Think About Future While Buying Medical Insurance

Buying a health insurance plan can be an expensive affair, but not buying it is even more expensive, when it comes to life. Simply put, if you do not have medical insurance, you will have to pay for all medical expenses by yourself. In case of medical emergencies, people may find it difficult to generate enough cash on time. On such occasions, medical insurance will come in handy.

In India, over the last few years the market for medical insurance, along with travel insurance has increased in terms of size and customers. Nowadays, even travel insurance plans offer medical insurance as part of their insurance package. These kinds of health insurance plan are synonymous with the offers of a travel insurance cover.

Coverage for various medical expenses, in case of emergencies or accidents, are provided by several mediclaim policies. Accident insurance, which acts as a rider, is provided under medical insurance. People, who think that they do not need a medical insurance, are the kind that may be under the delusion that they may never get sick or get hurt. However, unfortunate or unforeseen circumstances can occur at any time and to anyone. In such circumstances, a medical insurance can prove to be beneficial, especially when it is an emergency.

Typically, an average health insurance plan provides cover for doctor's bills, hospital room expenses, cost of minor surgeries, laboratory tests, X-rays, mental health care and emergency health care. In some case, a health plan may also provide cover for nursing home care, prescription drugs, and use of durable medical equipments, eye-care, and dental care.

In rare cases, a health insurance plan can also provide cover for education programs and support groups. Alcohol de-addiction programs, programs to stop smoking or substance abuse are covered under special types of health insurance. There are sophisticated plans that provide you with your doctor, in the form a relationship manager. In case the insured is admitted in a hospital, the assigned relationship manager will take care of all formalities and provide assistance with treatment.

Cashless services, at hospitals, are another feature. Under the mediclaim plan, the insured is given a card. This card in turn will act like a credit card of sorts. Upon the presentation, the hospital is authorized to go ahead with treatment, despite cash. The insurance company will then proceed to reimburse the hospital for all the expenses, based on the conditions stipulations of the medical insurance policy.

Finally, it is wise to buy a health insurance plan, as emergencies pertaining to health can occur at any time. Most of all choose a health plan that best suit your needs and the one that can provide you with adequate coverage against financial risks that can arise out of medical emergencies.

Is the Job Growth Affected by the Existence of Software That Handles Medical Billing and Coding?   General Overview of the Medical Billing and Coding Process   

6 Reasons to Think About SSI Disability

If you or someone you know has an interest in SSI disability, there are a great deal of things that need to be taken into consideration. Indeed, SSI disability is something that should always have a great deal of thought put into it for best results. In fact, there is really no way to go about it without taking everything into consideration before you start making important steps. In order to ensure that you're on the right path with SSI disability, you'll want to consider the six things that follow; all of which can help to point you in the right direction no matter what your prior history.

If you want to go about getting SSI disability, you have to dispel the myth that it is extremely confusing. In fact, implementing disability insurance isn't nearly as difficult and confusing as it is often thought to be; it's quite straight-forward, actually. All you really have to do is put the right amount of effort into the process, which can dramatically increase your ability to do well when it comes to getting SSI.

SSI disability is something that might not actually apply to you. A lot of people don't realize that they may or may not be candidates for SSI disability depending upon the circumstances. If you have a good idea as of whether or not you are a candidate, you'll be well on your way towards taking the next steps.

Taking with a professional via the telephone is a great way to decide whether or not disability insurance is something that will be right for you. If you are unsure as of which steps to take, this can be quite helpful in changing things for you. Be sure to take everything into consideration before taking any drastic steps.

SSI disability is something that doesn't need to be nearly as expensive to implement as a lot of people think. In fact, implementing SSI is actually a great way to save money in the long-run; it can make a huge difference in your life. The more effort you put into this, the better off you'll be.

Most people think that they area in which they live might have an effect on their ability to get disability insurance. It doesn't have to have anything to do with it, actually. The more you realize this, the easier it will be for you to implement SSI into your life.

You should always set out to find a book on SSI whenever possible. This can dramatically enhance your ability to enjoy understanding the benefits of SSI disability and how they apply to you. The more you can read, the better.

Consider all of the above 6 reasons for SSI disability for best results.

Is the Job Growth Affected by the Existence of Software That Handles Medical Billing and Coding?   General Overview of the Medical Billing and Coding Process   

Why to Use the Established Patient Code 99214 Versus 99213?

