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Below are the 20 most recent journal entries recorded in medicalbillers' InsaneJournal:

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    Tuesday, July 17th, 2012
    5:35 pm
    Average Single Specialty practices cater to 42-49 percentage of Medicare Populace!

    That means nearly half of your total patient population comprises of Medicare beneficiaries.  And, you could have remained indifferent as long as Medicare’s reimbursements continued to be as normal as private health insurance reimbursements.

    While physicians’ have remained immune to its impending backlash thus far, they may not be so lucky henceforth; the Federal Government, unable to contain the exploding Medicare expenditure, has finally pressed the panic-button which physicians had been feared of –

    Medicare reimbursements cut and their effects:

    • Approximately 4-5% cuts expected each year through 2012, – can result in a substantial erosion of practice revenues
    • Practice will find it hard to compete, sustain, and grow – on marginal revenues from private insurance reimbursements
    • Extreme possibility – the cumulative effect of such Medicare cuts may even bring practices on the brink of sell-out or closure

    Ways to off-set the adverse impact of the imminent Medicare cuts:

    • Maximize your Medicare reimbursements – error-free billing, coding, and submission
    • Being eligible for Medicare bonuses and incentives – adopt ACO model of medical care dispensation and compliant EHR practice
    • Focusing on getting as many reimbursements as you can from – other sources (private health insurance reimbursements and fees)
    • Get credentialing services for your practices

    Outsourcing your billing to dedicated specialists could be the key!

    • Specialization as their lone concern is to maximize their clients’ revenues from reimbursements
    • Voluminous operations – helps in reducing the cost of medical billing services
    • Market-orientation –  ensures that clients’ medical billing practices are compliant with the evolving industry standards

    Tackling Medicare as well as other reimbursements with MBC … – by virtue of being the leading consortium of medical billers and coders across the U.S – is uniquely poised to play the defining role in this regard. Combining its unique legacy with a comprehensive process of medical billing RCM Patient Scheduling and Reminders, Patient enrollment, Insurance Enrollment, Insurance verification, Insurance Authorizations, Coding and audits, Billing and Reconciling of Accounts, Account Analysis and Denial Management, A/R Management, and Financial Management Reporting – additionally offering value added services like consultancy and credentialing promises to guide physician practices through these testing times.

    5:31 pm
    How much salary can Medical Coders expect in New Mexico?
    • The New Mexico state government has introduced an incentive program where healthcare providers will be rewarded for moving their data operations to an electronic platform to be HIPPA complaint
    • Chronic diseases and conditions prevalent in New Mexico have led to an increase in consumption of healthcare services like laboratory studies, radiologic imaging, oncology treatment and other specialties

    These two seemingly disconnected developments, one relating to insurance compliance and another core care, have collectively made New Mexico a state highly in demand by medical billing and coding professional to be in for job and career opportunities.

    This increase in demand of medical billers and coders in New Mexico is apparently a matter of concern for the state as despite being a fairly large state, New Mexico has only about 1290 medical billers and coders, reports a survey.

    • The average billing and coding salary in New Mexico is about $32,070
    • A professional with about 10 years of experience in billing and coding can command around $45,740

    Moreover, a new billing and coding professional in New Mexico can expect his/her salary to span from $10.59 to $14.33 per hour.

    Medical billers and coders in New Mexico and surrounding states are experiencing an increase in demand of billers and coders triggered by HIPPA and a climb in chronic diseases. Moreover fees of billers and coders in all states are souring with ICD-10 implementation on everyone’s mind, and states like New Mexico, Arizona, Tennessee, Michigan and Idaho experiencing minimum 20- 22 percent hike in their hourly rates.

    Medical coders trained and certified in the methodologies of coding and familiar with the current software platforms required for compliance can make use of this industry trend in New Mexico, which many recruiters and industry insiders believe is an opportunity of the kind which comes once in long passage of time sometimes covering a lifespan of a career or two.

    Present in all 50 US states and in New Mexico for over 10 years now, MBC can help meet this industry need with a team of highly trained in-house and outhouse billers and coders who have sound familiarity with New Mexico specific regulations.

    MBC can further help meet this industry need by bringing care providers and billers and coders together through the MBC’s job board which is successfully catering to provider and biller needs across the US and in this way helping billers and coders to access job opportunities available in New Mexico and care providers to post their requirements.

    Thursday, June 21st, 2012
    5:45 pm
    Appealing a claim- Will a standard format work to improve your practice’s medical billing?

    The procedure of appealing an insurance claim is intricate, although it can be successful if completed properly because there are many grounds for claims to be denied by an insurance company or a payer. The payer collects a lot of claims on a daily basis and the claim can be easily denied if there has been a mistake in analysis or medical billing and coding errors including many others. Furthermore, there is also a requirement to understand if the claim is of importance because a claim of a very small amount need not be appealed and can be written off but one which is worth a considerable sum needs to be scrutinized. However the physician’s office in this case may need to apply various measures considered the following challenges.

    In Denial

    The fact that a physician or practice receives the accurate amount of reimbursement even when the claim is not denied is a wrong assumption. Insurance companies may con a physician out of his or her fair share of reimbursements in many ways that are very difficult to detect and need a dedicated and keen professional to find the lacunae in the proper reimbursement of physicians since almost 19% of claims denied are due to errors of the insurance companies. This especially holds true in the case of private insurers due to errors made by the insurance companies in claims and detecting these errors requires skill and sustained effort. As a result some physicians and practices are reluctant to appeal denied or underpaid claims since this may increase the administrative work and expenses. However, nothing can be further from the truth when considering the long term repercussions of the monetary benefits that can be enjoyed even with 5-10% increase in revenue which can be a considerable amount.

    The Impact of Reforms

    In the face of reforms, revenues are set to increase dramatically along with administrative and billing process as 31 million uninsured Americans receive insurance. Appealing a denied claim is becoming voluminous but the new billing and coding procedures are aimed at making this process of reimbursement or appealing much smoother with the transition from ICD-9 codes to ICD-10 codes and adoption of the 5010 platform and emphasis on quality care and patient privacy through HIPAA compliance. The importance of time and money cannot be overemphasized and denied claims, especially for private insurance companies, have to be appealed within a stipulated period of time after the claim is denied. Therefore preventive steps to save time such as error reduction through analysis and a scientific approach in Revenue Cycle Management (RCM)  is required in order to sustain the low rate of denial over longer periods of time.

    Vital Signs

    Analyzing the pattern in which claims are denied by an insurance companies and finding out the most common false denials is a crucial part of the process of appealing denied claims. Denied claims can fall in various categories such as:

    • Errors in documentation
    • Services not covered
    • Mistakes in medical billing and coding
    • Technical difficulties involving Electronic Health Records (EHRs)
    • Not considered “medically necessary” by the payer

    Arguing your case becomes more difficult due to the huge amount of laws, rules, and regulations that seem to drown the actual cause of the denial. Thus customization of claims becomes much easier when they can be categorized and scientifically solved within a given period of time.

    Scientific approach

    In this scenario appealing a claim may require more than a standard format and physicians short of time can benefit by acquiring services of a medical billing service. Medical billing and coding experts at not just perform basic coding and billing functions but are also backed by a team of research professionals who ensure efficient RCM, productive payer interaction, and a scientific approach towards collections with the “bucket” approach in Accounts Receivables (AR) and prompt reimbursements for physicians and practices all over the country with complete HIPAA compliance.

