Medical Billers and Coders

  Financial stability and profitability are becoming a rising concern for all medical practitioners with the ongoing changes that the healthcare industry is experiencing. Increased patient walk-ins, reduced Medicare reimbursements, declining collections and coding complexities are making bottom lines diminish for many medical practices. In such a bleak industry atmosphere, internists are facing the toughest of all times due to the diverse services offered by them. Internal medicine practitioners offer the first and foremost diagnosis for most medical conditions and in addition to providing basic treatments, they refer the majority of their patients to specialists for further medical care. This increases the dependence of an internist on other practitioners and thereby complicates the billing procedures tremendously. However, efficient billing and coding practices can not only improve profitability but also enhance patient care provided by internal medicine practices. To ascertain pr

  Podiatric medicine, as we all know, is one of the most sought branches of medical science dedicated to the diagnosis, prevention, and treatment of various foot disorders resulting from diseases or injuries. A Podiatric physician is to the foot what an ophthalmologist is to the eye and a dentist to the mouth -a specialist who has undergone lengthy, thorough study to become qualified to treat a specific part of the body. A Doctor of Podiatric Medicine makes independent decisions and performs all necessary diagnostic tests. Also, administer medications, performs surgery, and prescribes therapy regimens. Podiatric physicians educated in state-of-the-art techniques involving surgery, orthopedics, dermatology, physical medicine, and rehabilitation hence; require constant up-gradation to be the best in their field. As A Practicing Podiatric Physician…. Due to the sudden increase in the quality and quantity of Podiatric medicine-related research in the past decade, the physicians prac

  Family practices across the US have been facing difficulties in revenue collection due to challenges related to medical billing and coding. Modifier omission, untimely claim submission, underscoring and inaccurate documentation may seem like minor errors; but they eventually have a major impact on the revenue cycle of practices. Our  Family Practice billing  has enhanced cash flow, reimbursements, and insurance eligibility verification  services . Demographics & Charge Entry  Services . Family practice physicians shouldn’t ignore the importance of expertise and experience in  handling billing and coding tasks ; especially as they lose 10-20% of their revenue every year; due to coding errors. Considering the rates at which family physicians are being paid by Medicare, approximately $8,396 a year will be lost if coders underscore just one level for 4 visits a day. Medicare payment cuts have tightened the financial condition for family physicians and with the payment rates expect

  Ambulatory Surgical Centers or ASCs as it is commonly called were first established in Phoenix, Arizona in 1970 by two physicians who wanted to provide comfortable care to the people in their community so that they could avoid more impersonal venues like hospitals. Slowly over the years with Medicare approving payments to ASCs they have gained prominence and in some cases are scoring over the normal hospitals for certain procedures. The fact that ASCs provide a high-quality yet cost-effective alternative to the inpatient care provided at hospitals has seen a surge in outpatient centers. Hospitals grappling with scheduling delays, slow operating room turnover, and budget cuts which have impacted the purchase of new medical equipment, coupled with other operational issues that have prompted patients to visit ASCs to receive care. Industry Snippet The revenue of the ASC is slated at $28 billion with an expected growth rate of over 5 percent between the years 2010– 015. ASCs are sai

  The state of California is facing an increased shortage of primary care physicians especially – with a rise in the number of the elderly population in the State leading to an increase in health coverage under Federal Health care reforms. Additionally, 30% of primary care physicians in the state are nearing retirement being above 60 or older- the highest percentage in any state. However, compared to the shortage, the State has not significantly increased the number of primary care physicians trained. HHS’s Council on Graduate Medical Education recommends 60 to 80 primary care physicians per 100,000 people to adequately serve a population. Statistics show in fast-growing regions of California such as the Inland Empire there are only 40, whereas in low-income rural communities where care for 25% of patients is paid by Med-Cal, there are only 45 primary care physicians. Even though medical school applications have been high in California, with a high proportion of U.S. medical school

  Did you know that since October 2013 physicians need to conduct a face-to-face interview with the proposed beneficiaries before ordering durable medical equipment? This is one of the rules specified by Medicare, which further clarifies the need to document the data in the patient’s records. A copy of this medical record needs to be sent to the supplier of the ordered DME. Documentation-  During such a face-to-face meeting there needs to be enough documentation in the relevant parts of the patient’s medical records justifying the beneficiary’s eligibility for the particular piece of durable medical equipment ordered on behalf of the patient. The physician also needs to be familiar with the Medicare policy requirements for the same. The particular policy clearly explains the specific conditions that qualify a patient for that particular DME. The relevant documentation of the medical record needs to be furnished with the suppliers of the DME   who will need it before they can submit

  CY 2023 Medicare Physician Fee Schedule Proposed Rule On 7th July 2022, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that announces and solicits public comments on proposed policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues, effective on or after January 1, 2023. This calendar year (CY) 2023 PFS proposed a rule that made lots of provisions including expanding Medicare telehealth use even after the end of a public health emergency (PHE). Expanding Medicare Telehealth Use after PHE For the calendar year 2023, CMS is proposing a number of policies related to Medicare telehealth services including making several services that are temporarily available as telehealth services for the PHE available through CY 2023 on a Category III basis, which will allow more time for collection of data that could support their eventual inclusion as permanent additions to the Medicare telehealth services list. C