The below articles are all published in BC advantage
Magazine and written and contributed by Steve
Verno
Steve Verno Medical Billing and Coding Instructor/Consultant
at Quality Medical Management/Emergency Medicine Specialists
Miami, Florida
Learning the Language of ICD-10
In this series of articles, we will learn terms that are used in ICD-10 Coding, which is slated for implementation on October 1, 2015. We're going to help you be ready. What is our first word? DOCUMENTATION
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Questions from the Internet - Part VI - Deductibles
Has anyone had an issue with XXXXXXX applying amounts toward the OON deductible over and beyond the member's annual deductible? (The name of the insurance company has been X'd out to protect their name. The wording of the question has not been cha...
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Questions from the Internet - 5
I have been having problems with one insurance provider. Depending on the patient they sometimes send the check to the member.
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Questions from the Internet 4 - The Continuing Saga
I am a doctor and I provided one of my patients with a 1500 form with my required information and instructed him to make photocopies of the form to fill in with specific dates of service to submit to his insurance reimbursement (I'm an out of network...
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Questions from the Internet #3
My Dr. for whom I'm billing for put me down to bill for laceration repair. Can someone provide me with the CPT code for it ??
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Questions from the Internet #2
Apparently on his plan, for out of network doctor he is limited to $100/visit max they'll pay and $1,000/year max they'll pay.
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The Changing Face of Medical Billing
At one time in America, we went to a doctor's office or the doctor made house calls and came to us. We paid in cash or bartered with the doctor; however, that changed when insurance became available, and with insurance came CPT and ICD-9 codes, and ...
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Demystifying ICD-10-CM
It's a usual day in your office and your phone rings. You answer the call with your usual "Hello, Mayo-naise Clinic, how may I help you?" "Yes, this is (garbled), are you prepared for ICD-10? If you don't take our ICD-10 seminar, you will not get y...
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Contract Negotiations
What is a contract? It is a written agreement. The agreement specifies, in detail, what the insurance company is asking a doctor to provide to its members and it should specify, in detail, what the insurance company will pay the doctor for those se...
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Something to Work With
For years, I've been fighting insurance companies regarding how they denied claims I sent them. I've fought everything from timely filing, downcoding, bundling, non-par payments, non-par discounts, authorization was not obtained, and no benefits ava...
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Collections Tools
In any practice there are three things that generate revenue: They are insurance claims, patient payments, and debt collection. There are several types of collections. One is outstanding claims, another is patient collections, and another is debt col...
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Accountable Care Organizations
The Patient Protection and Affordable Care Act (PPACA) was signed into law and its constitutionality has been challenged. The United States Supreme Court has upheld the PPACA and it is now the law of the land. The law is very lengthy but it does cont...
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Emergency Care
There is a misconception that a non-emergency room physician or non-hospital emergency physician cannot submit a claim for services rendered in the emergency department. The CPT codes for services rendered in the emergency department are 99281 throu...
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Bundling Services
When our doctors treat a patient, we must be very careful that we do not intentionally unbundle services.
What is unbundling?
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