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Billing

Billing

medical collections front desk helping patient

5 Tips to Prevent Unpaid Medical Collections – Supercharge Your Staff

For years, deductibles were so low. Payers paid most of the patient responsibility on claim submission. Those days are obviously gone putting the onus on your practice’s medical collections to keep your revenue stream healthy. “Most patients maybe had a $250 or $500 deductible,” recalls medical collections expert Tracy Bird, FACMPE, CPC, CPMA, CEMC, CPC-I, […]
Published Date: September 3, 2019
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Claim form errors

Best Practices to Avoid Costly Claim Form Errors

Everyone makes mistakes. Unfortunately, sometimes small mistakes will cost you big time. Such is the case with claim form errors. The CMS form 1500 is your primary means of getting reimbursement from Medicaid, Medicare, and Tricare. Even a minor claim form error can delay processing and payment or worse—lead to denial. On the flip side, […]
Published Date: August 13, 2019
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Maximize Billable Opportunities for Coding Remote Patient Monitoring

CMS won’t release the 2020 Medicare Physician Fee Schedule final rule until later this fall, but that doesn’t mean you should wait to shore up your reimbursement for coding remote patient monitoring based on the proposed rule. Released in July, the proposed rule contains important clues about what you can expect next year. And even […]
Published Date: August 11, 2019
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What Type of Education Is Needed for Medical Billing and Coding?

Pursuing a career in medical billing and coding can be one of the most rewarding experiences in your life. This is a serious and complex field that is becoming more and more competitive. You don’t have to be a doctor or a nurse to help thousands of patients, because you can contribute quite a lot […]
Published Date: August 4, 2019
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Solve Your 5 Biggest Modifier 59 Problems by Focusing on ‘Separate’

If you’re using Modifier 59 to get paid for multiple procedures, auditors are watching you. Modifier 59 has been on the OIG’s (Office of the Inspector General) radar for a while now, and because of consistent misuse and abuse, it will likely stay that way. Modifier 59 allows you to unbundle — separately report and […]
Published Date: July 29, 2019
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abn form

Medicare’s ABN Form: Top 10 Mistakes You’re Making (and How to Fix Them)

Using Medicare’s ABN form, Advance Beneficiary Notice might be a routine part of your job, but are you sure you’re doing it correctly and compliantly? Providers and staff who treat Medicare patients must know exactly how and when to issue a CMS ABN form to avoid costly write-offs and penalties. If you’re like most providers […]
Published Date: July 3, 2019
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Documentation Checklist Bulletproof Your Claims

Documentation Checklist Can Bulletproof Your Claims

Provider documentation is your only defense if you’re faced with an audit. It must be rock-solid to support the claims you submit to payers. But how can you ensure this happens when each clinician has his or her own style and perspective when documenting a patient encounter? The answer is good basic, defensible documentation. Here […]
Published Date: April 1, 2019
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TRICARE Transition

TRICARE Transition Clarification

All Tricare West providers must secure new contracts with HNFS as UnitedHealthcare will no longer retain this contract. PGBA will remain the claims processor and there will be no disruption...
Published Date: December 1, 2017
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Modifier 51 over 59

When To Use Modifier 51 over 59

When would I use modifier 51 instead of modifier 59? If you would have asked me that question 10 years ago, I would have told you not to use a 51 modifier because it causes bundling reimbursement. But 51 is now in your CPT book for when you are doing skin or endoscopic procedures. There […]
Published Date: September 25, 2017
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