Research shows that 61% of Doctors use 99213 to bill for an Established Patient Visit. Many Doctors may be down coding when the visit could justify a higher-level code. CPT Code 99213 is used normally when a patient is not sick and is relatively healthy. For example, a patient cuts his arm but if a patient has an immune disorder or the cut is infected it would be better to bill with a higher-level code.

When you decide it's necessary to code at a higher-level it's important to be mindful of the time you have spent with the patient. Also it does well to keep in mind anything that has moved the focus to another initial complaint can also call for a higher-level code such as 99214. It's important that when a Doctor decides to use a higher-level code, they need to make sure to document, document, document! Good chart notes by a Doctor will help to back up the usage of a higher-level code if it has been denied by the Insurance Company. If the patient has discussed with the Doctor more than one problem, it would be appropriate to add all the diagnosis codes to the claim to meet the criteria for billing at that higher-level code.

A suggestion used by other Doctors for tracking the time spent with a patient would be to have a clock in each exam room and when the Doctor begins their exam, they would write down the time the exam begins and ends on the back of the Superbill. If the Doctor decides that they need to consult with another Doctor regarding their patient, while the patient is still in their office, this time too should be tracked. Writing the time on the back of the Superbill is so the patient does not see the Doctor looking at their watch, which could make the patient feel they are in a hurry and also the patient will most likely never see the time written on the back.

Doctors do well to talk with their Insurance Biller and Staff to let them know that they would like to implement this practice. The majority of Insurance Billers are in an office away from the hands-on patient care that's taking place in the office or the Doctor is using an off-site billing service. Communication with the Insurance Biller, Front Office, Nurses or Back Office Assistants is very important to implement any new practice within the office. A Medical Office that has good communication and cooperation have such a profound affect on any Medical Practice.

Doctors may be hesitant to change from billing 99213 to 99214 for office visits but when they sit down and calculate the time spent, they most likely will recognize they have been giving away hours of their day for free.

Is the Job Growth Affected by the Existence of Software That Handles Medical Billing and Coding?   General Overview of the Medical Billing and Coding Process   

EMS and Fire Department Billing Solutions, Help in the Midst of Chaos

Chaos is hard to control. Working in the medical industry, including EMS and fire department, may be filled with chaos everyday with patients; if not patients, then paperwork to catch up on billing. News reports show some patients don't receive ambulance billing until well after trips to the hospital. The amount of time between hospital visits and making a payment goes so far that patients potentially forget they are in debt. While ambulance billing services controls the status of patient's bills; yet, I don't see anyone is at fault or to blame. It's just chaos. EMS and fire departments have help available to them. Third parties are often being added into the chaos to keep it from spreading and get things organized.

EMS billing gathers current charges, reimbursements, and compliance resources per account. This gives a better understanding of the business that has been going on. This is pre-dispatch work. There are various departments billing companies' work through, such as data import, insurance, coding, or pre-collection. Agencies struggling to process bills and other paper work should consider ways to reduce administrative costs and optimize revenue. There are a few billing ways that help the chaos. Beyond pre-dispatch services, consultations can be utilized throughout your contract with an independent party. Aside from the paper work, an ambulance billing company focuses on full compliance, patient care and manageability. Meaning they will do more for you than organize. They want agencies to be involved in the process where you know and have access to all necessary information to manage EMS operations.

It's not often society associates the fire department with ambulances; yet alone include the fire department with medical industry as I did above. I guess I'm correlating them in the sense of that they are apart of rescuing teams. Fire service billing is an option for municipal offices experiencing budget challenges. As this happens around the country, alternative funding sources are needed to fulfill that financial void. So fire department billing collects department services like hazardous materials, specialty rescue, fire suppression, and motor vehicle accident response and extrications. For both EMS and fire department billing, third party company's services are all encompassing. They bill the correct party, collect payments and keep full track of every transaction for your viewing needs as well. When it's all said and done, it's still your agency's responsibility to know about the right accounts. Billing solutions are there for support and getting paperwork organized.

Is the Job Growth Affected by the Existence of Software That Handles Medical Billing and Coding?   General Overview of the Medical Billing and Coding Process   

The Importance of Medical Billing Codes

The process of medical billing is an interaction between a health care professional and the insurance company. By submitting and following up on insurance claims, healthcare providers receive payment for services they render. Medical billing codes play an important role in this process because they determine the amount of reimbursement the healthcare provider receives. Various codes exist for diagnosis, treatment, drugs, dental services, Medicare, and hospital treatment.

