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Latest Updates on Medical Billing

Latest Updates on Medical Billing

It can be the most unpleasant of surprises at a time a patient is still recovering from a recent surgery: A bill for hundreds, if not thousands, of dollars for medical services shows up — services that the patient believed were covered by insurance. In one scenario, the hospital and surgeon are in-network but, unknown to the patient, the anesthesiologist or radiologist or other specialist is not. So when the insurer balks at paying the

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IF YOU HAVE EVER EXPERIENCED a hospital stay, you have probably been confused by the bills. Surgery that requires several days in a facility can result in a line-item bill that will make your head spin. And even a quick emergency room visit can involve multiple tests and medical professionals — some possibly outside your insurance network — that will make deciphering the bills even more difficult. If you have a medical bill that is

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Illinois Valley Community College’s Continuing Education Office will offer a medical billing and coding program Tuesdays and Thursdays, Oct. 6 through Dec. 8 and Saturdays Oct. 24, Nov. 7 and 21. This 80-hour course will offer the skills needed to solve insurance billing problems, manually file claims, complete common insurance forms, trace delinquent claims, appeal denied claims, and use generic forms to streamline billing procedures. The course covers the following areas: Current Procedural Terminology (CPT),

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Mountain Medical Physician Specialists, one of the largest radiology practices in the U.S., with over 70 full-time physicians providing services in Utah and Idaho, has awarded MBX – Medical Billing Experts an exclusive outsourced medical billing contract. Historically, Mountain Medical has performed their billing in-house but the system was approaching end of life. “This caused us to review our billing operations and we ultimately concluded that outsourcing was the way to maximize operational efficiency and

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ICD-10 has been a coding conversation. I think it needs to be a documentation conversation. With less than a week until the long awaited—and for many, feared—deadline to ICD-10, reactions are at fever pitch. But as we enter the final days of preparation, have we asked all the right questions? Is ICD-10 really, as they say, a coding issue? Coders can only code what’s been documented; it’s as simple as that. If physicians don’t document

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ICD-10 is just a few weeks from “going live.” If your implementation plan involves using the Centers for Medicare & Medicaid Services’ (CMS) General Equivalence Mappings (GEMs) to “translate” your most common ICD-9 codes to ICD-10, you should (quickly) adopt a new plan. The Centers for Medicare & Medicaid Services (CMS) created the General Equivalence Mappings, or GEMs to assist in the conversion of I-9 to I-10 (other organizations have created similar mapping tools). GEMs

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Popular professional networking sites as well as medical services related websites are flooded with articles on benefits of outsourcing medical billing to a billing company. The most common claims are that it can get your revenue flowing in smoothly even during duress. However, providers’ apprehensions about outsourcing their revenue cycle management (RCM) to an external entity retains its own place. So, let us consider some basic parameters to get an answer to this question. Infrastructure

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It was only about 10 minutes into the game when I fell on the soccer pitch this summer and tore a ligament in my knee. My subsequent trip to the hospital garnered me a specific diagnostic code that went to my insurance company. My insurer was then able to see why I sought care and billed accordingly. Despite significant upgrades in medical knowledge and care, the same thing would have happened a decade ago. Those

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Mednax, a medical group based in Sunrise, announced that its affiliate MedData has acquired Texas-based Alegis Revenue Group, a national hospital billing management company. The purchase price was not disclosed. Alegis, of Woodlands, Texas, manages more than $3 billion in charges for more than 240 hospitals nationwide. MedData, acquired by Mednax in 2014, provides billing management services for more than 3,000 physicians at 700 medical centers in 43 states. It is headquartered in Brecksville, Ohio.

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The Centers for Medicare and Medicaid Services’ scheduled switch next month to a larger set of medical billing codes could ease Medicare secondary payer compliance for workers compensation claims.“The amount of detail it will provide the workers comp community will be amazing compared to what we’ve been using before,” said Rafael Gonzalez, Tampa, Florida-based vice president of strategic solutions at Helios Settlement Solutions, a unit of pharmacy benefit manager Helios. The International Classification of Diseases

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