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    Welcome to the ClaimCare Medical Billing Blog. We strive to provide content that improves the overall quality of medical billing efforts across the US. If you have any specific topics that you would like to see addressed in this medical billing blog please post the topic in the Medical Billing Questions & Answers Forum. If you have an article that you would like considered for publication in the medical billing blog then please email your article to resources@claimcare.net.


    The Best New Year Resolution To Improve Your Medical Billing

    Posted by Carl Mays on Sun, Jan 18, 2009 @ 03:08 AM

    medical billing resolutions

    We are fast approaching the end of January and the point in the New Year when the majority of people's New Year's resolutions have already failed. This is, however, the time for renewed efforts to focus one's resources on achieving the desired goal. There are two keys to reaching your goals:

    1. Treat your set backs as temporary failures and not total defeat (i.e., just because you broke down and smoked a cigarette does not mean you should just say I failed on my goal to quit smoking); and
    2. Break your goal down into manageable pieces (i.e., I will lose 2 pounds in January; 2 lbs in February versus I will lose 25 pounds this year).

    These ideas do not only apply to personal goals, but to business goals as well. If you are trying to improve your medical collections in 2009, you should build upon these concepts. So, given these two points what is the best way to achieve a New Year's resolution of improving your medical billing? The best place to start is with the goal of getting your claims out the door clean.  This is a great starting point because it does many wonderful things:

    • It focuses you on the most critical aspect of billing. If the claims go out the door clean you will find that all of the rest of the challenges start to become much more manageable;
    • It allows you to focus on achievable, smaller goals (85% of claims go out clean in January, 87% go out clean in February, etc);
    • Set backs position you for better performance tomorrow. How? You look at the claims that did not go out the door clean and learn what went wrong. Do you have a problem at the front desk with gathering demographics? Do you have a problem with training your data entry people? Do you have one physician that consistently codes incorrectly? Do you have one payer that really dislikes one of your common procedures?
    • It lends itself to technology aids. Invest in a scrubber that will help you find coding problems before you submit the claims (see our blog entry on claim scrubbers). Invest in insurance verification tools that will make it easier to have clean demographics. Invest in coding tools that will help improve your data entry performance.

    So, as we approach the end of January this is the time to double down:

    • Measure your current performance level;
    • Set your medical billing goals high (96% of all claims will be paid on first submission);
    • Break them down into bite size pieces (I will improve clean claim submissions by 2% each month), and
    • Adopt the mentality that you will learn from your mistakes.

    With this approach you can make 2009 your best medical billing year ever.

    Copyright 2009 by Carl Mays II, President, ClaimCare Inc

    Tags: motivation, improving medical billing, scrubbing, 2009 billing changes

    Are you prepared for the 2009 Cardiology Billing changes?

    Posted by Carl Mays on Sun, Jan 11, 2009 @ 12:47 AM

    cardiology billingIf you are not aware and prepared for the 2009 cardiology billing and coding changes you may be leaving a lot of money uncollected.

    The 2009 cardiology coding and billing changes are the most significant that have been seen since the mid 1990s.

    Cardiology practices were hit harder than the average physician by this year's changes (with a 2% reduction in Medicare fees instead of the 1% increase seen by the average physician) driven in large part by changes that will impact imaging performed in the office.

    Keep in mind the 2% reduction is an average number. Some practices will be well above this (especially heavy users of echo services) and others will actually see fee increases.

    Here are examples of some of the upcoming changes:

    • Significant changes in the codes used for follow-up on implanted devices (all of the old codes have been replaced) and external devices. The updated codes include new codes for interrogation and reprogramming of ICM and ICD devices, Pacemaker and Loop recorders.
    • Global periods related to device follow-up now include global periods of 30 or 90 days. The new codes are now service specific (i.e., either an interrogation evaluation of a programming evaluation).
    • Wearable cardiac telemetry devices (for instance Cardionet type service) now have specific codes. You no longer bill with an unlisted code. These new codes include the complication of global periods.
    • The echo services are also seeing new codes. When you do an echo with a Doppler and color flow you'll have a new code to submit that bundles these services into one code. The same is true for a new stress echo code that bundles the stress test code and stress echo into one code.

    These changes are far greater than the normally "tweaking" that occurs at the beginning of each year. If you cardiology billing department is not fully aware of the changes and how to respond to these changes it could have a significant negative impact on your practice. Be sure to invest in the proper training, coding resources and billing system upgrades to be prepared for 2009 cardiology billing.

    Copyright 2009 by Carl Mays II

    Tags: cardiology billing, 2009 billing changes

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