Thursday, February 14, 2013

5 Tips for Improving Anesthesia Billing Practice

Medical practices face complex challenges in order to maintain a healthy bottom line. Billing for anesthesia services can be even more complicated. These particular challenges can be overcome by monitoring and streamlining the advanced processes involved in maximizing revenue. Here are 5 tips for improving anesthesia billing practices.

1. Monitor Contracts And Be Familiar With Payors: Anesthesia billing can be more complicated for billers and payors. If a contact is particularly difficult to manage claims can be processed incorrectly, therefore it is crucial to closely monitor contracts and follow up with payors to be certain they are processing claims correctly. Billers need to be familiar with each contract and its cycle, and know what they should receive for the claims.

2. Collect From Patients Up Front: The collection process is an area where many anesthesia providers need improvement. In the last few years, collecting payment from patients has changed dramatically. Billers used to charge the payor and send an invoice. Receiving payment was less of a worry because patients had better means to pay and their deductibles weren’t as high. Billers today have to be much more aggressive to receive payment. Some practices are now requiring payment before services are performed.

It is important to educate patients about the costs of the services they will receive so that they are well informed about what payments they will be responsible for. Discuss a payment plan with the patients who cannot pay in full up front so you both can expect the bill to be paid off quickly.

3. Maintain Effective Collections: An anesthesia biller’s number one priority is to completely capture everything for the day. Ask yourself how long it takes for charges to be entered after service, and how long it takes the practice to submit the claims to the clearinghouse. Charges should be entered within 24 hours of service and claims to the clearinghouse should be made nightly.

Billers should always be sure that the correct payor is being billed, that any and all modifiers are added and that the payment policies of the payor are being adhered to in order to get a claim paid.

Also, be vigilant in monitoring how long unpaid services remain in A/R. Most of your accounts should be in the 30 day range. If you have unpaid services in the 60 or 90 day range you have room for improvement.

4. Be Aware Of Compliance: Providers are  accountable for compliance with the Health Insurance Portability and Accountability Act. There are countless opportunities for HIPPA violations everyday, so medical practices, anesthesiologists and billers need to keep aware of the rules and have a plan for staying up to date on changes. Changing laws have dramatically increased the ability of the U.S. Department of Health and Human Services (HHS) to impose monetary penalties for these violations. HHS is expected to take more formal action when there is willful neglect involved in a violation. Four recent changes that will have a significant impact on providers are:

  • Business associates and their subcontractors are now liable for breaches of personal health information (PHI).
  • Rights of patients to obtain electronic copies of their records have been enhanced
  • Rights of individuals to request restrictions regarding disclosure of their PHI have been enhanced
  • Any disclosure of PHI is now presumed to be a breach under the breach notification rule

Technology can be your best friend when it comes to compliance. Our coding system includes regulatory compliance checks.

5. Pay Special Attention To Post-Op Pain Blocks: Failure to properly document and bill for post-op pain blocks (POP) can result in a reimbursement issue and a compliance issue as well. Practices need to take the time to ensure that their entire billing staff is aware of what is needed for post-op blocks.

A surgeon and anesthesiologist will frequently use the same document to record the anesthesia event and the POP. This usually results in a denial of the claim by the insurance company the first time around. A second form is good practice to clearly separate the POP from the anesthesia delivery used for the surgery itself. It is vital to document the surgeon’s request for the block and a second reason for why the POP was administered.  If the request is not included in the patient’s record, it can be appealed, which will prevent timely payment.

Because billing for anesthesia and POPs is so complex, billers should not assume that all of the documents are complete. Doing so can be just as bad as up-coding. Put a specific plan in place for how your staff will handle the documentation of these procedures.

Is Outsourcing Your Medical Billing the Right Choice?

Many medical practices consider outsourcing billing at some point. There are a lot of reasons why a practice might opt for outsourcing, but the truth is that it isn’t for everyone. The best way to decide if outsourcing is for your practice is to analyze the pro’s and con’s and ask yourself a few basic questions about your business.

First answer the following:
  1. Are you a new practice?
  2. Is billing for your specialty especially complex?
  3. Have you had a high turnover of billing staff or is there a lack of qualified billing staff in your area?
  4. Are your billing processes inefficient (i.e., high denial rate, high A/R, low patient collections, etc.)?
  5. Would you rather focus more on patient care and less on business management tasks?
If you answered “yes” to most of these questions then outsourcing might be a better fit for your needs. However, there are pro’s and con’s to both ways of doing your billing. Simply put, in-house billing allows you to have total control over your billing processes but it also means managing staff, paying more for full time employees, and opening yourself to problems ranging from poor training and job performance to embezzlement.

