Tag Archives: billing
Posted on 16. Jun, 2010 by Editor.
Question: One of our optometrists wants to stop billing under the group’s tax ID and start billing under his own tax ID. I’m concerned that doing so will confuse the insurance companies and slow down his income, even though he has personally called some to notify them of the change and the effective date. Some payers are now asking for new W9 forms. Is there an easy way to do it?
Answer: Your optometrist can change his tax ID at any time, but you must submit a new W9 to your payers, in addition to
Posted on 17. Jan, 2010 by .
With fewer patients following through on procedures because of economic and financial struggles, and an increasing number of patients not paying their bills, your practice needs to find ways to improve your A/R and bring in deserved money. Adapting an up-front deductible collection policy is one proven way to do both — and setting up a policy can be as easy as 1-2-3.
1. Confirm the Deductible With the Payer
Insurance verification services now make it possible for practices to find out if a patient has met his deductible yet. Some services can tell you how much of the deductible remains unpaid. Because this information is available online, your practice can get this information last-minute, the day of, the day before, or several days before the patient is scheduled to come in for a service or procedure.
Posted on 15. Sep, 2009 by .
New, standardized reports will show you why your claim was rejected and how to fix it.
You’ve got a few years to implement the HIPAA 5010 form, but CMS wants to make sure you’re completely ready by the time it takes effect on Jan. 1, 2012.
The 5010 form, which will make way for the ICD-10 code set, increases the field size for diagnosis codes from five bytes to seven bytes, allowing for ease of use once the ICD-10 transition occurs. But it also includes other changes that you’ll need to know about.
For instance: Once the 5010 goes into effect, you’ll have to get familiar with the potential claims rejection notices.
Posted on 04. Sep, 2009 by .
This nifty tool tells you if collections cluelessness is hurting your practice’s bottom line.
You know that solid collections knowledge is the key to bringing in patient co-pays, deductibles, and balances, as well as payer reimbursement. Are you wondering where you should focus your time and energy? This quiz will help you determine whether you’re on the right track, or if you should work on your collections know-how.
Wish you could go ‘back to school’ for a few days to learn about coding and billing? Check out our new Billing and Reimbursement Conference, with Specialty Coding Tracks available. This December 6-8 in Orlando.
Question 1: If your physicians are seeing patients with insurance you do not par with, what are your options to ensure that your practice still gets paid?
A. Collect the fee for your services directly from the patient at the time of service.
B. Ask the patient to pay you when he receives reimbursement from the payer.
C. Submit the claims to the payer accepting assignment if the patient agreed to allow you to do so.
D. All of the above.
Question 2: True or false: Even if you can predict what the Medicare EOB will say (which is nearly impossible), the odds of knowing whether the patient will owe you her deductible get worse and worse every day after January 1.
Question 3: Which of the following are not good collections statements?
A. You need to pay your balance today before you see the doctor.
B. How will you be paying your balance today: cash, check, credit card?
C. Did you want to pay for that today?
D. All of the above.
Question 4: How often should you, preferably, review your practices collections efforts?
Posted on 03. Jul, 2009 by .
One third of physician practices don’t accept credit cards, and that number is up 5% from last year, reports American Medical News.
The plastic boycott is puzzling. More patients are paying for health care out-of-pocket, and a credit card payment means money in the bank for a practice rather than having to fuss with collections efforts later on, practice management experts point out.
What doctors can’t stomach: The credit card processing fees, which amount to 3-4% of the transaction … More from American Medical News.
Posted on 25. Mar, 2009 by .
Surprise! Here’s when the new form puts you on the OIG’s hot list.
The drop-dead date for using the updated advance beneficiary notice (ABN) just passed, so it’s out with the old and in with the new.
While the new form was first introduced last year, you haven’t been required to use it — until now. With March 1 behind us, you’re asking for denials if you’re still using the old forms.
You Now Have a Streamlined Form
The new form not only replaces both the previous ABN-G (for physicians) and ABN-L (for laboratories) but also incorporates the Notice of Exclusions from Medicare Benefits (NEMB) form, says Melinda S. Brown, CMBS, insurance biller for a primary-care provider in Kennewick, Wash.
Posted on 09. Mar, 2009 by .
Until recently, the number of returned checks had been decreasing, from 187 million returned nationwide in 2003 to 153 million returned in 2006, largely because of an increase in electronic payments, according to the Federal Reserve Bank. Now, the bounced check rate is bouncing back.
And doctors are feeling the pain, reports American Medical News. One MD saw her practice’s bounced check numbers double from the same month the previous year.
And bad checks from patients can quickly add up to lost revenue. If the bank charges your practice $25 for trying deposit a bad check, you’ve essentially lost the co-pay and then some, unless you take action. One solution is not to accept paper checks … More …
Posted on 10. Feb, 2009 by .
You can avoid unnecessary stress during physician vacations when you report reciprocal billing arrangements or locum tenens services. Keep this clip-and-save checklist handy when you apply modifiers Q5 and Q6.
1. Remember that reciprocal billing allows a physician to submit claims and receive Medicare payments for services that he has arranged for a substitute physician to provide on an occasional, reciprocal basis.
2. To appropriately report services a physician performs under a reciprocal billing agreement, use modifier Q5 (Service furnished by a substitute physician under a reciprocal billing arrangement).
3. Locum tenens also allows your radiologist to receive payment for services another physician performs. But a locum tenens physician cannot work for another practice, and your physician cannot restrict the locum’s services to your office.
Posted on 06. Feb, 2009 by .
Medical offices may not need to file an appeal to correct a claim if the mistake is deemed “minor,” according to new rules from CMS. When an office commits a minor error on a claim, the biller can ask the carrier to reopen the claim so she can correct the problem — entirely avoiding the appeal process. With most carriers, minor errors will include basic typographical and clerical errors.
Try this: If you get a denial from an insurer that contains a minor error, follow these three steps to determine if you can fix the error without appealing:
Posted on 29. Jan, 2009 by .
Use this sample letter to provide all of the information your payer needs.
When you send a refund to a payer, you want to be sure that it correctly applies the refund to the proper claim and patient. You can up your chances by always sending a standard form, such as this example containing pertinent patient, claim, and payment information.