When a patient visits the doctor, a medical record is created. The doctor issues a diagnosis or cites a reason for the visit. A level of service is established, based on patient history, comprehensiveness of a physical examination, and complexity of medical decision making. This service level is subsequently converted to standardized procedure code taken from the Current Procedural Terminology (CPT) database. The diagnosis is also translated to a numerical code, taken from an ICD-9-CM database.

To arrive at these codes, medical coders translate the doctor notes from the patient visit into the proper numerical sequences. Treatment and diagnosis codes are listed on the claim form transmitted to the insurance company. Electronic transmission is the most common method, replacing paper forms used in the past. Medical claim adjusters or examiners with the insurance company process the claims. An approved claim is reimbursed at a certain percentage of billed services pre-negotiated by the insurance company and healthcare provider.

If a medical coder does not understand how to determine and assign the correct codes, the claim will be rejected by the insurance company. A rejected claim is returned to the healthcare provider, usually in the form of an electronic remittance advice or explanation of benefits, also called an EOB. The provider must then decipher the information, reconcile the details with the claim originally submitted, make any necessary corrections to the claim, and submit the revised claim to the insurance company.

Though these extra steps may not seem time or labor intensive for one claim, consider the hundreds of claims submitted by a single healthcare provider each week. In some cases, claims may be rejected and resubmitted multiple times before they are paid in full. It is not uncommon for a provider to eventually give up and accept incomplete reimbursement. To avoid loss of income for the provider, medical coders should assign the correct codes the first time the claim is submitted.

Nearly 50 percent of the time, a claim is either denied, rejected, or overpaid. This is due to the highly complex nature of some claims and errors resulting from similarities that exist with diagnoses. In some cases, the insurance company is to blame for attempting to get away without covering certain services. After the medical coder makes a small adjustment and resubmits the claim with relevant documentation, the denial may be overturned.

On October 01, 2013, the ICD-10-CM database will replace the ICD-9-CM version. Medical coders must become familiar with the medical billing codes contained in this database, so they can hit the ground running when submitting insurance claims in the future. Properly coding each claim ensures that the healthcare provider is accurately reimbursed.

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Tips For Running A Productive Medical Private Practice That Thrives

Running a thriving private medical practice can have its every day challenges. There are quite a few aspects of running a practice that contribute to keeping your staff and yourself productive. One of the first issues is your staff. Having a good staff can mean everything to an efficient practice. It's important to hire friendly, reliable and resourceful people to help run your office. Understanding your staffs strengths and weaknesses is important in order to optimize the work flow.

Having an office manager can help to relieve the physician from every day office issues and endless paperwork. It's also an advantage to "cross train" your employees so that each staff member is interchangeable in most aspects of the office if it gets really busy or if a staff member is out of the office for a period of time.

Another important issue is having an onsite biller or an offsite billing service to handle all the insurance claims and patient accounts. A good and qualified biller is key to a productive office. A good relationship with your biller is crucial. A physician who is running a private practice needs to know how to bill. Physicians didn't realize when they were in medical school that they would become a small business owner. In reality, that's what physicians become whether they like it or not. So it's important that this is a priority when starting a private practice.

Have quarterly promotional events at your office. Become involved with your local community, for example with the local chamber of commerce. Get to know other physicians in your area. A strong relationship is more fruitful and beneficial for your patients.

Another area to concentrate on is the cleanliness of your office. Nothing is worse than walking in as a patient to a dirty and messy physician's office. Patients want to feel welcomed and comforted by the environment they are in before they see the physician. A professional cleaning company is a good idea to have in order to keep the office looking clean and welcoming. Their also should be staff members assigned periodically to check the restrooms to refill the soap dispenser, toilet paper and any other paper products. A sign should also be posted in the restroom the importance of washing your hands after using the facilities. Most office's close at lunch time and that would be a good time to straighten up the waiting room from the mornings patients. This area should also be checked throughout the day.

Doing small things such as these can make a world of difference to your practice and more importantly the patients will feel that they are in good hands and are valued. Happy patients mean more referrals; here's to your thriving business!

