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.

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.

CMS Coverage Email Updates | Centers for Medicare & Medicaid Services

CMS Coverage Email Updates | Centers for Medicare & Medicaid Services

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.

Physicians to Manage Revenues amidst the Impending 26.5% Medicare Cut with a Medical Billing Service

Ever since Sustainable Growth Rate (SGR) began overshooting budgeted Medicare spend, physicians have been under the constant threat of Medicare cut. While Congress’ intervention has delayed the inevitable thus far, it may be a little tougher this time – Centre for Medicare Services (CMS) has already indicated that its fee schedule for 2013 is designed to initiate 26.5% Medicare cut if the Congress fails to intervene before Jan. 1, 2013. While physicians may still be optimistic of a breakthrough in their favor, they still need to be prepared for any eventuality. And if 26.5 Medicare cut is indeed set in motion, it would have a debilitating effect on physicians’ clinical and operational efficiency – practices may not be able to support operational expenditure, leave alone the thought of ‘profit’.

Despite the looming fear, practices can still find ways to off-set the impact of Medicare cut – transition to new payment and delivery models will help meeting the primary objective of improving patient care as well as moving to a higher-performing Medicare program.

Accountable Care Organization (ACO) is one such care model, which will increasingly become mandatory for care providers in the Medicare network. ACO requires physicians to form a clinical network that can achieve optimum clinical efficiency at minimum cost to patients. ACO works on the formula that a clinical network with A-Z medical services can considerably bring down patients’ medical expenditure. While physicians in an ACO get to be recognized for high performance, they also stand to benefit from shared-savings. Moreover, being in an ACO is indeed helpful in building credibility among patients.

The provision of Affordable Care will also help physicians counter the impact of Medicare cut. The significant thing about this reform is that it extends Medicare to every uninsured citizen in U.S. With roughly one-third of population expected to be Medicare beneficiaries, physicians can look forward to off-set Medicare cut with operational volumes from Affordable Care provision. But transiting to these novel care models may be seemingly difficult for physicians who have been used to protective health care models. Amongst possible challenges, understanding fee schedule, negotiating and renewing payer contracts, being conversant with multiple payer policies, and striking beneficial deal with payers will be more important. Moreover, a proper mix of public-private payers is more than advisable.

And, amidst these Medicare-cut-generated challenges, mandatory EHR, PQRS, and ICD-10 & HIPPA 5010 compliant coding too will add to the burden, which may be far too much to bear for physicians. With the in-house staff incapacitated to take responsibility of this enormity, outsourced medical billing services seem to be the only way out. Medical billing companies – with experience and competence in stage-managing transformation to high-performance Medicare models, managing mandatory EHR, PQRS, and ICD-10 & HIPPA 5010 compliant coding on behalf of physicians who are essentially focused on clinical efficiency – could provide helping hand.

Best 10 Ways to Prevent Claim Denial

How widespread is medical claim denial? According to the U.S. Government Accountability Office (GAO), the Department of Health and Human Services (HHS) collected data from insurers nationwide and found that the aggregate application denial rate was 19 percent in the first quarter of 2010.* That’s approximately one in five claims. Nobody wants their medical claim to be denied. Very often, claim denial is totally avoidable. Here are the 10 best ways to limit the amount of denied claims your office receives:

1. Ensure all patient information is available and accurate. For example, make sure the patient’s name is spelled correctly, the date of birth matches, and there are valid subscriber and group numbers.
2. Verify the patient is still covered by the insurance benefits provided before rendering services.
3. Coordinate benefits to make sure you have the right primary insurance listed, confirm the eligibility of benefits and verify the insurance information is up to date.
4. Contact the patient’s insurance provider to make sure the healthcare provider is a part of the policy’s network of planned participants. Also, check to be sure that the requested services are covered and that the services will not fall under a pre-existing condition clause.
5. Confirm any necessary referrals from the patient’s primary physician are on file before rendering services.
6. Check to see if prior authorization or pre-certification is required.
7. Be certain the doctor provided complete information and proper documentation. Request necessary medical records.
8. Bill the appropriate liability carrier if treatment is for an auto- or work-related accident.
9. Provide complete and valid CPT and/or HCPCS codes where applicable.
10. Make sure to file claims in a timely manner prior to the insurance carrier’s filing deadlines.

Billing “Urgent Care” As It Emerges As One of the Fastest Growing Specialties

Urgent Care

Urgent care is fast developing as a viable alternative to what has traditionally been known as “family practice”. The main reason behind this new-found fancy is that physicians can now operate from designated facilities without having to trek around offices, nursing homes, and hospitals. Additionally, urgent care centers are preferred to other similar types of ambulatory healthcare centers, such as emergency departments, and walk-in primary care centers by the scope of illness treated and facilities available on-site. It will not be long before we witness further addition to already 8,700 urgent care centers (UCCs) across the US.

While it is true that practicing Urgent care offers physicians an extended scope and avenue for revenue generation, there are certain criteria (established by The Urgent Care Association of America) that physicians must abide by. These criteria describe scope of service, hours of operation, and staffing requirements. A qualifying facility must treat walk-in patients of all ages during all hours of operation. It should treat an entire range of illnesses and injuries, and have the facility to perform minor procedures. An urgent care center must also have on-site diagnostic services, including phlebotomy and x-ray. Because of this inclusive medical service coverage, Urgent care medical billing has become far more complex than usual. Urgent care physicians will be called upon to deal with:

Code that allows urgent care centers to code and get reimbursement for the extra expenses involved in providing urgent care services

Code that allows the urgent care center to receive reimbursement at one flat rate (Global Fees for services rendered at Urgent care centers) for all visits coded with it

The usage of evaluation and management (E/M) codes as per EMTALA guidelines if it is a Type B emergency department

Facility codes in urgent care

National Provider Identifier (NPI)

E/M Code plus Procedure Code in Urgent Care

Level 1 E/M Code 99211

Codes for services rendered during extended hours

E/M Code + IV injection procedure code

Added to this complex coding is a reimbursement environment which has become more restrictive post a series of healthcare reforms recently. This additional burden of revenue cycle management (RCM) to an already overweighing clinical schedule may impede the very focus of clinical excellence. This is precisely the reason why physicians are turning to specialist billing and revenue cycle management from “urgent care medical billers”. Consequently, there has been an unprecedented demand for billers and coders in this domain.

At a time when the market is still peaking, Medicalbillersandcoders.com – the leading source for specialist billing and RCM services – has taken the lead in supplying the right billing and RCM sources to urgent care practitioners. Spread across all the 50 states in US, we provide experienced billing experts for urgent care billing & RCM for your medical practices.