or particular circumstance requiring special treatment that prevents timely payment in accordance with the Member's Health Benefits Plan and the Provider - Payer Agreement.
A Clean Claim shall not include those claims which require coordination of benefits and third party liability issues until receipt of Explanation of Benefits from primary carrier or claims, which are being reviewed by the Medical Director, Medical Consultant, or Peer Review for medical necessity.
A clean claim shall accurately reflect billed Charges. “Substantiating Documentation” includes, but is not limited to:
Legible claim form—CMS UB 92, CMS 1500 or other required forms
Full Name of Patient/OHP Member
Member's Date of Birth
Member's Recipient ID Number
Date(s) of Service
Place of Service
CPT Procedure Code
Modifier(s) if applicable
Line Item and Total Charges
Quantity of Units of Service
ICD-9 CM Diagnosis Code (to the highest specificity)
Physician's Name and Address
Physician's Tax ID Number
Bill type
Admission date and time
Discharge date and time
Billing number for Facility
Revenue Center Code
Date of Service for each line item
Quantity of units of service
Line item charges
ICD-9 CM Diagnosis Code (to the highest specificity)
CPT HCPC code
Attending Provider Number
If applicable, Inpatient Nursing Facilities
Bill type
Admission date and time
Discharge date and time
Nursing Facility Billing Provider Number
Type of Admission Code
Patient Discharge Status Code
Date of Service (dates of admission through discharge)
Dates of Service through discharge except continuous stay nursing facility clients
(Use the last day of the month or the discharge date)
Revenue Center Code(s)
Line item charge(s)
Total Charge
ICD-9 CM Diagnosis Code (to the highest specificity)
ICD 9 CM Procedure Code when a procedure is performed
Attending Physician OMAP Provider Number
Written referral, if applicable
A Clean Claim shall not include those claims which require coordination of benefits and third party liability issues until receipt of Explanation of Benefits from primary carrier or claims, which are being reviewed by the Medical Director, Medical Consultant, or Peer Review for medical necessity.
Do yourself a favor and cross-check each claim that you enter to verify you have all applicalble information above.
You are a professional medical biller - do your BEST to gain the knowledge and skills required to EARN the right to call yourself such.
For help or guidance on this and more, visit www.MedicalBillingFoundation.com
Treatment may be covered for one condition but not covered for another. For example, arthodesis may be covered for a dislocation but not covered for an anomaly. Remember, the pairing of the condition with the treatment determines which line the service is on.
Reasons For Denied or Returned Claims:
A Clean Claim means a claim that has no defect, impropriety, lack of any required substantiating documentation or particular circumstance requiring special treatment that prevents timely payment in accordance with the Member's Health Benefits Plan and the Provider - Payer Agreement.
A Clean Claim shall not include those claims which require coordination of benefits and third party liability issues until receipt of Explanation of Benefits from primary carrier or claims, which are being reviewed by the Medical Director, Medical Consultant, or Peer Review for medical necessity.
A clean claim shall accurately reflect billed Charges. “Substantiating Documentation” includes, but is not limited to:
Legible claim form—CMS UB 92, CMS 1500 or other required forms
Full Name of Patient/OHP Member
Member's Date of Birth
Member's Recipient ID Number
Date(s) of Service
Place of Service
CPT Procedure Code
Modifier(s) if applicable
Line Item and Total Charges
Quantity of Units of Service
ICD-9 CM Diagnosis Code (to the highest specificity)
Physician's Name and Address
Physician's Tax ID Number
Bill type
Admission date and time
Discharge date and time
Billing number for Facility
Revenue Center Code
Date of Service for each line item
Quantity of units of service
Line item charges
ICD-9 CM Diagnosis Code (to the highest specificity)
CPT HCPC code
Attending Provider Number
If applicable, Inpatient Nursing Facilities
Bill type
Admission date and time
Discharge date and time
Nursing Facility Billing Provider Number
Type of Admission Code
Patient Discharge Status Code
Date of Service (dates of admission through discharge)
Dates of Service through discharge except continuous stay nursing facility clients
(Use the last day of the month or the discharge date)
Revenue Center Code(s)
Line item charge(s)
Total Charge
ICD-9 CM Diagnosis Code (to the highest specificity)
ICD 9 CM Procedure Code when a procedure is performed
Attending Physician OMAP Provider Number
Written referral, if applicable
A Clean Claim shall not include those claims which require coordination of benefits and third party liability issues until receipt of Explanation of Benefits from primary carrier or claims, which are being reviewed by the Medical Director, Medical Consultant, or Peer Review for medical necessity.