Is the Job Growth Affected by the Existence of Software That Handles Medical Billing and Coding?   General Overview of the Medical Billing and Coding Process   

Health Insurance Gimmicks

If you are getting health or medical insurance through your company, hopefully you won't have to worry about being scammed, but if you are looking on your own, you do need to be aware of scams. Getting health insurance shouldn't be a hard thing to do, but due to the recent economy, and people who don't really care about the well beings of others, they have found new ways to scam the population. There are a few signs you should look for to determine whether or not you are being scammed.

One sign is if the sales person is extremely pushy, you know, like when you are thinking about signing up for a gym and they tell you to sign up that day because they are having a special deal that ends tomorrow. Also, if the sales person seems to harass you with calls, emails and faxes saying you don't want to miss out on their good deal. They may be reluctant to give all the details of the offer, but might still want to get your personal information from you even before you sign up.

A type of scam that has been going around is those in which have to do with the health-care reform. If the sales rep says that they work with the government, or are part of "Obamacare" it is a scam. "Obamacare" is not actually a type of healthcare like medicare or medicade, so do not be fooled when you hear this term. Health insurance in the United States does not technically go through the government, and there are no plans for this to change. So, if a sales rep tells you they are with the government or a government program, you are probably getting scammed.

Of course, like with any deal, if it seems too good to be true, then it probably is. Some of these so called "companies" that are offering "insurance" will have offers with extremely low rates or premiums. If you have done your homework and find that this one offer has a rate that is way lower than those of other trusted companies, it is probably a fake. They may also offer you the insurance plan without checking for a pre-exisiting condition, or they say it doesn't matter what type of pre-existing condition you have that you can still be covered. Don't fall into this gimmick.

If you do decide to go with this insurance policy, you probably will find that your insurance card or policy information never makes it out to you. Companies that are legitimate will send you your insurance card within an appropriate amount of time; they may even give you a temporary card if you ask for one. So, if you have been waiting and waiting for your card or policy, chances are you probably won't get one and won't get a straight answer as to why when you call and ask the company. If you still decide that they are in fact a real company and aren't taking you for a ride, you will probably have some issues when it comes time to pay the medical bills. When they receive your bill, chances are they aren't going to pay for it, and if you ask why not they will tell you there must have been a mistake with accounting, or some other excuse.

Do your research when looking at health insurance. If the offer the company is giving you seems like it is too good to be true, chances are it probably is. Before you sign any papers agreeing or accepting an insurance policy, have a lawyer whom you trust look it over just to be sure. Knowing what the warning signs of a scam are is the first step to protecting yourself.

Is the Job Growth Affected by the Existence of Software That Handles Medical Billing and Coding?   General Overview of the Medical Billing and Coding Process   

Billing and Collections During Hard Economic Times Part I

Insurance companies are more and more shrinking reimbursement to physicians. Unfortunately this is out of the physicians control but there's hope. Physicians and medical insurance billers need to be more aggressive and in turn they will be more successful in collecting payment from insurance companies and patients that is owed to them. There are two aspects of revenue being decreased. First, claims are being denied by insurers and some claims are not resubmitted after a denial, or if they are resubmitted, they are past the allowable date. Generally, about 7% to 15% of claims are denied by insurers.

Second, because of these hard economic times, patients are simply not paying their bills. A study showed that 40% to 50% of patient balances are not being paid. This is sometimes due to high deductible health plans and the rise in people losing their jobs.

Most physicians have mastered their specialty but didn't realize that they would have to become business owners and also would need to learn the billing part of their business.

Physicians should compile a spreadsheet that shows each month's accounts receivable compared to the prior months. It should also list the date of submission of all claims and the number of denials each month. The number of denied claims resubmitted and the time that it took to resubmit the denied claims.

Offices that employ an onsite biller can delegate this responsibility to this person; or even better using an outside billing service they should be able to provide this type of report for you.

Start with denied claims

Some of the most common reasons a claim is denied is problems with eligibility and benefits verification. This should be verified EVERY time a patient comes in the office, even if it was the day before. Anything can change and it could mean losing out on revenue. Some other reasons are miscoding, duplicate submissions, transposed or missing numbers and billing the secondary insurance plan instead of the primary plan.

Improve the way patients are checked in during the registration process. It may take a little more time but the form that patients fill out when they are new or returning should be thoroughly gone over with the patient to verify everything is correct. On the patient registration form at the top should be an expiration date of the form that should be re-filled out after at least a year. Changes happen in people's lives everyday; divorce, new insurance, new job, change of address, change of phone number and all these things can affect your claim and could lead to a denial.