    3:58 pm
    ‘Pay-as-you-go’ as a value-based medical billing service model

    While we are not alien to the term ‘pay-as-you-go’, it is something that is catching the imagination of physicians opting for outsourced medical billing services. Unlike in the past, when ‘pay-as-you-go’ was sporadically availed by a few physicians, it is now emerging as a viable alternative to long-term contractual medical billing services. Well… what is this ‘pay-as-you-go’ service model after all and what makes it so affable to physicians opting for outsourced medical billing services? Much true to its name, ‘pay-as-you-go’ service model’ is a niche medical billing service wherein physicians are obliged to pay their service provider (usually a percentage of the eventual reimbursement) only when they approach for getting their bills reimbursed. Usually, a percentage is worked out prior to soliciting ‘pay-as-you-go’ medical billing services from prospective medical billing companies. The reason why the present-day generation physicians deem ‘pay-as-you-go’ service model’ appropriate is primarily because of their restrictive financial ability as well as being able to transact on value-based system.

    The surge in the demand for ‘pay-as-you-go’ service model’ has its roots in a combination of factors – spiraling cost of contractual billing services, continuous fall in reimbursement rates, rapid increase in stand-alone or small physician practices, and less incidence of insurance-backed medical services, popularly known as cash-based services. The thought of countering this adverse impact on physicians’ revenues through in-house medical billing seems to have lost its significance amidst the monumental cost associated with switch over to mandatory EHR, and the ensuing ICD-10 & HIPAA 5010 compliant clinical and operational mandate. While physicians are convinced of the efficacy of ‘pay-as-you-go’ service model’ in countering their sagging revenue fortunes, service providers need to be equally responsive to such demand from physicians. Notwithstanding it being an additional service portfolio in the medical billing companies’ service offering, many medical billing companies are apprehensive of the future of the contractual model. But, their reasoning may not be true.

    The main reason why they may not be true in assuming ‘pay-as-you-go’ service model to be detrimental to the future of the contractual model is the fact that large hospitals, clinics, multispecialty groups, and more importantly the ACOs will continue to drive the demand for contractual model of medical billing services.  Therefore, ‘pay-as-you-go’ service model will not come in the way of their main service portfolio, but will only evolve to be an additional revenue source. In view of such scope for additional portfolio of service, medical billing services would do well to strategically expand their ‘pay-as-you-go’ service model to the areas where challenges faced in medical billing are rampant. On the whole, it puts both physicians as well as service provides in a win-win position.

    While most of the medical billing companies are still analyzing the pros and cons of ‘pay-as-you-go’ service model, ( – by virtue of being the largest consortium of medical billers and coders across the U.S – has already begun to reach to the physician practices in need of ‘pay-as-you-go’ service model. The strategic spread of its diverse medical billers and coders across the regions dominated by stand-alone practitioners makes it easily accessible and affordable.

    Thursday, April 19th, 2012
    6:21 pm
    Factors Affecting Hospital Employment and Physicians’ Revenue

    There has been an increasing trend in the healthcare industry where physicians are opting for hospital employments and the reasons and repercussions of these seem numerous. It cannot be argued that there are many positives for ‘being your own boss’ in a private practice. However, due to numerous reasons and changes taking place in the health industry, physicians are seeking hospital employment not just for the financial benefits but also due to numerous factors such as increased responsibility, risk, high overheads,  and a host of other reasons that come with managing a private practice.

    The health care reforms taking place in the country are also profoundly affecting the way in which delivery of healthcare is carried out. Physicians seem to be caught in this maelstrom of the choice between a private practice and hospital employment and are seemingly struggling to stay financially afloat; especially in private practices. One of the motivating move hospitals are making for physicians is shelling out a salaries to fresh graduates that are considerably high compared to what they would earn in a private practice and the promise of financial stability along with incentives provided by hospitals to physicians. The risk factor involved in starting a private practice is also slowly but steadily pushing solo and small group physicians to seek employment in hospitals.

    Inevitably, this increasing trend of physicians abandoning their private practice and choosing hospital employment is also having an effect on hospitals. Moreover, the demand for healthcare is dramatically increasing due to millions being newly insured and hospitals require physicians to slake this demand by pouring in more physicians in the facility in a short period of time. In addition to these factors, the steep learning curve involved in the implementation and maintenance of Electronic Health Records (EHRs) and other compliance issues regarding government policies in health care has driven a small part of physicians to completely close their practices and find hospital employment.

    Hospitals are increasingly hiring more staff and providers in face of increasing demand but it is a fact that the amount of workload would dramatically increase not just in the core aspects in hospitals but also in administrative and in other departmental processes. The challenges faced by hospitals are not just limited to providing quality care but also includes getting paid for the services that they provide.  Moreover, increased internal workflow and departmental processes due to this increased demand for services can lead to high costs which has a direct affect not only on the revenue but the quality of care as well. The changes in the health industry are affecting almost all the entities and processes involved in health care delivery and departmental processes are no different.

    The changes in various processes and departmental protocols due to the recent reforms have challenged many professionals who carry out such processes. The changes in medical billing and coding, stricter insurance policies by the Federal government, and the extensive implementation of Health IT have made these processes more cumbersome and highly skilled, more than ever before. is the largest consortium of medical billers and coders in the United States that provide medical billing and coding services that are not just limited to medical billing and coding but also encompasses revenue cycle management, interaction with payers, denial management and streamlining of these processes for IT adoption. The consortium has adapted to the new changes in policies and processes to provide optimized solutions to business needs and increase your bottom line.

    For more information visit: physician billing services

    Wednesday, April 4th, 2012
    5:11 pm
    AltaPoint EMR Version 11 – reigning supreme in the EMR market

    “Reigning superiority over its closet competitors in every aspect of compliant and secure EHR performance, AltaPoint EHR/EMR Version 11 has built an enviable reputation in the EHR/EMR market. The qualitative features that lend AltaPoint competitive edge over its immediate competitors happen to be distinctive innovative.”

    As EHR compliance becomes mandatory and moves to a higher order, the EMR/EHR manufacturers’ ability to sustain a winning relationship with physician fraternity is going to be decided on how best they can orient their product offers to diverse practices’ needs. While several EMRs are in the reckoning for being innovative and compliant with the latest EHR mandate by the Federal Healthcare Department, AltaPoint EHR/EMR Version 11 (ONC-ATCB Certified) distinctively stands apart on two counts: richly innovative and highly cost-effective.

    AltaPoint EHR/EMR, having evolved with diverse practices’ clinical and operational EHR/EMR needs for more than 15 years, has really unleashed its full potential in its new version – AltaPoint EHR/EMR Version 11. Fully integrated with clinical and practice management software, AltaPoint EHR/EMR Version 11 can easily be adapted to diverse specialties –  Allergy & Immunology, Ambulance Transportation, Anesthesiology, Behavioral Health, Cardiology,  Chiropractic, Dental, Dermatology, Family Practice, Gastroenterology, General Surgery, Hospitalist Billing, Internal Medicine, Mental Health, Neurology, OB& Gynecology, Occupational Health, Oncology, Optometry, Oral and Maxillofacial, Orthopedic, Otolaryngology, Pain Management, Pathology, Pediatrics, Physical Therapy, Podiatry, Primary Care, Pulmonology, Radiology, Rheumatology, and Urology disciplines. Going at $3995 for complete, certified 2 user system, there is hardly any other robust Electronic Medical/Health Record (EMR/EHR) combined with a complete Practice Management/Billing System that comes with a price tag as affordable as this.

    Reigning superiority to its closet competitors in every aspect of compliant and secure EHR performance, AltaPoint EHR/EMR Version 11 has built an enviable reputation in the EHR/EMR market. The qualitative features that lend AltaPoint distinctive competitive edge over its immediate competitors are:

    • Being hosted on controllable server, AltaPoint ensures that data is not vulnerable to unscrupulous intentions as in the case of many open source and “cloud-based” system. Moreover, it comes with the security options of for allowing authorized and monitored access to the data stored.
    • Practices need not worry about other cross-connecting interfaces as it comes with fully integrated EHR and Practice Management solution for efficient clinical and operational practices.
    • AltaPoint comes with automatic data conversion option, through which data in other EHR modules can easily be converted into the parent data depository.
    • Physician practices need not pay for additional modules as AltaPoint is built with ANSI 5010 and Electronic Remittance Advice (ERA) posting systems.
    • AltaPoint, being highly intuitive, allows multiple methods of data input; physician practices can choose between direct input and customized templates.
    • Unlike most of EHR platforms that charge annual “subscription” or “software assurance” fees to keep the program running, AltaPoint does impose any annual fees for their clients. Further, special upgrade features such as E-Prescribing, Smart Phone Access, Patient Portal, and Automated Appointment Reminder systems can easily be added as and when physician practice choose to upgrade their AltaPoint EHR/EMR.