Do yourself a favor and cross-check each claim that you enter to verify you have all applicalble information above.
You are a professional medical biller - do your BEST to gain the knowledge and skills required to EARN the right to call yourself such.
For help or guidance on this and more, visit www.MedicalBillingFoundation.com
Monday, July 9, 2007
Medical Billing Tip - STOP PROCRASTINATING!
I found this article which can help ANY person in ANY business type, but I found that it hit home for me in my industry which is medical billing. I often work into the night, feeling that there is NEVER enough time during the day to get done all that I have to do. This can be a NASTY business practice - it invites a feeling of resentment toward's one's very own business.
Projects are a challenge and breaking a project down to reasonable pieces can be a BIGGER challenge.
Here is a list of 5 tips from an expert.
You can read more at www.ezinearticles.com
As you read this, think through these tips and how they relate to you and your duties as a professional medical biller!
Developing the skill of procrastinating over an activity that doesn’t have much impact on your business is not an issue. The problems start when you procrastinate over important and critical activities that have an impact on your productivity and increase your stress levels.
Here are five top tips to help you overcome procrastination.
1. Daily planning the night before.
People don't plan to fail; they do sometimes fail to plan. Without a plan of action in place before you arrive for work it’s too easy to get caught up in ‘stuff’. The phone rings, you get engrossed in your emails, someone pops into the office and you spend your time responding to the loudest voices rather than to the most important priorities. A plan of action, prepared the night before is like a roadmap for the next day. It focuses your brain on the important aspects of the day and creates a path of the steps you need to take to get you into productive action and away from procrastination.
2. Work with a clean desk.
Out of sight, out of mind. The reverse of that is also true. When it's in sight, it's in mind and most of us can’t help getting distracted. You’ll then create the danger of your time being directed to less important and easier tasks, causing you to put off more important activities. Working with a clean desk or clean work environment allows you to focus all your attention on the most important tasks…without other visual distractions.
3. Reduce large projects to bite-sized pieces.
How do you eat an elephant? One bite at a time!
Tomorrow you plan to work on a three-hour project. Unless you are very lucky, you won’t have three hours to work on any one activity. You have to deal with interruptions, meetings and anything else that crops up. That’s in addition to the challenge of a three-hour attention span! It’s easy to end up procrastinating on big tasks because you’ve not enough time to get it done. So, instead of scheduling the entire three-hour project for tomorrow, schedule a small bite: a step or two that might take 20 or 30 minutes. Then put the next step on the next day's ‘Action Plan’ list and the next step after that on the next day's plan. It may take you several days, but you will get that elephant eaten up, one bite at a time.
4. Plan around interruptions.
Interruptions tend to occur in identifiable patterns. You may get most of your interruptions early in the day rather than later in the day. You may get most of your interruptions early in the week rather than later in the week. So, if you plan a big project make sure it works with your normal schedule of activity. Don’t create stress for yourself before you begin. As soon as your interruptions arrive they will re-focus your attention, causing you to procrastinate what you really want to do. It’s so much easier swimming downstream with the current rather than against the tide. Therefore, plan those larger projects for quieter times of your day and week when you tend to get fewer interruptions.
5. Assign deadlines.
Have you ever failed to achieve a New Year's resolution? If so, that probably happened because you didn’t set a deadline. Deadlines will move you to action. Without a deadline, activities will end up in your ‘soon as possible’ pile, a never never land where items might get attended to some day, when you get the time. Create a deadline and you’ll be moved to action.
Now go do those sales and marketing activities you know will generate business for you!
Projects are a challenge and breaking a project down to reasonable pieces can be a BIGGER challenge.
Here is a list of 5 tips from an expert.
You can read more at www.ezinearticles.com
As you read this, think through these tips and how they relate to you and your duties as a professional medical biller!