In the following article we will continue to discuss ways to collect and how to avoid denials from insurance companies. Collecting from patients will be the next subject we discuss in detail.

Is the Job Growth Affected by the Existence of Software That Handles Medical Billing and Coding?   General Overview of the Medical Billing and Coding Process   

A Brief on Medical Billing And Coding Schools

Medical billing and coding schools will help a person to obtain employment in medical billing. In order to obtain employment, a person needs to go to the right school. There are many schools that offer medical billing and coding, but they all may not prepare the person to be successful. In order to start the process of working in the medical field, a person will need to research the top three schools. Most doctors will prefer a person who has received not only book training, but hands-on-experience.

Self-Paced and Vocational Schools Online

Career Step is a self-paced online course that takes 640 hours to complete. The course prepares students to sit to become certified. There is no hands-on-training, but a student will not have a hard time finding employment after graduation. Career Step is one the medical billing and coding schools that provides a quality education to their students. At Career Step, the financial aid department will help a student to finance their education. They offer private loans, scholarships, and payment plans.

A person who doesn't have the funds to a self-paced school can look for vocational schools. Vocational schools that offer medical billing and coding can be found by entering in "medical billing and coding" and "vocational schools" in the search engine box. Vocational schools may offer financial assistance to students. Most of the medical billing and coding schools offer training online. A person may want to contact as many schools as possible to find out what their curriculum is and if the school offers job placement. It may be a good idea to find a vocational school in the same state that you live since a lot of the schools tend to have connections in the state where the school is located.

Community Colleges

Medical billing and coding schools online are good for someone who doesn't want to commute to school. On the other hand, a student may need to see their instructor face-to-face. Community colleges are another place where a person can receive training in medical billing and coding. When a person goes to a community college, they can apply for financial aid. The student may have to take entrance tests such as Reading, Writing, and Math. Once the student graduates from the course, they will be able to find work if they get into contact with the Career Services department. At a community college, the Career Services department has a list of hospitals and clinics that hire their graduates.

Is the Job Growth Affected by the Existence of Software That Handles Medical Billing and Coding?   General Overview of the Medical Billing and Coding Process   

Have Insurance For Your Medical Needs

Medical insurance has emerged as the need of the hour. The advantage of having insurance can be succinctly summarized into, 'takes care of your medical bills.' In case of emergencies or even in regular situations, people may require medical care. Sometimes it's affordable but how about when it's not? Well, you will most definitely end up in a very sticky situation that requires monetary help. With medical insurance or a health insurance plan, you'll never have to worry about that kind of situation and consequently, save a life!

The need of insurance has increased considerably over the last few years. Factors such as an increase in cost of living, inflation, medical expenses and various other factors can be attributed to this reason. insurance can serve the need of taking care of your medical expenses, especially in times of emergencies. A Health insurance plan also serves this same purpose, but it facilitates a larger cover. It caters to covering medical expenses that can be incurred as part of the doctor's consultation fees, medical tests, purchase of medicines, use of ambulance and X-rays and various other medical needs. In any case, they can prove to be very useful.

Corporate insurance are group policies, under which employees of an organisation are covered under the medical insurance of one policy provider. In this case, the premiums are paid by deducting a part of the employee's salary. In most cases, medical insurance or a health insurance plan is included as part of the employee CTC. Some companies also provide cover to their employees in case of accidents, or in other words accident insurance. This is kind of insurance serves the need for bearing medical expenses, exclusively for accident cases. Accident insurance provides additional rider benefits, which may not be covered under an ordinary health insurance plan. Medical claim policies that pertain to these are usually bought on a professional basis. Drivers, sport car drivers, bike racers, etc. are usually the recipients for this kind of insurance.

Travel insurance, which is generally bought online, caters to insurance in foreign countries. This is because having a domestic insurance will not cover medical expenses arising in foreign countries. In the event of a foreign tour plan, it would prove to be more prudent to have travel insurance. There are several insurance companies in India that provide some of the best and the most beneficial travel insurance plans. Especially in countries like USA and Canada, where medical expenses are extremely high, travel insurance can and will prove to be a very beneficial and helpful companion.

Is the Job Growth Affected by the Existence of Software That Handles Medical Billing and Coding?   General Overview of the Medical Billing and Coding Process   

How Does Cancer Insurance Pay?

Cancer insurance is designed to be used with a comprehensive health insurance policy. It pays the policy holder in a lump sum once a doctor has confirmed a positive diagnosis. The benefits can be used in a variety of ways to help defer the cost of treatment.