     Therefore, irrespective of whether physician practices seeking to implement EHR for Meaningful Use attestation or as a cost-effective EHR system to streamline their practices, AltaPoint EHR/EMR Version 11 may well be the prudent choice. ( – known for its credibility in advising on EHR implementation as part of its comprehensive medical billing service offers – is quite happy to recommend as credible an EHR/EMR as AltaPoint EHR/EMR.

    Tuesday, March 13th, 2012
    5:49 pm
    Medical Reimbursement issues push Physicians to flee hospitals triggering a reverse trend

    For over a decade, US healthcare has seen hospitals integrating with primary healthcare physicians across all the states of the US, challenging the traditional notion of primary care as a separate set of services from hospital healthcare, to provide all types of healthcare services under one roof and ensure mutual benefits that help all the sides involved in a treatment cycle and healthcare operations – access to physicians to a larger pool of healthcare opportunities; availability of all healthcare services ,etc.

    Although the practice of independent primary healthcare providers joining hospitals has existed in the US healthcare for some time, the introduction of various payment modules, including bundled payments, accountable care organizations (ACOs) and medical home, by the Obama administration has made this alignment unavoidable, thanks to the common feature of these payment modules which is delivery of healthcare services based on a collaborative approach.

    However, this collaborative nature of treatment leaves hospitals to do more of what they should be doing less, financial administration. And as financial administration – preparing insurance claims, following them up with insurers, etc. – is neither the core competency nor concern of healthcare providers, they are ill-equipped to handle the situation.

    This leads to physicians having to do non-clinical activities, like paperwork, and additionally results in an upshot in claim denials- resulting in the healthcare providers mounting unrealized account receivables and the primary healthcare physicians not getting their dues. This phenomenon is predominantly responsible for triggering a reverse trend in US healthcare – disgruntled primary care physicians dissociating themselves with hospitals and returning to reoccupy their traditional position in the healthcare industry outside the sphere of organized hospital healthcare.

    According to a report published by The Physicians Foundation, regulations and administrative responsibilities brought by the Patient Protection Care Act (PPCA) have caused physicians to spend more time on administrative responsibilities and less time on patients, impacting their relationship with patients.  “In 2012, physicians will need to vigilantly monitor their administrative burdens and take steps to minimize any further impact on their relationship with patients,” the report warned.

    While healthcare providers can’t ignore the exigencies of a changing industry neither can, they lessen their focus on delivery of quality healthcare services. This makes the role of medical billers and coders more pronounced than earlier in the US healthcare industry, in a post reform scenario. One way, to meet this post-reform challenge and is by bringing the benefits of outsourcing financial administrative responsibilities by a care provider to a medical biller and coder who has a sound knowledge of the healthcare industry and its changing trends, latest technologies and experience in handling technical details involved in healthcare claims and a proven track record to show for its capabilities.

    Browse All: Medical Billing Companies, Medical Billing Services

    By combining the above competencies,, the largest consortium of medical billers and coders in the US, has been able to ensure seamless claim realization and greater control over operating costs for healthcare providers resulting in redirecting of internal healthcare staff to core activities, leading to enhanced focus on healthcare and saved costs. These benefits, if seen vis-à-vis the challenges brought about by the healthcare reforms, cited by the report discussed above, are necessary to arrest the reform-triggered trend of physicians parting ways with hospitals.

    5:45 pm
    Revenue Management & Being Vigilant amidst the impending Medicare backlash

    “Although, physicians can expect their Medicare reimbursements to be unhindered at least for another year or so, they need to equally vigilant with their medical billing, coding, submission, realization, and the Revenue Cycle Management so as to be sure of not letting their Account Receivables (A/Rs) beyond the expiry of the current window for Sustainable Growth Rate (SGR) temporary fix.”

    Dispelling all the speculation of a permanent solution to the impending Sustainable Growth Rate (SGR) fix, the Federal Government has deferred Medicare cuts till 2013, and with that it is pretty sure that the issue will meander for another year or so. Despite its possible impact on the Federal Budget, the Federal Government seems to be in no mood to stir hornet’s nest as it could possibly have demoralized physicians’ morale and motivation, resulting in deterioration of the quality of medical services – which remains the uttermost concern – across the nation’s healthcare industry.

    Strangely, the Sustainable Growth Rate (SGR), which was promulgated to limit the Medicare expenditure within the permissible limit, has contributed to an alarming escalation of Medicare expenditure, which now stands cumulatively at 27.4%. The Federal Government, in a desperate attempt to keep the figure from swelling further, is diverting $11.6 billion from the Patient Protection and Affordable Care Act, including $5 billion from the prevention fund, and $2.5 billion from Medicaid funds earmarked for Louisiana. Although physicians can heave a temporary sigh of relief for having escaped the backlash of Medicare cuts, they would always carry the apprehension of the impending possibility.

    Although, physicians can expect their Medicare reimbursements to be unhindered at least for another year or so, they need to equally vigilant with their medical billing, coding, submission, realization, and the Revenue Cycle Management so as to be sure of not letting their Account Receivables (A/Rs) beyond the expiry of the current window for Sustainable Growth Rate (SGR) temporary fix. When you consider the ominous task of being vigilant with medical billing practices along with the imminent healthcare reforms – mandatory EHR implementation, Accountable Care Organization (ACO) model, ICD-10 and HIPAA 5010 compliant coding & reporting amongst others – it is sure going to tell on the physicians’ ability to keep their quality of medical services unblemished.

    Therefore, amidst all these realignments, outsourcing the medical billing Revenue Cycle Management (RCM) from credible and competent vendors seems to be more viable. Apart from easing the possible workload on physicians, the outsourced model of medical billing Revenue Cycle Management (RCM) can prove financially vindicated as it can offer the advantages of voluminous operations from being source to many medical practices, clinics, and multi-specialty hospitals.

    But, like in case of decision involving trusting the credentials of a vendor, physicians need to be doubly sure of their service providers’ integrity so as to avoid falling prey to unscrupulous intentions. (www. – the largest consortium of medical billing services with over a decade of proven credibility and competence – has become a premier source of medical billing and operational management solutions for a majority of medical practices across the length and breadth of the U.S. Compliant with the best practices in the industry, its medical billing solutions – being ICD and HIPAA compliant, processed on the latest automated EHR platform – traverse the comprehensive Revenue Cycle Management – comprising Patient Scheduling and Reminders, Patient enrollment, Insurance Enrollment, Insurance verification, Insurance Authorizations, Coding and audits, Billing and Reconciling of Accounts, Account Analysis and Denial Management, AR Management, and Financial Management Reporting – is built for clinical, operational and revenue augmentation.

    For more information visit: medical billing companies

    Monday, March 5th, 2012
    6:29 pm
    Medical Billers & Coders demand spiked as US Healthcare adds about 31,000 jobs in January

    Remaining resistant to the pressures of the economy, the healthcare sector has long been lauded as a recession-proof sector, including jobs involving no direct patient care – one of them being medical billing and coding. According to the U.S. Bureau of Labor Statistics (BLS) – the healthcare sector jobs rose 0.2% to around 14.2 million workers since December, with the sector adding approximately 31,000 jobs in January, also stating that employment of medical billing and coding specialists is expected to grow at a much faster than average rate through 2018.