On the flip side, if you use a reputable billing service, you should see lower costs with a good return on your investment. Generally, you can expect a certain level of results and consistency in performance. The downside is that you will have little control over the process and the cost may vary based on your claim volume at any given time.
To assess the pro’s and con’s for yourself use this simple checklist:
  1. Would you prefer to hand over control over the daily billing process?
  2. Are you concerned about the time and cost involved in managing more full-time staff?
  3. Are you worried about the possibility of embezzlement or negligence in your billing?
  4. Would you rather pay a small percentage of your claims than a full-time salary?
  5. Are you comfortable with the varying cost of outsourcing billing tasks?
  6. Are you looking for more comprehensive reporting and substantial analysis of your business?
  7. Are you concerned about staying on top of changing reimbursement and compliance issues?
If you answered mostly “yes” again, then it is probably time to consider an outsourcing solution. Watch for our next post on outsourcing your billing, Ten Questions to Ask Before Hiring a Billing Service.

Monday, February 4, 2013

Facts about salary differences in medical billing and coding

The salary of medical billing & coding is basically depends upon the type of medical field you have selected for your career. In addition, the certain set of skills and talents is also required in that field. For instance, the average expected salary for the post of medical billing assistant is around $ 45000 or more per annum while in other intricate fields of medical, the salary for the same post can reach at around $ 60000 per annum.images

If you are searching for the salary of billing assistant in Canada, you may search for this in the major cities like Toronto, Ottawa, Vancouver, Edmonton, Montreal and Calgary online and you can see the top companies that are hiring the candidates. Now, you can search for the best healthcare units that hire the people for the job of medical billing and coding and their salary structures.

How medical billers and coders work?

First of all, you will gather the relevant information so that you can start with the pc by inputting all the information. After inputting all the information required by you, the statement or claim will be transferred to the insurance agency. In case, the claim is rejected by the company, this is the duty of the coder to investigate about the reason of rejection. After the claim is accepted, the medical bill will be produced and sent. All these things are considered at Medical Billing & Coding Training.


Friday, January 18, 2013

Five Key Facts Your Doctor Wants You To Know

Being a great patient is a matter of taking an active role in your health care and getting the facts about a few important health care issues. Your doctor is your partner in healthy living – and there are a few key facts that he or she would like you to know.

Here are some of the top issues that you need to know about in order to be healthier and have a great doctor-patient relationship:

If Overweight, Losing Just 10% of Your Weight Will Do You a World of Good

When you’re overweight or obese, it can be frustrating to look at the scale and realize that you need to lose 40, 60 or 80 lbs. However, losing just 10% of your weight is a much more doable goal, and can give you a lot of health benefits. If you’re 200 lbs, the 10% goal is just 20 lbs total.

Losing 10% of your current weight can help improve your heart health and lower cholesterol levels. You’ll have better blood pressure and decrease your risk for diabetes. Your joints and spine will feel less pain because you won’t be carrying as much weight. Your risk for colon and breast cancer will drop. And finally, you’ll have more energy, which will make it easier to exercise more and lose even more weight.

Don’t Believe Everything You See on TV or the Internet

Doctors are facing a huge challenge with misinformation online and on television. Sometimes patients get a particular treatment or prescription into their mind and are convinced that it’s the best option for them. As a patient, you need to trust your doctor’s opinion and not have your mind set on something that you saw on television or read online. This goes for medical conditions as well as specific treatments or prescription medication. Reading something or seeing something and performing a self diagnosis isn’t smart healthcare. Discuss your options with your doctor, let him or her know your concerns and let them make a decision with you.

Herbal Supplements Aren’t Always Safe

Although the FDA regulates herbal supplements, they do so as foods and not drugs. Unlike prescription medication, manufacturers do not have to seek FDA approval before they bring herbal supplements to the market. They can claim certain health benefits – but only if they have supporting research and include a disclaimer from the FDA. Once an herbal supplement is on the market, the FDA will monitor its safety.

However, even if an herbal supplement stays on the market long term, it may not be safe with your prescription medications. Be sure that you let your doctor know about everything that you are taking, and discuss your options before you start taking a new supplement. By doing this, you can avoid serious side effects. You should also avoid supplements if you’re pregnant, breast-feeding, using a blood thinner or having surgery.

Make Good Use of Your Appointment Time

Your doctor is a partner in your health care. But it’s also your responsibility to give them the information that they need to help you. Forgetting to mention important details during your appointment, waiting until the last minute to discuss your problems or ignoring important instructions can impact your level of health care.