Using Cancer Insurance to Pay Medical Bills

A comprehensive health insurance plan will pay a large portion of your medical expenses for treatment, but there is always a portion that is the responsibility of the policy holder. A cancer policy can be used to pay off the amount that is left over once the health insurance has paid its part. Sometimes this can be a significant amount, depending on the type of health insurance coverage.

Cancer Insurance for Out of Network Costs

Some people have to make a choice about their own health care treatment and those options are not always covered by a comprehensive plan. When a patient chooses a doctor for their cancer treatment that is out of the doctor network designed by their health insurance, the financial benefits of the health insurance are significantly decreased. The policy may cover a lower percentage of the total bill compared to an in network doctor. These benefits can help with the costs of out of network care.

Cancer Policy for Experimental Treatment Drugs

Experimental treatment and drugs are also an issue with a normal health policy and are rarely covered. A cancer policy will help you fund experimental treatments and drugs when a health care policy fails to. This leaves more treatment options open for the cancer policy beneficiary than someone who does not have this coverage.

Paying Non Medical Bills with Cancer Policy

Income lost during treatment can be devastating to a family. These pay outs can be used for everyday bills while receiving treatments. The house payment, car insurance, groceries, and even gas are things the money can be used for to get through those difficult times.

Cancer Insurance for Gas and Lodging

The money received from this additional policy can be used to fund expenses related to treatment. Sometimes treatments require travel and the cost for gas and lodging can add up quickly. Radiation or chemotherapy can be prescribed every day during treatment and being away from home can be costly.

When diagnosed with cancer, the cancer insurance pay out can be used in multiple ways. Whether for medical expenses or day to day bills, this additional policy will help a family through a health and potential financial crisis.

Is the Job Growth Affected by the Existence of Software That Handles Medical Billing and Coding?   General Overview of the Medical Billing and Coding Process   

Medical Billing Outsourcing: Choosing An Appropriate Vendor

The medical billing industry is experiencing some changes and medical billing outsourcing is playing a significant role. The job outlook for medical billers and coders looks promising; however, outsourcing to reduce costs is becoming commonplace. There are several benefits to outsourcing medical billing tasks.

What Do Medical Billing Personnel Do?

Medical billing professionals use a number of skills to complete the claims process on behalf of doctors, hospitals, outpatient facilities and other medical operations. They are responsible for organizing and understanding a health facilities medical data to ensure the information is accurate.

The Billing professional understands human anatomy and medical terminology. He uses this knowledge to ensure claims filed with insurance companies include the appropriate coding for specific conditions, diseases and procedures.

One of the most important components of the job, and one that plays a role in outsourcing, is the understanding of the Health Insurance Portability and Accountability Act. In addition, changes in the American health system will likely require additional knowledge of the Patient Protection and Affordable Care Act.

Billing specialists are also able to identify loopholes and apply their technical skills to identifying billing concerns before they arise.

What Are the Benefits of Outsourcing?

There are multiple benefits involved with outsourcing billing services. Reducing your expenses and gaining the knowledge that someone skilled at billing are two examples. Following are more examples of how outsourcing benefits doctors and other medical vendors:

* Less money spent on employees. Outsourcing medical billing to an experienced and reputable contractor will cost less in health insurance, vacation pay and other costs associated with hiring a full- or part-time employee.

* You gain access to modern technologies. The billing and coding process requires advanced technologies to ensure information complies with government regulations. Contractors have access to the appropriate technologies.

* You may experience increased turnaround time. Doctors may attempt to complete their own medical billing, but in a busy office, this can lead to delays in payment, which affect cash flow. Selecting a contractor for this type of work can increase turnaround times substantially.

What You Should Look For in a Contractor?

Selecting the appropriate business partner is essential to continued success. Not every medical billing contractor is the same. Following are a few key things to consider when searching for a provider:

* Does the company have the level of staff required to support your business? Some companies are small and may have few employees. If you are running an operation that needs to submit multiple claims daily, you may consider finding out how many people the company employs.

* Is the company compliant with HIPAA regulations? Supplying patient information to a company that lacks the appropriate security measures could result in a disaster. Consequently, asking questions about HIPAA compliance and inquiring about training programs offered to employees could make the difference between a happy relationship and a sour one.