    According to the bureau’s preliminary statistics – Hospitals added around 12,700 jobs, ambulatory-services segment saw an increase of about 12,900 jobs, while around physician office jobs increased by 2700 since December. Moreover, BLS predicts an increase of 20% in the employment of all health information technicians, including medical billing and coding specialists.

    With the changing healthcare industry and reforms, and as the EHR system continues to broaden and alter medical billers and coders job responsibilities, BLS states that job prospects will be especially  bright for professionals with strong computer software skills. With the clinic requirements and patient population growing amongst other variables, demand for medical billing and coding is escalating along with a steady growth in income with increasing career prospects.

    Institute wise average medical coding and billing earnings

    Institute Average Pay/ year
    General Hospitals $32,600
    Nursing $30,660
    Federal Branch $42,760
    Physician offices/clinics $26,210
    Outpatient centers $29,160

    Source: U.S. Bureau of Labor Statistics (BLS)

    On a ‘highly’ optimistic note – being a recovering economy, if the job growth continues at this rate, the health care industry can be expected to add more than a quarter of a million new jobs by the end of 2012. Moreover there is tremendous scope for earning for medical billers and coders and the outlook of this stream is bright due to increasing requirements in medical centers, besides being able to practice in any part of the globe. Coding being highly vital to a physicians practice as any discrepancy in this area can result in low reimbursements, various physicians are seeking services of medical billers. is a preferred choice among physicians for over a decade now, gives coders a platform to excel in their domain and are equipped with experienced Billers and Coders well-versed with HIPAA, ICD-10 and other compliances, and training themselves constantly as per the industry requirements.

    Medical coding and billing salary range is wide, with a low percentage of employees in this medical field expecting to see a salary of $31,000 per year while another percentage expecting to see a salary range as high as $48,000 per year. However the average salary for a medical coder and biller will likely be between $36,000 per year and $44,000 per year and is expected to get a higher scope in upcoming years. However these are just averages and eventually only the medical biller and coder can determine their earnings depending on variables they adopt. providing updated knowledge, placement opportunities and analyzing current salary trends is the largest consortium of medical billers and coders in the US.

    For more information visit: Medical Billing Companies, Medical Billing Services

    Thursday, November 3rd, 2011
    6:05 pm
    Superbill Analysis – an imperial stamp of authentication

    “Consequently, physicians’ medical bills get an imperial stamp of authenticity, and nullify the chances of undesirable delay, denial, resubmission, and audits from highly stringent medical insurance companies”

    Notwithstanding physicians’ integrity in preparing honest Superbills, comprehensive analysis has become imperative before these can be submitted to payers for reimbursement because of the highly dynamic nature of US healthcare industry. Apart from being assured of the accuracy of the bill, a routine analysis saves the healthcare providers from being embarrassed with undesirable delay, denial, and resubmission notices from insurance payers on account of factual errors in the claim forms. Considering the efficacy of such a convention, the question is who should carry out Superbill analysis? Well, it is immaterial whether physicians get it verified in-house or outsource the procedure to an expert third party as long as it serves the purpose of authenticating medical bills.

    But, judging from the historic reference of failed in-house verification experiments, outsourcing Superbill analysis, from proven Medical Billing Management providers with their professional expertise, seems an ideal solution.

    How is Superbill analysis carried out?

    Having established the wisdom in outsourcing Superbill analysis, it would make sense to highlight how Superbill review vets out the accuracy of various crucial pieces of information contained in the document. Well, getting to the crux of the matter, Medical Billing Management specialists scrutinize the Superbills for accuracy of:

    • Provider Information, wherein last/first name and degree, service location, and signature are verified
    • Ordering/referring/attending physician, wherein last/first name and degree, NPI (national provider identifier) are scrutinized.
    • Patient Information, wherein patient’s first and last name, patient DOB, insurance information (insurance name/and id), date of first symptom (upon necessity), and last date seen (upon necessity) are checked.
    • Visit information, wherein date of service; procedure codes (CPT) – list of commonly used codes by medical provider according to the provider specialty; diagnosis codes (ICD-9) – list of commonly used codes by medical provider according to the provider specialty; modifiers (location and conditions modifiers); time (for timed codes); units and quantity for drugs, and authorization information, (if applicable), are cross- verified.

    Thus, Superbill review and analysis process culminates in authenticating the Superbills for claim submission only after ensuring the following:

    • Establishing the legitimacy of the bills in terms of signature by provider of service
    • Filling up of required fields for information
    • Legibility of the information
    • Apt CPT and ICD-9 codes with corresponding description of service/diagnosis

    Physicians can hire outside services for the entire process of Superbills preparation, verification, submission, and realization of medical bills from the insurance companies. Such services come with utilities such as preparation of super bills from the physician notes and transcriptions that are available in their system; utmost care while coding; adherence to HIPAA compliance and CPT, ICD-9, and HCPCS coding; and assigning of appropriate modifiers and related information into the Medical Billing Software accurately.

    Consequently, physicians’ medical bills get an imperial stamp of authenticity, and nullify the chances of undesirable delay, denial, resubmission, and audits from highly stringent medical insurance companies., being the largest consortium of medical billers in the US, has made Superbill analysis – comprising coding of the diagnosis and the procedure, checking the compatibility of the diagnosis with the procedure code, checking for the modifiers in relation to the procedure, quality checking before the generation of the claim – an integral part of its comprehensive Medical Billing Management Services.

    6:04 pm
    Sustainable Physician Practices: A Judicious Mix of Human Resources and IT

    While physicians’ competence will forever remain pivotal to excellence in patient care, the auxiliary services – on duty nurses, para-medical staff, and administrative staff – which ease the load off physicians are equally crucial. There are ample instances, wherein, despite best efforts of physicians, healthcare services have been found well short of bench-marked quality, largely on account of disoriented auxiliary medical staff. Consequently, along with a direct impact on patient’s well-being, it will also show up in physicians’ inability to practice sustainable growth.

    Streamlining clinical administration through an optimum mix of technology and human resources

    In an industry characterized by radical computerization of healthcare administration, the recent Federal Health Reforms, calling for more emphasis on further automating medical operations, should come as a relief to practitioners seeking to balance their auxiliary and administrative functions with an optimum mix of technology and human resources. But, finding an optimum mix of technology and human resources is no easy task: cost of installing technology interface, and training required to orient human resources to the installed technology comes in the way of providing medical services at competitive prices.

    The recent study by Healthcare Information and Management Systems Society (HIMSS) has unfolded some interesting facts about prevailing status of technologically oriented medical services:

    • Most hospitals are still capturing patient data manually, fouling up clinical transformation goals
    • While many healthcare organizations have teams in place to modernize clinical practice across the enterprise, plenty still struggle to capture the right data and provide optimal staffing to produce ongoing quality improvement
    • An astonishing 79% of respondents said they still gather outcomes data by hand – manual processes for capturing, collating, and analyzing data responsible for the lack of electronic means to conduct these functions.
    • Close to two-thirds total respondents said the staff at their organizations simply did not have enough time to participate in all necessary quality-improvement activities, which becomes a particular concern when hospital executives cannot have direct access to quality reports or specialized IT staff has to intervene to develop reports because the staff running the reports do not have the authority to directly create them.
    • Sometimes, organizations lacked the right types of employees, meaning inability to find a right mix of support and administration staff.

    Outsourcing staffing requirements to Medicalbillersandcoders

    While the result of the survey is an eye-opener on the current problems plaguing Physicians’ practice in the US, it is also a guideline for finding a useful mix of administration staff, and technology for advanced quality in medical care. Still, the word ‘Optimum’, being subjective, should be left to the discretion of concerned practitioners, who can best judge depending on their operational and revenue margins. Alternatively, there are proven agencies, which have the requisite expertise on advising optimum staffing for technology-driven medical operations. What is more, they even source and supply compatible human resources to complement their comprehensive advisory solutions., being the premier advisory for administrative medical services, has the credentials and competence to deliver custom-made solutions for medical practices seeking a judicious mix of technology and human resources in their administrative functions.

