Medical Claims and Billing

[...] Outsourcing your medical billing claims to a third party partner may be one of the smartest business moves you make in 2010. [...]

[...] Long term care medical billing has it’s own set of nuances that must be followed in order to ensure that you receive [...]

[...] documented. The reason is that Medicare is very strict about seeing specific modifiers on medical billing claims that involve a substitute or locum tenens physician. Further, your medical billing [...]

[...] most obvious, contact the carrier and ask them how they want the procedure reported on your medical billing. Colonoscopies are part of a check up for most individuals over the age of 50, however when [...]

[...] for treatment and management and you are more likely to receive reimbursement for your medical billing claim if you meet this criteria. [...]

[...] documentation of the time elements is critical and will result in reimbursement for your medical billing claim. [...]

[...] . The answer to this question will be different depending on which entity is paying the medical billing claim. When you code for the use of tissue adhesives, including Dermabond; Medicare has its own [...]

[...] codes to describe what was done, attaching your documentation and then submitting your medical billing claim for reimbursement? Now we have codes for codes and modifiers and the need to when to [...]

[...] Neonatal patients seem to present confusing scenarios for many medical billers. It could be due to the fact the patient is so tiny that many of the procedures seem [...]

[...] One point that many medical billers find confusing is the correct procedure for coding the use of tissue adhesives when used [...]

[...] goal being fair reimbursement for procedures done. Modifiers cause a lot of confusion for many medical billers. One such confusing modifier that is worth clarifying is Q6. This applies to Medicare [...]

[...] a leave of absence for any reason and a substitute physician fills in, you need to add the Q6 modifier to Medicare claims the sub handles if you want to ensure reimbursement for the services that [...]

[...] reduce reimbursement by roughly 50%. However, in the case of this type of procedure, your medical documentation documenting both the necessity of the procedures as well as the outcome should be iron [...]

[...] have a long term history of care – it’s sometimes tempting to skimp on the medical documentation and necessity but since you have no way of knowing who is going to review your claim, you [...]

[...] physician. Further, your medical billing claim must have the time limits observed for locum tenens doctors. Otherwise, Medicare won’t pay for their services rendered to patients. Also, you [...]

[...] wants to see specific modifiers on claims. This is to make sure that the time limits on locum tenens doctors are strictly observed. In order to be reimbursed, make sure that modifier Q6 (Service [...]

[...] billers. One such confusing modifier that is worth clarifying is Q6. This applies to Medicare medical billing claims only, but in a nutshell when one of your staff physicians takes a leave of [...]

[...] service. You can report the code but you won’t receive any reimbursement for it from Medicare payers. Private payers will have different guidelines, a quick check with the payers to see if they [...]

[...] replacement that substitutes for the services of a specific physician. Remember to use Modifier Q6 on all your locum tenens claims. There are some extra steps that must be taken in order for [...]