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Medical Billing News

As Kids Grow Older, Egalitarianism Honed
A study in Nature shows that egalitarianism begins to appear in most kids between ages 3 and 8. Scientists who studied 229 Swiss children found that at age 3, 9 percent were willing to share candy with another person. But by age 8, that number rose to 45 percent.

Medication Error Death Rate Up 500 Percent
Painkillers, sleeping pills and anti-anxiety drugs are being prescribed to out-patients in high doses, without the oversight of a doctor. A new study found that in the last 20 years there has been a 500 percent increase in the death rate from medication errors made at home.

Breast Exam Rebuttal: 'An Exam Saved Me'
Last week we reported on a study that showed that self breast exams don't help prevent death from breast cancer in women. The interview generated quite a response from listeners. Several women wrote in to say that they had found cancerous lumps in their own breasts and wouldn't be alive today if not for breast self exams.

A Partisan Divide On Health Care Reform
While both John McCain and Barack Obama agree that the American health care system needs reform, the candidates differ markedly in their vision of the remedy. Political scientist Jonathan Oberlander offers an in-depth comparison of the candidates' proposals.

Web Sites Compare How Hospitals Measure Up
A new Web site called "Hospital Compare" evaluates hospital death rates around the country and shows how individual hospitals stack up against the national average. Guests discuss the reliability of the data on the site and describe the measures hospitals are taking to improve performance.

Doctors Fear Effects Of Illegal Immigrant's Arrest
The recent arrest of a popular woman who happens to be an illegal immigrant has some North Carolina doctors concerned. The woman's immigration status apparently was turned over to authorities after she received medical care. Doctors worry that illegal immigrants will be afraid to seek care, which might lead to public health problems.

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Medical Billing Articles (updated Frequently)

Effective Medical Billing: Get Paid On Time

By: Pinky McBanon

Timely medical claim reimbursement/payments for the medical provider are a serious problem by most of medical practices nowadays. How can a medical practice survive with slow revenue? too many claims denial and rejection? The solution here is to get the collection done as effectively as it can.

Empirically, insurance companies will delay or deny claims payments! They are very slow on medical reviews, predetermination and processing claims. I think, that is one of their business strategies in doing business. They are too is running their own business' revenues. But if you are a good medical biller, you are aggressive and can effectively collect payments in less than the time your provider expects.

Having an effective office manager in your practice that knows the administrative task is very important. As a provider, you should be more focused on your patients' care and not on how you run your practice. Your patients must know their benefits and eligibility. Encourage your patients to contact their insurance company regarding their unpaid claims. The insurance is more attentive when the member makes the phone follow up.

As a medical biller myself, I can collect Medicare payments by "paper billing" in less than 2 weeks!, you can imagine the electronic claims submission. I refuse denial and rejection, because I believe, if the medical service have been rendered, it is just right to have it get paid. Many of my provider clients just give up, but, well, I don't. As long as he wants his payments, I never give up collecting his money.. at the end, we were successfully got paid. It is just a matter of how you deal with the insurance and aggressive follow-ups.

Medical claims should be submitted on a daily basis. Never delay claims submission. Promptly respond "immediately" to insurance letters that you receive, if they require additional documents, such as, medical referral, medical prescription, progress notes and letter of medical necessity to process the claims. Always comply what they require to expedite processing of the claims.

As a medical biller, you should also be a medical coder. The doctor gives the diagnosis description on the script but usually always with the wrong diagnosis code. It is not their concern to code a diagnosis, but to descriptively provide the diagnosis. You must know how to analyze and help your provider submit the right diagnosis code. Analyzing the proper and right diagnosis code is also very effective to get paid. Remember that when submitting your claims, the insurance company does not read your diagnosis' description. They process claims based on the right procedure codes and based on medical necessity (diagnosis code) Right procedure, service and supplies coding is also very essential in submitting your claims (CPT/HCPCS, Modifier Codes). There are procedures that the insurance denies for payment because it is NOT medically necessary based on the diagnosis on the patient. You should understand each insurance company's payment/fees guidelines.

But here's the thing, "if" the insurance company still keep on denying your claims, then it's time for them to get notified, they will be reported for non-payment of claims to the proper agencies/bureaus if they don't process your claims in 15 days!. I think, this time they will be more attentive.

Now, here is another issue, you should choose a medical billing company that will help you do all this. It is going to be a big decision that you have to make. But here are the things that you have to consider in making that decision:

(1) Able to handle accounts regardless of the medical practice account's size

(2) Electronic & Paper Billing Capability with fast-turn around time

(3) Experienced in analyzing proper procedure and diagnosis coding

(4) Lesser claims rejection/denial. Efficient in filing of appeals for denied claims

(5) Knows how to submit claims on worker's compensation and "no-fault"

(6) Unlimited client support and able to provide full service medical billing

(7) and the most important thing, they strictly understand, follow and comply with HIPAA guidelines, rules and regulations.

The Author: Pinky Mcbanon is a Systems Engineer and a Medical Biller/Coder.

About the author:

The Author: Pinky Mcbanon is a Systems Engineer and a Medical Biller/Coder.

She shares her medical billing and coding expertise with http://www.medclaimsplus.com

And she shares her technical support expertise with http://www.fix-exchange.com (your online source for free computer technical support!)

Keywords: Medical Claim Medical Claim, medical claim reimbursement/payments, follow-ups medical claims, medical billing, medical biller, medical, medical practice, claims, claim, timely medical claim

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