    Browse All: Houston Medical Billing , Chicago Medical Billing

    6:02 pm
    Patient Engagement Model: Enhancing Patient Care & Revenue Through IT

    Notwithstanding best quality of medical care offered by individual physicians, clinics, hospitals, and multispecialty groups across the US, there has been an interesting debate – how to leverage digital technology in pushing the prevailing medical care standard to the next rung while also optimizing revenue in the process. Whereas Patient Engagement Model is not a novel entity, yet, given its compatibility with Digital Technology, it assumes greater significance than ever before. In fact, the report released by a consortium of health IT experts affiliated to the Institute for Health Technology Transformation vindicates the importance of technology-driven business model for patient engagement, which also works to enhance your revenue returns.

    Increasing patient volume through enhanced engagement
    Calling for research and collaborations among industry stakeholders, the report is optimistic of a turnaround in quality, safety and efficiency of medical care should healthcare providers realize efficacy of Patient Engagement through Digital Technology Tools. Providing a broader guideline for implementation, the white paper (published by the consortium) has also spelt out ways to engage patients for seamless medical efficiency. Thus, gone are the days when your medical competence alone could attract, retain, and swell your patient base. In a highly technology-enabled modern healthcare industry, you are equally vulnerable to lose your patient-base to your competitors, who – not withstanding their equally competent medical knowledge – may have a better Patient Engagement Model in place. Therefore, it is advisable that individual physicians, clinics, hospitals, and multispecialty groups alike adopt the guidelines – issued by the experts at the Institute for Health Technology Transformation – as the commandments for IT-enabled Patient Engagement Model.

    • Complementing your patients’ healthcare-related information needs with customized delivery through various IT Media channels: although patients themselves derive health-related information for better management of their diagnosis and treatment, yet channelizing information – through online health tools, such as reminders, instructions and educational information about their diagnosis and treatments – from your end can be more apt and assuring. And satisfied patients translate into enhanced reputation and increasing patient volume.

    • While there can be no substitute for your medical competence, yet enabling a dialogue across your patient-base is seen as promoter of transparency, and goodwill amongst your patients. Social Media tools – Facebook, Healthgrades, ICYou, Patientslikeme and Twitter – are ideally suited for ensuring a networked dialogue.

    • Whereas targeting young patient-base – who are generally tech-savvy – assumes greater significance, there is an interesting phenomenon that elderly group and their well-wishers are equally fascinated with the web medium. This can provide interesting opportunities for physicians to include their patients from all age groups in meaningful online interaction. Therefore, there is a balancing act to be done that can go a long way to increase your patient base.

    • In an environment, where patients believe your advice to be authenticated, physicians and hospitals can leverage that trust by ensuring their patients with factual report on their personal health information, generated and delivered through networked systems.

    • As your patient-base tends to be highly mobile, you need to find a delivery mode that best suits your patients who are always on the move. The new age smart-phones, and tablet androids – which are capable of replicating computer-aided features – are made for the situation.

    • Although IT-enabled information channels can take your Patient Engagement Program to a new level, there is always an element of security threat as the sensitive health information is prone to undesirable proliferation over the web or wireless medium. Therefore, system security tools need to be in place for mitigating such scenario.

    • Contrary to the general conception of technology being expensive, IT-enabled Patient Engagement Program can be implemented at no cost at all through free social media tools like Facebook, YouTube and Twitter.

    • Although your Patient Engagement Program may not show tangible benefits directly like dramatic increase in your Rate of Return on your Investment (ROI), yet, being a quality measure at increasing medical care efficiency, it is bound to yield goodwill to practice or institution, which is invaluable.

    Browse All: Atlanta Medical Billing , Dallas Medical Billing

    IT-enabled Patient Engagement Model: an opportunity not an option

    Judging by its inherent potential, IT-enabled Patient Engagement Model should never be an option but an opportunity for individual physicians, clinics, hospitals, and multi-specialty groups to provide meaningful and enhanced patient care. While they can be adopted freely, healthcare providers can tackle that burden by subscribing to the consultancy services from a credible source such as for implementing medical management systems. While the government incentives can hugely subsidize the financial investments involved in the implementation of these processes, the consultancy services offered by Medicalbillersandcoders can easily streamline the implementation process as well as staff training involved in it.

    6:01 pm
    Family Physicians

    Medical Billing Challenges in Family Practice
    Family Medicine forms a crucial point of entry in the health care system, and the need as well as the shortage of family physicians in the United States is becoming a growing concern. Other specialties such as radiology, neurosurgery, and dermatology are more attractive due to the higher amount of compensation provided to physicians in these areas. Moreover, the looming Medicare cuts that have been postponed for a long time and are now extended to January 1, 2012 presents another problem for family practitioners for avoiding losses in income.

    Another important factor is the health reforms coupled with increasing number of aging baby boomers in the coming years which would keep family physicians busier than before and hard pressed for time and money.

    Chronic Hurdles
    Medicare is facing problems because of Federal fiscal troubles and Medicare cuts have been proposed in order to compensate for the rising health care costs. The recent debt ceiling increase at the eleventh hour by the government bears witness to the fact that Medicare is unable to withstand the increasing pressure brought on by a large number of aging population in the country. The inevitable solution to this income crisis faced by family physicians and in the field of primary medicine is better payer performance and adhering to the guidelines in regards to administrative or other processes involved in the revenue cycle management. These chronic pressures in the revenue of family physicians can be relieved by ensuring reduction of errors in the billing and coding procedures which are becoming more complex and extended in nature. Professionals who can perform better payer interaction and medical coding and billing can bring about speedy and fair reimbursement compared to an inexperienced or overworked in-house staff.

    The Geriatric Paradox
    The increasing number of baby boomers and elder people indicates better life expectancy but also makes physicians, hospitals and clinics dealing with chronic illnesses associated with old age busier by the day. Moreover, the Medicare fiscal issues exacerbate the problem by proposing to provide easy access to insurance for the elderly but lesser payments for physicians. As the baby boomer population grows, the number of physician-patient encounters by the elderly would also increase drastically, leaving very less or no time for physicians to handle paperwork or administrative tasks. Outsourcing the whole process of billing, coding, and payer interaction can be an easy and a frugal solution to relieve the administrative burden faced by physicians and health care providers.

    ICD-10 and Family Practice
    The migration from ICD-9 to ICD-10 codes is a major overhaul in the medical billing and coding industry and brings more complexity to the billing and coding procedures. Moreover, the fact that family physicians face diagnostic as well as treatment challenges across all ages, gender, diseases and parts of body makes billing and coding more detailed which requires dedicated professionals in order to avoid errors. The repercussions of errors impact not only the amount of reimbursement for physicians but can also jeopardize the privacy of patients’ healthcare data, emphasizing the importance of error-free billing and coding practices.

    How Do Healthcare IT Reforms affect Family Practice Physicians
    The health reforms also extend to the health IT sector which would provide easy access to physicians, administrators, medical billers and coders, as well as insurance companies regarding the information related to the treatment and other relevant data. Dedicated medical billers, transcriptionists, and medical coders can understand these changes from implementation and testing of EMR and EHR to following up with payers to receive timely and accurate reimbursements. The need for medical coders and billers who can cut down on the errors and save physicians’ time and money is being felt more in the field of primary care and by family physicians due to the extensive changes in the health industry as the latest health reforms are being implemented across the country.

    For more information about meaningful solutions to tackle these issues in the context of family practice and other specialties, as also for professional medical billing and coding services, please visit, the largest consortium of medical billers and coders in the United States, also specializing in Family Practice Billing.

