HIPAA Enhancements: How They Affect Your Practice

Although HIPAA has been in effect for 17 years, confusion remains about some aspects. The passing of the HITECH act earlier this year added a few wrinkles and brought this issue back to the forefront. Do you know the difference between HIPAA and HITECH or when it started? The Health Insurance Portability and Accountability Act(HIPAA), sets the standard for protecting sensitive patient data. HIPAA was introduced in 1996 by the late Senator Edward Kennedy (D-MA) and former Senator Nancy Kasselbaum...

10 Common Medical Billing Mistakes That Cause Claim Denials – Part 2

In our previous post, we discussed the first five most common medical coding and medical billing mistakes that cause claim denials. Today we will walk through the next five common reasons claims are denied. 6. Duplicate billing. Many times, a duplicate bill is the result of human error. However, duplicate bills can result from resubmitting a claim instead of a follow up or canceling a procedure or test but not removing it from the patient account.All claims processing systems contains...

10 Common Medical Billing Mistakes That Cause Claim Denials – Part 1

Medical coding and billing involve complex processes that can differ depending on the patient, insurer and procedure. Even the most diligent financial services departments experience claim denials, but knowing the most common mistakes can help you take steps to avoid them. These top coding, billing, and filing errors are a digest of actual clearinghouse data derived from millions of medical claims. The top five of the 10 most common medical coding and billing mistakes that cause claim denials 1. Coding...

NUCC Announces Form 1500 Changes in Anticipation of ICD-10

To accommodate ICD-10 reporting needs, the National Uniform Claim Committee (NUCC) has announced a change to Version 02/12 of the 1500 claim form. Payers will begin receiving and processing paper claims on the revised form on January 6, 2014, dual form use will be in effect through March 31 and only claims submitted on the revised form will be processed after April 1. There are two main changes to the form. First, there is an indicator in Item 21 to...

5 Things to Look for in a Medical CRM System

As a provider with a small or mid-sized practice, you may think you don’t need a CRM system. For one thing, CRM stands for customer relationship management, and you have patients, not customers. Second, most CRMs are designed for large, complex businesses with a sales force. But there are new systems emerging for providers like you, and although they’re still called CRMs, the acronym stands for care relationship management. These systems not only help you with traditional lead management, they...

Why I Changed My Medical Billing Software

Betty Harder, owner of BJ’s Medical Billing Service in Portland, Michigan, was looking for solutions to help grow her business. She had worked directly as a medical biller for several providers but wanted to branch out on her own and build something special. Betty doesn’t just enter and process claims for her providers and their patients, she’s a real advocate for patient satisfaction. She makes sure their claims get processed quickly and accurately. To do that, Betty wanted to find...

Top 6 Ways Medical Billers Can Avoid Claim Rejections and Denials

Medical billers have a tough job. They are tasked with keeping healthcare providers on solid financial ground through billing and payment and satisfying patients with timely, reliable processing and payment of their health insurance claims. This task requires expert knowledge of the ever-changing regulations, accurate coding and the ability to navigate the many different claims processes of health insurance companies. Faced with these challenges, it’s hard enough getting claims processed, but then you receive the news a claim has either...