Developing the skill of procrastinating over an activity that doesn’t have much impact on your business is not an issue. The problems start when you procrastinate over important and critical activities that have an impact on your productivity and increase your stress levels.
Here are five top tips to help you overcome procrastination.
1. Daily planning the night before.
People don't plan to fail; they do sometimes fail to plan. Without a plan of action in place before you arrive for work it’s too easy to get caught up in ‘stuff’. The phone rings, you get engrossed in your emails, someone pops into the office and you spend your time responding to the loudest voices rather than to the most important priorities. A plan of action, prepared the night before is like a roadmap for the next day. It focuses your brain on the important aspects of the day and creates a path of the steps you need to take to get you into productive action and away from procrastination.
2. Work with a clean desk.
Out of sight, out of mind. The reverse of that is also true. When it's in sight, it's in mind and most of us can’t help getting distracted. You’ll then create the danger of your time being directed to less important and easier tasks, causing you to put off more important activities. Working with a clean desk or clean work environment allows you to focus all your attention on the most important tasks…without other visual distractions.
3. Reduce large projects to bite-sized pieces.
How do you eat an elephant? One bite at a time!
Tomorrow you plan to work on a three-hour project. Unless you are very lucky, you won’t have three hours to work on any one activity. You have to deal with interruptions, meetings and anything else that crops up. That’s in addition to the challenge of a three-hour attention span! It’s easy to end up procrastinating on big tasks because you’ve not enough time to get it done. So, instead of scheduling the entire three-hour project for tomorrow, schedule a small bite: a step or two that might take 20 or 30 minutes. Then put the next step on the next day's ‘Action Plan’ list and the next step after that on the next day's plan. It may take you several days, but you will get that elephant eaten up, one bite at a time.
4. Plan around interruptions.
Interruptions tend to occur in identifiable patterns. You may get most of your interruptions early in the day rather than later in the day. You may get most of your interruptions early in the week rather than later in the week. So, if you plan a big project make sure it works with your normal schedule of activity. Don’t create stress for yourself before you begin. As soon as your interruptions arrive they will re-focus your attention, causing you to procrastinate what you really want to do. It’s so much easier swimming downstream with the current rather than against the tide. Therefore, plan those larger projects for quieter times of your day and week when you tend to get fewer interruptions.
5. Assign deadlines.
Have you ever failed to achieve a New Year's resolution? If so, that probably happened because you didn’t set a deadline. Deadlines will move you to action. Without a deadline, activities will end up in your ‘soon as possible’ pile, a never never land where items might get attended to some day, when you get the time. Create a deadline and you’ll be moved to action.
Now go do those sales and marketing activities you know will generate business for you!
Wednesday, July 4, 2007
Medical Billing - Web Presence; Is it Necessary?
YES. YES. YES!!!
As a medical billing professional, I purchased a web site immediately! I did not have much money, so I purchased a basic template that had several pages about what I do. As I mentioned, it was a template - quite generic, but it offered me a lot. It offered me the appearance of having more experience than I really had. Also, a few days after meeting with a practice owner, handing them my business card and "First Appointment Folder", they would review the provided information and visit my site to confirm all that I promised them. Medical Billing companies that do not own a web site do NOT do as well as those that own one.
Again, starting off is difficult and costly, so just get a VERY basic site that describes your talents and details exactly what you do. Templates are available to you for very little cost at www.MedicalBillingFoundation.com. I am confident that the sites available there are under $500! That is "CHEAP"! (pardon the expression)
As a medical biller, a web presence is a necessity! Mark my words!
So the tip for today is to get yourself a web site - no matter how basic. Your company will be "Googled"! I promise you!
As a medical billing professional, I purchased a web site immediately! I did not have much money, so I purchased a basic template that had several pages about what I do. As I mentioned, it was a template - quite generic, but it offered me a lot. It offered me the appearance of having more experience than I really had. Also, a few days after meeting with a practice owner, handing them my business card and "First Appointment Folder", they would review the provided information and visit my site to confirm all that I promised them. Medical Billing companies that do not own a web site do NOT do as well as those that own one.
