Category Archives: Coding & Billing
Tips on Ordering and/or Referring Providers
UPDATE ON 4/25/13: CMS announced the delay of PECOS edits that would result in denial of home health claims & Medicare part B claims when the ordering/referring physician is not enrolled in PECOS. CMS will advise the new implementation date … Read Full Post
What We’re Reading – Getting prepared for ordering and referring denial edits
Are you aware that, effective May 1, 2013, CMS will deny claims if the ordering and/or referring providers are not enrolled in the Medicare system? This will affect all Medicare Part B covered services, durable medical equipment, orthotics, and supplies … Read Full Post
Do EHRs Contribute to Coding and Payment Inaccuracies?
Many providers have touted the electronic health record (EHR) as the magic bullet to improve billing accuracy. However, according to the Center for Public Integrity, “Medicare regulators also acknowledge they are struggling to rein in a surge of aggressive — … Read Full Post
What We're Reading – Patient Collections: 5 Mistakes Your Practice Can Avoid
As we always say, the billing department is the heart of the medical practice. Sickness in the billing area extends throughout the office and death is possible. This article cites some very common mistakes that, in our experience, are made … Read Full Post
What We’re Reading – Sometimes physician query is imperative
A staff member’s role is one of supporting the clinician. However, in the area of coding and billing, the perspective is more of collaboration as the employee must appropriately transfer the practitioner’s documentation into correct codes, advise him/her on the … Read Full Post
Electronic Prescribing: the Double-Edged Sword
In these days of information overload, it’s easy to overlook things that affect a provider’s bottom line. One such item is the Electronic Prescribing (eRx) Incentive Program. Established in 2009, eRx encourages eligible professionals (EPs) who render services to Medicare … Read Full Post
What We’re Reading – Top Five Rejections Related to HIPAA Version 5010
The conversion to 5010 on January 1st has been relatively smooth one, but there has been some hiccups along the way that have caused denials and associated cash flow disruptions. Ken Bradley researched the reasons that claims were being denied … Read Full Post
CMS Provides Guidance on 5010 Discretionary Enforcement Period for Medicare Fee for Service
Medicare Fee-for-Service (FFS) issued an announcement on December 14th regarding its plan for the 90 Day Discretionary Enforcement Period for non-compliant HIPAA covered entities. According to that announcement, CMS provided a 90 day discretionary period for compliance with planned January … Read Full Post
5010 – Much Ado about Nothing?
It seems like not a day goes by in healthcare without some gloomy prediction about the changes lurking on the horizon. The one causing the most stir at the moment is 5010. To understand “5010,” we first need to take … Read Full Post