* Does the vendor offer relevant reporting tools and generated reports? The purpose of outsourcing is to save money and increase revenue. Understand where the budget is going requires sound information delivered in a timely fashion. Ask the potential vendor if they provide reports. If so, find out if you can customize the reports to fit your needs.

The medical billing and coding industry offers a substantial service that affects the revenue, and overall health, of medical services facilities. Outsourcing certain aspects of the medical office workload can have a positive impact on revenue and expenses. There are multiple contractors available, but asking the right questions will help you decide the best medical billing outsourcing contractor for your needs.

Is the Job Growth Affected by the Existence of Software That Handles Medical Billing and Coding?   General Overview of the Medical Billing and Coding Process   

Billing Practices That Can Be Costly - Part I

Obviously, to receive proper reimbursement it is very important to have accurate coding practices for all health care practitioners however; here are several reasons. A group that is often involved in the billing process is nurse practitioners. Generally they are billing for their own services or they may be using a billing form (superbill) provided by their employer by marking procedural codes and diagnostic codes in order to bill for their services. The responsibility for the accuracy of the coding and billing, as well as for maintaining medical records that support the diagnosis code and procedural code that is being used to bill for specific services, is the professional provider or the nurse practitioner.

Keeping up to date with accurate coding procedures is very important when billing to receive maximum reimbursement. However, due to new codes being added, modified or deleted, this may cause an impact on reimbursement. Sometimes the definition of a code may not be so clear. That's why it is vital to utilize sources that are available to the medical community. Such as workshops, online information and online telephone consultation services for health care providers to get better clarification on a code before billing.

It's also important to remember that even if billing by the physician or nurse practitioner is outsourced to an outside billing service or a trained billing clerk that is onsite, it is the person on whose professional licensure the care and billing are based is the person that is responsible for accurate billing. A nurse practitioner or a physician still has to learn something about reimbursement and coding.

Any health care professional who knowingly cheats on coding to enhance their reimbursement, can be guilty of both civil wrongs which is considered a "breach" of the insurance contract, and it's considered a crime, which can lead to costly legal fees. Billing fraud can also result in having to return part or all of the wrongly paid money, fines, loss of their professional license and possibly serving time in prison.

How do fraudulent claims get noticed? There are several ways. Some insurance carriers have fraud detection software which they use to analyze data. When unusual billing patterns are discovered, they initiate an investigation. Sometimes it is the patient that is complaining about the amount of the bill or services that were billed. Employees have revealed on their good conscience of fraudulent practices and don't want to be part of the scheme or it violates their own ethics. Bottom line is physicians or other health care providers who engage in this type of behavior have been costly and have led to them no longer being able to practice in the medical field.

Is the Job Growth Affected by the Existence of Software That Handles Medical Billing and Coding?   General Overview of the Medical Billing and Coding Process   

Ways to Collect Deductibles at the Beginning of a New Calendar Year

It's that time of year again when patients' deductibles are needed to be met. EOB's are being received with no check and a large portion or all of the amount billed is going towards a patient's deductible. Then from that point, a patient invoice is sent out and it's up to the patient and it's their responsibility to pay the physician. With that in mind, how can practices keep the cash flow going during the first few months of a new calendar year? Most offices have taken a proactive approach with patients that have deductibles.

Here are a few tips on ways to keep a steady cash flow during this time.

(1) Take the appointment schedule for the week or even each day and go through all returning patients and call the insurance company to verify how much of the deductible has been met.

(2) Start a separate list with the patients name and insurance and how much of the deductible has been met and what the deductible amount is.

(3) When making appointments, ask the patient if they have a deductible and if they say they do, then it would be wise to inform them that a portion will be collected at the time of service.

(4) Decide up front how much your office is going to collect, some offices collect between 20% to 30% of the total bill.

(5) Make sure to indicate on the superbill for the insurance biller that the amount collected is for that days visit. Otherwise the patient may have an outstanding account and you don't want to confuse what date of service it should be applied to.

(6) Patients with Medicare may also have a deductible but if they have a secondary insurance, that insurance will usually pick up the secondary balance such as Medi-cal.

Most patients know that they have a deductible and should not be surprised that they are responsible for that portion before their insurance starts to pay. It's best to be as tactful as possible when asking the patient that they are expected to pay up front when a lot of times the patient is ill and it may seem uncomfortable asking for payment under those circumstances but it is not unreasonable.