Again, starting off is difficult and costly, so just get a VERY basic site that describes your talents and details exactly what you do. Templates are available to you for very little cost at www.MedicalBillingFoundation.com. I am confident that the sites available there are under $500! That is "CHEAP"! (pardon the expression)
As a medical biller, a web presence is a necessity! Mark my words!
So the tip for today is to get yourself a web site - no matter how basic. Your company will be "Googled"! I promise you!
Tuesday, July 3, 2007
Medical Billing - You DO NOT Need to Earn a Coding Degree! Suprised??
Many individuals considering a career in Medical Billing have ZERO knowledge about the industry and the requirements to open a Medical Billing Firm. MOST will speak to friends and family, call local colleges, and search the web looking for information on HOW to begin. A COMMON misconception is the necessity of becoming a certified coder.
I own and operate a successful medical billing company. I am NOT a certified coder, nor do I pretend to be. I HIRED a certified coder as a member of my staff. This young woman attended a medical coding course for 1.5 years and was referred to me for work. What people don't realize is after you spend $5,000 to $15,000 on a coding certification course, you complete the course with one MAJOR QUESTION - "Now what do I do?" Many of these medical coding institutions CLAIM that the employment market offers a LONG list of coding jobs. This is simply NOT the case. A certified medical coder MAY find work at a hospital or major clinic. That's it. I know MANY coders that finish their education and CANNOT find work - they don't fulfill a need.
Medical Billing is a different animal all together. What I recommend is the following;
1. Go to www.MedicalCourse.com and buy the 9-chapter course on medical BILLING. Tammy Harlan is the owner of this course and it's offerings. I took the course and I cannot tell you the value and understanding of billing that I learned. It walks you through ALL aspects from start to finish - from the point of receiving a superbill and patient info sheet all the way through posting payments and aging. It also educates the student on industry rules and language. It is a VERY cost effective course being offered for UNDER $1000, start to finish. ALSO, it is taken at your own pace. Some finish the course in two weeks, some in two months - depends upon the student's employment status, commitment and personal obligations to study around.
2.Align yourself with a powerful, accredited medical billing software provider. My favorite? DAQBilling, by Antek Healthware out of Maryland. This company is phenomenal. Their tech support is top notch and their SALES assistance is key to your success in this industry!
3. Go to www.MedicalBillingFoundation.com. This site was created by an alliance of members who ARE successful medical billers. They recognized that new Medical Billers still have a VOID even if they complete steps one and two (indicated above). New Medical Billers are HUNGRY for help in the STREET portion of really applying their new knowledge to practical application - LIVE on the street, meeting private practice owners and doctors. They offer networking advise, effective marketing tools, a modifiable brochure and business card template, presentation documents, proposal ideas and documents, contracts and agreements relating to confidentiality and HIPAA compliance. THE WORKS. They also offer monthly webinars, conference calls and regional seminars. Why REINVENT THE WHEEL? Rub elbows with fellow medical billers - successful ones. Their package is ALSO under $1,000! AND, the webinars, conference calls and seminars are VERY reasonable prices d too.
With the three steps COMPLETED above YOU WILL BECOME A SUCCESSFULL MEDICAL BILLER.
Tip for today?
DO NOT WASTE YOUR MONEY ON A MEDICAL CODING DEGREE - UNLESS you would like to work in a hospital.
If you are looking to STARTING a Medical Billing Firm - DO THE COURSE, GET DAQBilling, Get the tools for success.
This, my friend, is ALL YOU NEED.
This is one heck of a tip.
The only thing that I cannot offer you IS THE DRIVE for success.
I suspect that you have it if you are willing to invest (LESS THAN) $7,000 on your business.
I am not down playing the amount of money $7,000 is - BUT, NO OTHER BUSINESS OPORTUNITY IS AVAILABLE FOR THAT LITTLE MONEY.
GO FOR IT!
I own and operate a successful medical billing company. I am NOT a certified coder, nor do I pretend to be. I HIRED a certified coder as a member of my staff. This young woman attended a medical coding course for 1.5 years and was referred to me for work. What people don't realize is after you spend $5,000 to $15,000 on a coding certification course, you complete the course with one MAJOR QUESTION - "Now what do I do?" Many of these medical coding institutions CLAIM that the employment market offers a LONG list of coding jobs. This is simply NOT the case. A certified medical coder MAY find work at a hospital or major clinic. That's it. I know MANY coders that finish their education and CANNOT find work - they don't fulfill a need.
