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L1- Medical Billing Data Associate

October 1, 2022
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ROLES & RESPONSIBILITIES: Should understand the client requirements and specifications of the project and work accordingly. Should meet the productivity targets within the stipulated time. Timely input of demographic charges and time of service payment information. Expert ability to add specific data such as modifiers, payer specific information, including authorization…

16 Sep 22

How to Use Modifier 25 Correctly

Introduction Modifier 25 is a critical part of the Medicare program, but it can be difficult to understand and use correctly. In this post, I’ll explain what Modifier 25 does, why it’s needed, and how to use it properly. If a patient comes in for a preventive visit and the…

16 Sep 22

What Information Does A Medical Claims File Contain?

Introduction Every medical claims file contains details specific to each patient and patient encounter. In a medical file, this information is split into two parts: the claim header and the claim detail. The details are broken down to as granular a level as necessary to help ensure that all charges…

16 Sep 22

How To Code Claims (Depending On Rental Vs. Purchase)

Introduction When coding medical claims, it’s important to remember that different health insurance companies have different requirements. Each company has its own list of CPT codes (which are basically just a shorthand way of categorizing services). They’re also all different sizes: some might have 200 codes while others have more…

15 Sep 22

HCPCS Common Coding Questions

Introduction The Healthcare Common Procedural Coding System (HCPCS) is a system to classify items, supplies, and services used in health care. The United States Department of Health and Human Services specifies the codes that are included in the HCPCS. There are three levels of codes: Level I, Level II, and…

15 Sep 22

How To Write An HME Startup Operational Plan

INTRODUCTION As a HME startup owner, don’t forget to create your operational and strategic plans. You can also use this template as a guide or template for your own business plan. OPPORTUNITY Opportunity is the reason why you are starting your business. It has to be something that you’re passionate…

09 Sep 22

Ways Lengthy Processes Affect Hospitals and Healthcare Professionals

An abundance of meetings and procedures is common in most industries, but healthcare professionals face an especially challenging environment when it comes to keeping things streamlined. Red tape is abundant within the healthcare industry, with many departments having their own rules and regulations that must be followed exactly. With the…

26 Aug 22

Are You Chasing Your Revenue

Introduction Your practice’s revenue cycle management is the process of collecting, tracking, and reporting on your payments from patients and payers. If you’re not collecting 100 percent of your revenue, it’s not only costing you money—it’s also hurting your reputation with patients who may decide to go elsewhere when they…

12 Aug 22

What Makes A Successful Revenue Cycle System

Introduction We’ve talked before about what revenue cycle management is and why it’s important, but you may still be wondering what a successful revenue cycle looks like. What are the components that make up a revenue cycle and how do they come together to produce success? Let’s take a look…

11 Aug 22

Why Do Some Plans Cover Benefits From Network Providers, But Not Out-of-Network Providers?

Patient Resources When you are shopping for coverage, you might be wondering why some plans cover benefits from network providers but not out-of-network providers. While the two types of providers aren’t exactly similar, there are significant overlaps between them. An out-of-network provider is a doctor or other healthcare professional who…