    Browse All: LOS ANGELES Medical Billing , San Diego Medical Billing

    5:58 pm
    Coping with financial challenges in US healthcare (2)

    A Brief Anatomy of Financial Challenges Faced by Physicians

    The US healthcare system is facing major reforms in the next two years and this not only includes adoption of new healthcare IT reforms such as EHR (Electronic Health Records) and EMR (Electronic Medical Records) but also changes in the way physicians are reimbursed. The most crucial aspect of health care in the United States is cuts in Medicare which would leave doctors with reduced revenue resulting in dropping of Medicare patients by physicians. This 21% cut in the reimbursement for Medicare is scheduled to take effect on January 1, 2012 and would have negative financial repercussions for physicians, clinics, hospitals as well as patients. However, President Obama mentioned in a Whitehouse weekly address that such cuts would be unfair for health providers and the senior citizens of the country adding that this problem can be counteracted by reducing abuse and fraud in the health care industry.

    The Overheads
    One of the major problems that physicians and health providers face is the overheads that amount to more than 40% of the revenue that is earned. In an era where baby boomers are at their highest, it does not make sense to drop Medicare patients when the cuts take place (if they, in fact, do take place, which is unlikely). Instead reining in the overheads can work wonders if the cutbacks happen. Getting partial or even full-time support for billing and coding requirements as well as other revenue cycle management areas from expert professionals can help healthcare providers in cutting costs to some extent. It also frees up the staff to focus on voluminous core areas such as patient care and research etc. Apart from that, getting experienced and expert support for medical billing and coding and denial management can reduce avoidable errors and improve revenue as well as save time and efforts.

    Revenue Cycle Management
    Revenue cycle management is an integral part of a financially successful physicians practice and optimization of the same can lead to prevention of losses due to an inefficient or ineffective revenue cycle management. The process of revenue cycle management is a job that requires meticulousness and understanding the technology that boosts the outcome of such management. Using the latest technology can not only increase the revenue by saving time but also through the incentives provided by the government for using such technology. However, successful revenue cycle management also entails shorter turnaround time for reimbursement and efficient and productive interaction with payers which can be done much more effectively by a dedicated and professional team of medical billers and coders rather than a physician’s assistant.

    Codes and Ethics
    The transformation from ICD-9 codes to ICD-10 codes is going to impact the finances and the cash flow of hospitals, clinics, and physicians because of the complexity and increased volume of codes. The number of codes are going to increase more than six times and handling and navigating through this maze of medical codes would increase the chances of errors. To solve this problem, it is imperative that physicians and healthcare providers hire dedicated medical billers and coders who are experienced and trained in utilizing ICD-10 codes. Moreover, HIPAA guidelines also require that patient privacy be given paramount importance since information would be transmitted to various entities using the internet. To establish patient data privacy, the healthcare providers need to ensure that the third party vendors who support their administrative, technical and revenue cycle management are fully conversant with HIPAA privacy laws, as also their staff has stringent training in HIPAA compliances as they are the first ones to handle PHI data. This would ensure that HIPAA guidelines are not compromised even by mistake and they do not have to bear the financial brunt of breaking such regulations.

    Facing financial challenges in the current scenario is not likely to be easy but for long term gains and standardization it makes good sense to initiate meaningful changes and actions now. And doing this with an expert’s support will only establish those changes more efficiently and effectively in the physicians’ practice. For more information on how to bring about desirable changes to enhance your practice and revenue management and move ahead in these challenging times, please visit – the largest consortium of healthcare professionals dealing with Financial Challenges in the industry.

    Thursday, September 22nd, 2011
    6:33 pm
    Importance of IT for a Clinic

    ‘Notwithstanding their knowledge of how IT can do a world of good to their practices, it is the overwhelming investment on the constituents of Healthcare Information Technology that often is the bone of contention’

    ‘Incredible’ is the word that can best describe the way Information Technology has transformed health care industry – revolutionizing a human-intensive industry into technology-driven industry, IT has become indispensable in storing, retrieving, sharing, and using health care information, data, and knowledge for communication and decision making. Devising ingenious hardware tools and software applications, custom-made to the healthcare industry, Information Technology has taken the level of medical efficiency to unprecedented heights. Consequently, there has been appreciable

    • Improvement in health care quality

    • Prevention of medical errors

    • Reduction in health care costs

    • Increase in adminis\trative efficiencies

    • Decrease in paperwork

    • Expansion of access to affordable care

    Therefore, it should not come as a surprise that a majority of hospitals in US are IT enabled – the recent Federal Healthcare Statistics puts it an impressive 60% of the total healthcare providers across the U.S. While the statistics holds true for hospitals, and multispecialty groups, it is the marginal clinical practitioners – who fall into non-adopter category – that need to be advised on the efficacy of being IT enabled. Notwithstanding their knowledge of how IT can do a world of good to their practices, it is the overwhelming investment on the constituents of Healthcare Information Technology that often is the bone of contention.

    That brings us to discuss the various constituents of a comprehensive Healthcare Information Technology:

    • Electronic Medical Records: Apart from reducing errors in prescription drugs, preventive care, tests and procedures, Electronic Medical Records enables collaborative access of information related to disease management and patient care, and statistics for federal healthcare policies.

    • Clinical Decision Support (CDS): Clinical Decision Support system is another technological constituent that is integral to physicians’ decision-making on the course of medical intervention for a particular medical emergency. Known for providing historical references to similar medical emergencies, Clinical Decision Support System (CDSS) happens to be indispensable data base for future referencing.

    Couple with these main constituents, there are auxiliary systems such as – Health Informatics, which provide crucial data on various medical-related knowledge; computerized physician order entry (CPOE); applications for dispensing including bar-coding at medication dispensing (BarD), robot for medication dispensing (ROBOT), and automated dispensing machines (ADM); and applications for administration comprising electronic medication administration records (EMAR), and bar-coding at medication administration (BarA).

    Much like the demands of the constituents that form the core requirements, there is another equally demanding set of constituents that are associated with Medical Bill Submission and Realization with insurance carriers:

    • Electronic Medical Billing: Electronic Medical Billing – which lays the foundation for apt coding – demands the implementation of state-of-the-art technology platforms that demand heavy initial investments, felt imposing by individual or marginal practitioners.

    • Electronic Coding: Much like billing software, coding platforms too tend to be costly and heavy for individual physician practices.

    Coupled with these demanding platforms, there are incidental IT adaptations for processing claims online. Despite their insurmountable demands, marginal physicians should invariably make their practices IT-driven as their sustenance and growth largely hinges on how best they adapt to the prevailing scenario in an increasingly IT-driven sector.

    Having established the meaningful contribution of IT adaptation, what still needs to be reiterated is the limited ability of individual physicians to actively implement and incorporate these constituents in their processes. Not only do they have to bear heavy costs in implementing these changes but also in providing simultaneous training to upgrade their staff for its successful incorporation in the routine processes. While the incentives offered by the government can ease the financial load attached with the adaptation, the consultancy services offered by MBC, the leading medical billing and coding consortium in the US can go a long way in facilitating the implementation as well as staff up gradation processes. is capable of handling their clients’ information technology needs from a centralized state-of-the-art technology interface, presenting timely opportunities to the physicians faced with the ‘Ghost of IT’.

    Browse All: LasVegas Medical Billing, Phoenix Medical Billing

    Wednesday, September 21st, 2011
    3:47 pm
    Impact ICD 10

    ICD 10: Improving patient care and enhancing ROI

    The transition from ICD 9 to ICD 10 codes is the core of the health reforms and marks an era where Health Information Technology is at its zenith in the United States. The conversion from Health Insurance Portability and Accountability Act (HIPAA) Accredited Standards Committee (ASC) X12 version 4010A1 to ASC X12 version 5010 aims to provide better patient care, speedy reimbursements for physicians, and shorter turnaround time for claims. The codes would be more elaborate compared to the older version and increase the accuracy in medical billing, coding, claims denial, and physician revenue. However, the sheer complexity of the codes and the looming deadlines for expected compliance by almost all the entities in the healthcare industry make it a formidable task.

