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It is essential that every physician practice verify the insurance eligibility and benefits of patients before services are provided. There are many missed opportunities to secure income and reduce staff time when patient eligibility is not verified at the time of check in. Training staff to complete this task can…
What is EOB? An explanation of benefits (commonly referred to as an EOB form) is a statement sent by a health insurance company to covered individuals explaining what medical treatments and/or services were paid for on their behalf. The EOB is commonly attached to a check or statement of electronic payment. In most cases your physician has signed a…
Medical billing is a frustrating process for counsellors who are often juggling too many business tasks, as well as trying to provide excellent clinical care. In fact, many counselling practices collect less than 85% of the monies that they’re rightly owed from insurance companies. However, with good planning, and a…
Overcoding and undercoding are two coding mistakes that can have damaging results on the medical office. Medical coding is not just about receiving reimbursements for services provided. Coding claims accurately lets the insurance payer know the illness or injury of the patient and the method of treatment. Overcoding is Fraud: Overcoding leads to insurance companies making much higher…
According to a research conducted by the Medical Group Management Association, better performing practices generate more revenue, create operational efficiency, ensure provider productivity and collect receivables quickly compared to their peers. It is important to review the AR on a regular basis to ensure the practice is collecting payment for…
These two common terms are Denied Claim and Rejected Claim. Both these terms are often used to discuss the medical billing claims and are also time and again used interchangeably. But, it is extremely important to understand that Rejected Medical Claims are very different from Denied Medical claims, yes they…
The goal of the medical biller is to ensure that the provider is properly reimbursed for their services. In the pursuit of this goal, errors, both human and electronic, are unfortunately unavoidable. Since the process of medical billing involves two incredibly important elements (namely, health and money), it’s important to…
There are many items that are confusing in the world of medical billing. One of the most confusing areas for individuals that are new to the business side of medicine is the idea of medical billing allowable. There are not many businesses where a bill is sent out for…
Practices that bill Medicare incorrectly create newsworthy events. If you don’t want to see your practice on the front page for the wrong reasons, you’ll need to check your E/M coding conventions to be sure you aren’t miscoding E/M services. The lowdown: In 2014 Medicare Fee-for-Service improper payment rate was 12.7 percent.…
The US Centers for Medicare and Medicaid Services (CMS) has announced that the use of the International Classification of Diseases, 10th revision ICD 10 codes will begin on October 1, 2015, which according to CMS is the soonest possible date allowed in a law passed by Congress earlier this year. The…
