Medical Billing

In today’s health care environment patients have more responsibility for paying their medical bills. In the new environment, patients are responsible for paying higher copays and have high deductibles. With the decrease in reimbursements from the insurance companies, medical practices must run a tight schedule in order to maximize the revenue that they generate. An important aspect of practice management is to ensure that patients...

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Medical Billing is one of the most important functions of a medical practice. Medical Billing is part of the revenue cycle management process of a practice. So, medical billing is much more than submitting claims to insurance companies and waiting to be paid for those claims. The revenue cycle management of a medical practice is a complex process that involves: insurance verification, patient demographic entry, medical...

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Under the HIPAA / HITECH Omnibus Rules, covered entities need to update their HIPAA compliance programs by September 23rd. One of the major changes under the HIPAA / HITECH Omnibus Rules is related to business associates. Business associates are not considered to be covered entities but have access to patient information. Under HIPAA, business associates can be IT companies, pharmacy benefit managers, insurance brokers, copy...

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All the changes that are happening in the healthcare industry in the next few years will challenge the way medical practices operate. Physicians are going to be pressed to see more patients with the new influx of patients that will come into the health care system with Obamacare (this is if Obamacare was to be fully implemented).   Doctors main focus is patient care and not running...

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On a day to day basis a medical practice is busy with taking care of patients and running the back end operations. The staff is busy scheduling patients, seeing the daily inflow of patients, calling insurance companies to request authorizations or follow up on claims, etc. In such a dynamic and hectic environment it is not uncommon to see mistakes being made that result in...

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The medical billing and revenue cycle management aspects of a medical practice are keys to its success. Medical billing is among the most important processes within a medical practice. At the end of the day, the cash flow levels of a medical practice depend on how the billing is done. Medical practitioners have to decide whether they want to do the billing themselves or whether they want...

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Know your state’s law on timely filing limitations. Also, you should know the time limits for all carriers in which your doctor/client participates with. The contract for participation will define timely limitations.   Example from BCBS of Arizona: BCBSAZ asks providers to submit complete and accurate claims, preferably within 30 days of service, and require submission within one year of the date of service. BCBSAZ will deny...

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