Start out by being up front at the start of the appointment about any major changes in your health. Be honest with your answers. If you don’t exercise, you smoke cigarettes or drink a little too much, tell the truth. Any of these truths can and likely will affect your care. Listen to your doctor’s advice and take notes if you have to. Having a pad of paper and a pencil can help you remember important details later on – especially if you have a new treatment or new prescription.

Reducing Your Stress Levels Can Improve Your Life

Everyone lives with a little stress, but if you find yourself constantly overwhelmed and stressed out, your health can suffer. Your doctor’s tips for stress reduction will not only make you feel better but can also have some powerful physiological effects. You can reduce your cortisol levels, improve your response time and reflexes and boost your immune system. During your next appointment, talk to your doctor about specific techniques that you can use to reduce your stress levels.

Knowing these important health facts can help you lead a healthier life and work with your doctor as a partner in your health care.

Saturday, January 12, 2013

What does a doctor expect from his medical billers & coders

A significant challenge that care providers face in the US today is unrealized account receivables stemming from rejected insurance claims by Medicaid and Medicare officials. Physicians often find this challenge daunting because it requires them to handle what they are not meant to: administrative responsibilities
The medical billing and coding cycle requires thorough knowledge and deft handling of the entire process and related procedures including familiarity with electronic platforms and the ability to handle sensitive medical data.
The above scenario, if broken in terms of skills doctors expect their billers and coders to have, will demarcate the following areas:
  • Knowledge of billing life cycle
  • Theoretical and working knowledge of data collection, data entry, paper claims, creating and editing reports, patient demographic forms, etc
  • Usage and understanding of codes
  • Knowledge of electronic platforms in use
This makes medical billing and coding among the most knowledge-driven and challenging disciplines which needs keeping up with the changing trends of the industry to effectively handle billing and coding responsibilities for care providers, so that they can concentrate on quality of care even as they enjoy a steady flow of revenue.

Accuracy vs. Productivity – Medical Coder 

Recently, AAPC conducted a survey to find out from billing and coding professionals which among the two (accuracy and productivity) is preferred over the other by billing and coding managers and the survey revealed a mixed response establishing the supremacy of neither of the two over the other, leading to the conclusion that a billing and coding manager expects his/her team of billers and coders “to efficiently produce accurate work”.

Medical Coding with MBC

MBC believes, that when it comes to billing and coding, certifications help bridge this gap. Most of MBC’s billers and coders are certified in CPC, CCS which CPAT, all of which require passing a coding certification examination which involves questions to examine the ability of billers and coders to accurately apply CPT and HCPCS procedures and supply ICD-9-CM diagnosis codes. This helps MBC’s coding professionals to refresh and renew their skills and be assured of them.

Friday, December 28, 2012

Top 5 Reasons to Become a Medical Billing and Coding Specialist

Do you enjoy working with computers, pay exceptional attention to detail and aspire to work in the healthcare industry? If so, a medical billing and coding specialist position may be a viable option for you, and can lead to a rewarding career. To give you a little more insight, here are some of the top reasons for becoming a medical billing and coding specialist:
  1. There’s a Demand for Qualified Medical Coding Professionals – The U.S. Bureau of Labor Statistics (BLS) reports that job prospects for medical records and health information technicians, which includes medical coders, appear to be good in the coming years. Employment rates for this field are actually expected to increase 20% between 2008 and 2018, which is much faster than the average for all occupations.*
  2. Education Can Be Completed in Less Than a Year – Some medical billing and coding training programs can be finished in as few as 10 months, or about a year-and-a-half for an associate degree. Take time to explore your education options and choose a quality medical billing and coding training program. Ideally, the program you choose should also prepare you for industry certification, such as the Certified Professional Coder (CPC®) designation from the American Academy of Professional Coders (AAPC).
  3. Availability of Online Medical Billing and Coding Education – Thanks to the convenience and flexibility of online medical billing and coding degree and diploma programs, you can accomplish your healthcare education goals without the common barriers of time and location. You’ll want to select a reputable, accredited medical billing and coding school with a specialized curriculum. These primary qualifications can help ensure that you receive a quality education.
  4. Ability to Work in Healthcare Without the Typical Physical Demands – Many healthcare workers have to work extremely long hours and are required to move patients, stand or walk for long periods of time, clean up after patients and so on. As a medical billing and coding specialist, you will be able to assist healthcare providers and patients alike, all while working from your computer.
  5. Potential to Work at Home and Set Your Own Schedule – Some healthcare providers outsource their medical billing and coding workload to fully trained specialists. This option gives you the opportunity to build your own home-based practice. As an independent medical billing and coding specialist, you have the freedom to decide what hours you would like to work and create an environment that fits your personal and professional needs.