    The Deadlines

    The deadline for utilization of ICD-10 codes in HIPAA transactions is October 1, 2013 and includes outpatient as well as inpatient claims. However, since the transition from ICD-9 to ICD -10 codes requires a change from ASC X12 version4010A1 to ASCX12 version 5010, the deadline for transition to 5010 is set for January 01, 2012. There would be a penalty for those who are not HIPAA compliant by the end of 2013 and a danger of falling behind in the quality of care provided to patients along with decreased revenue for clinics, hospitals and physicians.

    Compliance Levels

    There are two compliance levels – Compliance Level 1 and Compliance Level 2 where Level 1 Compliance according to CMS is “that a covered entity can demonstrably create and receive compliant transactions, resulting from the compliance of all design/build activities and internal testing”. This simply means that involved entities should be able to transact with others using the ICD-10 codes. Level 2 states “that a covered entity has completed end-to-end testing with each of its trading partners, and is able to operate in production mode with the new versions of the standards”. Level 1 Compliance deadline is December 31, 2010 and Level 2 compliance is December 31, 2011 and full compliance is expected by January 1, 2012.

    Denial Management

    ICD 10 codes would play a major role in denial management since there would be almost eight times the number of codes to deal with and the amount of errors may increase. Insurance companies can simply deny a claim by pointing out a medical coding error whether it is due to non compliance of deadlines or due to the complexity of the codes. However, payers would also benefit from the fact that the ICD-10 codes are more detailed and would help payers to understand the reasons for various steps taken by physicians while providing patient care and whether they should pay for such procedures. Ideally ICD-10 codes should cut down on the turnaround time and make it easier for physicians to obtain speedy reimbursements while benefiting payers who have to spend lesser amount of time on the processes involved in managing claims. However, this is still a theory since it demands due diligence on the part of medical billers and coders as well as payers to make denial management an efficient process.


    The costs of implementing ICD-10 codes are not just limited to software changes but also towards training staff, physicians, and insurance company professionals who would use these codes. Training for a migration from 4010 ICD-9 to ICD-10 codes can be costly and requires time and testing for ensuring efficiency. The easiest way of cutting costs is hiring a third party which is experienced and trained in ICD-10 medical billing and coding, claims denial, and armed with the latest technology to provide optimum utilization of resources at lower costs.

    Patient Care

    The most important aspect of the transition from the 32 year old ICD-9 codes to ICD-10 codes is enhanced patient care along with successful return on investments (ROI) for hospitals and physicians. ICD-10 codes would be HIPAA compliant and would ensure patient privacy, better provisions in areas such as ambulatory care, would include expanded substance or alcohol abuse codes, expanded injury codes, and combination of codes to make them explicit and transparent. This would benefit the patient in a direct manner since payers, physicians, and health care providers can understand trends, changes and future implication in the health industry and the standard of health as a nation.

    For more information on how successful implementation of ICD-10 codes is likely to impact physicians and their billing processes effectively and cost-effectively cope with it, or to know more about our consultancy services on how physicians can handle such and similar issues in their practice, please visit, the largest consortium of billers and coders in the US across all specialties.

    For More Information Visit: Seattle Medical Billing, Austin Medical Billing

    Tuesday, September 20th, 2011
    1:32 pm
    Physician Staff Shortage: Problems &Solutions

    There is an acute shortage of medical billers and coders along with other clinical staff for physicians in the United States and the health reforms are making it even more difficult for providers to recruit experienced and well trained staff. The recent health reforms bring with them numerous changes in the way in which reimbursement is processed by insurers or payers in addition to the reforms in medical billing and coding.

    Moreover, the extensive utilization of healthcare IT in the form of Electronic Medical Records (EMR), Electronic Health Records (EHR) and such other technologies makes it important for physicians, hospitals and clinics to quickly adopt such changes or lose time, money, and even patients. Here are a few ways in which these hurdles can be overcome in order to ensure timely and correct reimbursements for health care providers without sacrificing the quality of care that is provided.

    Training Costs

    The changing face of the health care industry due to changes in medical billing and coding procedures, the migration from ICD-9 codes to ICD-10 codes, the adoption of HIPAA 5010 platform, integration and standardization of data related to health care, and the health care IT sector reforms necessitate rigorous training. This training is not just limited to medical billers and coders but is also required for nurses, assistants, and insurance companies. However, training requires a lot of time and money because of the sheer volume and complexity of codes, adoption of new health care IT reforms, and compliance of HIPAA guidelines.

    By outsourcing your billing and coding requirements fully or partially to a third party vendor such as medicalbillersandcoders who can expertly implement and integrate medical billing and coding along with denial management and has the requisite training updates in the latest guidelines and codes, can substantially cut down on your training costs. The MBC consultancy experts can also motivate the physicians’ team to adopt these compliances by underlining their relevance in effective patient healthcare and RCM management.

    Testing hiccups

    Physicians, hospitals, payers, and medical billers and coders are required to test the new codes for HIPAA compliance in various stages. The best way to ensure that you as a health provider do not lag behind at any stage due to the inevitable testing hiccups is to delegate the responsibility to a professional third party such as medical billers and coders who can effortlessly integrate these upgrades and compliances into physicians’ system through the testing and transition phase as also after the regulation deadline, thus increasing revenue and saving time and hassle.

    Technical Support

    The implementation of Electronic Medical Records and Electronic Health records would also require technical support for ensuring there are no delays due to downtime of software or hardware. Many physicians and small clinics have successfully installed the required hardware or technology but have lost precious time and revenue due to system crashes and downtime. A professional medical billing and coding company can ensure that there is minimum damage due to technical glitches since they usually have dedicated professionals who can handle such situations and get the system fixed whenever there are technical difficulties.

    Handling Errors

    Many hospitals and health care providers have found that errors while coding and billing can lead to denied claims and loss of time as well as revenue. Moreover, the quality of patient care can drop due to this directly impacting the revenue of clinics, physicians, and hospitals. The best way to ensure that no errors are committed by the staff is to outsource the complete process of billing and coding and denial management to a company that is an expert in handling billing, coding, and other related administrative services and ample experience.

    This would directly lead to reduction of errors and ensure that claims are not denied just because of wrong entries in the system. Moreover since the number of codes would increase more than six times after adopting 5010 platform makes it crucial that the billing, coding, and interaction with payers is delegated to an experienced and already trained staff instead of investing in training and testing of new codes and standards.

    For more information about better solutions to physician staff shortages and professional medical billing and coding services please visit, San Francisco Medical Billing, SAN JOSE Medical Billing.

    Monday, September 19th, 2011
    12:09 pm
    Physicians Apprehensive of Retiring Early: Recourse to Feasible Medical Practice

    There seems to be no respite for physicians, who are already reeling under immense pressure from radical healthcare reforms introduced by the Federal Government. Faced with prospect of unsafe retirement life in the face of continuously receding economy, physicians – who earlier had planned retirement in 5-6 years – are actively reconsidering such plans. The recent survey by the physician recruitment firm, Jackson & Coker – has found 52 percent (of the total 522 physicians interviewed) to have deviated from their original stand of going in for an early retirement. Attributing their rethinking to adverse factors — devalued assets, the continued economic uncertainty, governmental cutbacks on healthcare spending, and a general lack of confidence – the survey has been able to delve deeply into physicians’ alternative course of action.