Medical Billing is a different animal all together. What I recommend is the following;
1. Go to www.MedicalCourse.com and buy the 9-chapter course on medical BILLING. Tammy Harlan is the owner of this course and it's offerings. I took the course and I cannot tell you the value and understanding of billing that I learned. It walks you through ALL aspects from start to finish - from the point of receiving a superbill and patient info sheet all the way through posting payments and aging. It also educates the student on industry rules and language. It is a VERY cost effective course being offered for UNDER $1000, start to finish. ALSO, it is taken at your own pace. Some finish the course in two weeks, some in two months - depends upon the student's employment status, commitment and personal obligations to study around.
2.Align yourself with a powerful, accredited medical billing software provider. My favorite? DAQBilling, by Antek Healthware out of Maryland. This company is phenomenal. Their tech support is top notch and their SALES assistance is key to your success in this industry!
3. Go to www.MedicalBillingFoundation.com. This site was created by an alliance of members who ARE successful medical billers. They recognized that new Medical Billers still have a VOID even if they complete steps one and two (indicated above). New Medical Billers are HUNGRY for help in the STREET portion of really applying their new knowledge to practical application - LIVE on the street, meeting private practice owners and doctors. They offer networking advise, effective marketing tools, a modifiable brochure and business card template, presentation documents, proposal ideas and documents, contracts and agreements relating to confidentiality and HIPAA compliance. THE WORKS. They also offer monthly webinars, conference calls and regional seminars. Why REINVENT THE WHEEL? Rub elbows with fellow medical billers - successful ones. Their package is ALSO under $1,000! AND, the webinars, conference calls and seminars are VERY reasonable prices d too.
With the three steps COMPLETED above YOU WILL BECOME A SUCCESSFULL MEDICAL BILLER.
Tip for today?
DO NOT WASTE YOUR MONEY ON A MEDICAL CODING DEGREE - UNLESS you would like to work in a hospital.
If you are looking to STARTING a Medical Billing Firm - DO THE COURSE, GET DAQBilling, Get the tools for success.
This, my friend, is ALL YOU NEED.
This is one heck of a tip.
The only thing that I cannot offer you IS THE DRIVE for success.
I suspect that you have it if you are willing to invest (LESS THAN) $7,000 on your business.
I am not down playing the amount of money $7,000 is - BUT, NO OTHER BUSINESS OPORTUNITY IS AVAILABLE FOR THAT LITTLE MONEY.
GO FOR IT!
Monday, July 2, 2007
Medical Billing - The Truth About this Industry & It's Potential
"Medical Billing Home/Office Business
The health care industry is predicted to add nearly 3.5 million new jobs between 2002 and 2012, an increase of 30%. (U.S. Bureau of Labor Statistics). Taking advantage of this growth by beginning a Medical Billing Business now is a smart move!"
The quote above was provided by Tammy Harlan of www.MedicalBillingCourse.com, a nationally recognized course offered for VERY reasonable costs.
This medical billing business is NOT seasonal and it IS recession-proof. Doctors need to bill for patients that saw them on Valentine's Day, Christmas day, during Hanukah, Thanksgiving, etc.
So, TODAY's tip is to GET INVOLVED IN ONE OF THE ONLY GROWING INDUSTRIES IN THIS COUNTRY!
The health care industry is predicted to add nearly 3.5 million new jobs between 2002 and 2012, an increase of 30%. (U.S. Bureau of Labor Statistics). Taking advantage of this growth by beginning a Medical Billing Business now is a smart move!"
The quote above was provided by Tammy Harlan of www.MedicalBillingCourse.com, a nationally recognized course offered for VERY reasonable costs.
This medical billing business is NOT seasonal and it IS recession-proof. Doctors need to bill for patients that saw them on Valentine's Day, Christmas day, during Hanukah, Thanksgiving, etc.
So, TODAY's tip is to GET INVOLVED IN ONE OF THE ONLY GROWING INDUSTRIES IN THIS COUNTRY!
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