Even though this may be very time-consuming for the office to handle, it really makes a difference during this time of year when you would normally be receiving payment from the insurance company but many offices have implemented this policy and have seen a big difference in their cash flow. The office will truly benefit and it's also a way to keep your patient portion accounts receivable lower.

Is the Job Growth Affected by the Existence of Software That Handles Medical Billing and Coding?   General Overview of the Medical Billing and Coding Process   

Maximize Your Medisoft! (Unknown and Underused Functions of Medisoft)

How Medisoft Helps Your Practice Run More Efficiently..

Please keep in mind when reading this article that some of the features I will discuss may not be available in earlier versions or in all models, Patient Accounting, Advanced and Network Professional.

Many practices are more than satisfied with the day to day uses of Medisoft. Did you know that most practices are only using Medisoft at approximately 40% of its capabilities?

For those who are unfamiliar with Medisoft, here's a brief review. Medisoft is a physician / medical office practice management software. Any practitioner from physical therapist to brain surgeon can use this software. Facilities and organizations such as pharmacies, home health agencies, billing services and surgery centers can also maximize their office functionality by using Medisoft. The suite of Medisoft solutions gives offices everything they need to completely automate their practice. From scheduling to the electronic documentation of patient care to billing and account management, Medisoft helps make the practice more efficient and more profitable.

Medisoft is the most user friendly software you can buy and can easily be customized to your individual practice needs. Medisoft is more than just a medical billing system, it has the capability to enhance productivity, improve efficiencies, simplify administration and strengthen work and financial flow.

Medisoft manages patient appointment scheduling, patient and insurance past due accounts, collections, write-offs, and patient co-pays. Here are some key features you might not be aware of:

Scheduling Patient Appointments: The workflow process begins when a patient schedules an appointment. Did you know that you can schedule office visit templates so that the Find Open Time feature can be utilized. You can also check patient balances and apply patient balances from the appointment window

Patient Payment Plans: Medisoft has the ability to create patient payment plans that include the date the first payment is due, the payment due date (i.e. every 30 days), as well as the amount due. Should the patient default from the scheduled payment plan, the patient will then be included in the Collection List feature at which time you can generate a collection letter.

Patient Quick Entry: This feature lets you select which fields from the Patient and Case windows are included on a Patient Quick Entry template and you can even include initial default settings. You can also select any custom data elements created in the Custom Patient Designer or Custom Case Designer such as a custom combo box. This feature allows you to enter patient and case data from one easy window.

Collection List: The Collection List has replaced the Work List, which was available in previous versions of Medisoft. The Collection List helps you manage financial transactions that need to be singled out for collection. You can create tickler items to keep track of collection efforts with patients and insurance carriers. You can also generate and track collection letters.

BillFlash Intergration: Medisoft allows you to process your statements online through BillFlash. From Medisoft, you upload your statements to BillFlash and BillFlash handles printing and mailing them. You retain the ability to review and approve the statements before BillFlash distributes them. All of your data is stored and transmitted securely.

Default Printer Option: Medisoft 15 introduced a new feature for selecting a default printer for printing superbills, claims, and statements. This setting is saved to the user's Medisoft login profile/workstation.

Future Appointment Warning- Office Hours Professional and Office Hours Network Professional: Medisoft's Office Hours Professional will alert you when entering a new appointment for a patient that already has a future appointment scheduled. This alert appears in the New Appointment Entry or Edit Appointment Entry window as a "Patient has Future Appointment" button with a lookup magnifying glass. You can click the button to view future appointments for the patient.

Small Balance Write-off Option: Medisoft has the ability to write-off statement balances that have been sent the selected number of times set in the submission count field, by cut off date and/or dollar amount.

Task Scheduler: This feature allows users to schedule backups of their data and schedule reports so that they are automatically generated according to a user defined schedule. This can save valuable time by automating the report printing process.

Final Draft: Final Draft is a word processing program that can pull data from the Medisoft program into documents prepared in Final Draft. You can use this feature to enter patient notes and narratives as well as letters and other documents necessary for the practice. This includes creating templates in the Letter Wizard for things such as appeals and overpayment requests that can automatically pull preselected data from the patient chart.

Medisoft Reports: Medisoft has 229 reports, pie charts and graphs to help you manage your practice. All reports can be modified using the Medisoft Reports Professional version.

Is the Job Growth Affected by the Existence of Software That Handles Medical Billing and Coding?   General Overview of the Medical Billing and Coding Process