    The survey goes on to highlight the growing level of dissatisfaction with governmental healthcare policies, amidst which physicians would find it difficult to sustain a feasible medical practice. Foreseeing an adverse future, many physicians are contemplating:

    • Working part time or locum tenens,

    • Intensifying their present practice further

    • Switching position in the same field

    • Deviating to a new thing altogether

    Therefore, it is timely that such an exodus be mitigated in the larger interest of the healthcare-needy population, which is growing at an alarming rate already. And with an impending population of senior citizens eagerly waiting to be inducted into Medicare, the situation is going to get worse. Since the Federal Government has made it clear that there is no going back on reforms, physicians have the added responsibility of finding recourse somehow.

    Browse All: Medical Billing

    While the reasons for such drastic measures are profound, physicians – who are justified in their instant reaction to impending problems – need an extra degree of caution prior to arriving at any decision for which they would repent later. Having been physicians all through their lives, it is advisable that they continue doing what they know best. And as far as addressing governmental healthcare impositions is concerned, there is always recourse to engage competent professionals who can ensure sustainable practice through:

    • Setting Up Electronic Medical Recording Compliance (EMR) for Incentive Eligibility

    • Advising on feasible composition for Accountable Care Organization (ACO)

    • Efficient Management of Medical Billing Reimbursement

    • Proactive measures for cost-effective implementation of ensuing ICD-10 and HIPAA 5010 Compliant System of Health Recording

    • Owing and executing all compliance and administration functions that would relieve physicians off an undesirable burden, and concentrate on their core-concern (medical efficiency) for sustenance and growth.

    Physicians re-considering moving to part time practice require effective administrative support to optimize the part time investment of time and effort in delivering quality healthcare. Expert support on reimbursement and appointment scheduling can help physicians have a profitable part time practice as well.

    Physicians looking to “Intensifying their present practice” need to manage their practices more efficiently by focusing on the healthcare as their core service and relying on reimbursement experts to enhance revenue in a growing practice. Expert Medical Billing professionals can facilitate the initial return on investment strategy better., with a long-standing credibility for owning and executing their clients’ compliance and administration functions in congruence with the prevailing standards, can prove to be an ideal ally in such a scenario. Armed with extensive multispecialty experience and expertise in billing and coding and healthcare IT-related services, MBCis well equipped to extend professional support to healthcare providers by optimizing their existing practice.

    The largest consortium for professional billers and coders for healthcare providers in the US, MBC offer consultancy services across all states of US, for the implementation of their strategic, operational, and financial purposes, no matter the size of their organization.

    For More Information visit: Denver Medical Billing, Nashville Medical Billing

    Author Box is the largest consortium of Medical Billers and Coders in the United States. We offer Medical Billing, Denver Medical Billing, Nashville Medical Billing, and Washington Medical Billing.

    Saturday, September 17th, 2011
    12:15 pm
    Demand for primary care doctors peaks

    Gone are the days when radiologists and cardiologist were amongst the most in demand specialties in healthcare; family practice and general internal medicine physicians have taken over as the two top sought after specialties.

    According to a survey, need is driving the demand for primary care physicians; listed below are the major reasons for this increased demand:

    • Many healthcare groups are in the process of forming patient-centered medical homes (PCMH), ACOs, and various other employment models which have strengthen the demand for primary care physicians as they form the base for these emerging delivery systems.

    • There is a shortage of primary care physicians as the number of medical students willing to opt for primary care is very low.

    • Practice style and physician demographics are additional factors inhibiting the supply of primary care physicians; many physicians are looking for part-time practice work or more structured practice hours that fit better with their personal lifestyles.

    • Population growth in the United States is creating a greater demand for primary care physicians. An estimated 32 million uninsured are expected to join the ranks of medically insured under healthcare reform, so the healthcare system is likely to register a surge in the demand for Primary care physicians.

    For More Information Visit: Dallas Medical Billing, Los Angeles Medical Billing

    To attract and retain primary care physlicians, healthcare organizations continue to offer massive signing bonuses and relocation and medical education allowances in recruitment packages. Also, it has become very important for these healthcare organizations to keep their revenue cycle intact in order to properly pay their current employees to retain them. It makes good business sense to improve the revenue cycle by letting an expert handle this;

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    <p>Gone are the days when radiologists and cardiologist were amongst the most in demand specialties in healthcare; family practice and general internal medicine physicians have taken over as the two top sought after specialties.</p>

    <p>According to a survey, need is driving the demand for primary care physicians; listed below are the major reasons for this increased demand: </p>

    <ul type=disc>
    <li>Many healthcare groups are in the process of forming patient-centered medical homes (PCMH), ACOs, and various other employment models which have strengthen the demand for primary care physicians as they form the base for these emerging delivery systems.</li>
    <li>There is a shortage of primary care physicians as the number of medical students willing to opt for primary care is very low.</li>
    <li>Practice style and physician demographics are additional factors inhibiting the supply of primary care physicians; many physicians are looking for part-time practice work or more structured practice hours that fit better with their personal lifestyles.</li>
    <li>Population growth in the United States is creating a greater demand for primary care physicians. An estimated 32 million uninsured are expected to join the ranks of medically insured under healthcare reform, so the healthcare system is likely to register a surge in the demand for Primary care physicians.</li>

    <p><b>For More Information Visit: <a href="">Dallas Medical Billing</a>, <a href="">Los Angeles Medical Billing</a></b></p>

    <p>To attract and retain primary care physlicians, healthcare organizations continue to offer massive signing bonuses and relocation and medical education allowances in recruitment packages. Also, it has become very important for these healthcare organizations to keep their revenue cycle intact in order to properly pay their current employees to retain them. It makes good business sense to improve the revenue cycle by letting an expert handle this; <a href=" ></a> can provide the best solutions for optimizing the revenue cycle and consultancy services for the changing industry norms.</p>

    <p><b><a href="">Dallas Medical Billing</a>, <a href="">Los Angeles Medical Billing</a></b>, and <a href="">Washington Medical Billing</a>.</p>
    Thursday, September 15th, 2011
    4:27 pm
    Bundled payment initiative to lower healthcare costs, help coordinate care

    A new program to aid and improve patient care while patients are in the hospital and after they are discharged has been announced by the U.S. department of Health and Human Services (HHS).

    These initiatives will also motivate doctors, nurses and specialist to perform coordinated care and hence reduce cost. Till date, hospitals, physicians, and other clinicians who provide care for beneficiaries’ bill are paid separately for their services by Medicare. However, with this initiative they can get bundled payments to treat a patient for specific medical condition during a single hospital stay, also termed as episode of care.

    Doctors, hospitals and other healthcare providers can apply to participate in this program. It offers four models:

    • Model 1:

      In this model, the episode of care would be defined as the inpatient stay in the general acute care hospital. Medicare will pay the hospital a discounted amount based on the payment rates established under the Inpatient Prospective Payment System (IPPS). Medicare will pay physicians separately for their services under the Medicare Physician Fee Schedule. Hospitals and physicians will be permitted to share gains arising from better coordination of care.

    • Model 2:

      The episode of care would include the inpatient stay and post-acute care and would end, at the applicant’s option, either a minimum of 30, or 90 days after discharge; the bundle would include physicians’ services, care by a post-acute provider, related re-admissions, and other services proposed in the episode definition such as clinical laboratory services

    • Model 3:

      The episode of care would begin at discharge from the inpatient stay and would end no sooner than 30 days after discharge.

      In both Models 2 and 3, the bundle would include physicians’ services, care by a post-acute provider, related readmissions, and other services.

    • Model 4:

      CMS would make a single, prospectively determined bundled payment to the hospital that would encompass all services furnished during the inpatient stay by the hospital, physicians and other practitioners. Physicians and other practitioners would submit “no-pay” claims to Medicare and would be paid by the hospital out of the bundled payment.

    For More Information Visit: Dallas Medical Billing, Los Angeles Medical Billing

    The final date for registration for model 1 is 21st October 2011; and for rest of the models is 15th March, 2012.

    Dallas Medical Billing, Los Angeles Medical Billing, and Washington Medical Billing.

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