outsource medical billing

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How To Prevent Medical Billing Claim Denials?

https://thehomosapienhuman.blogspot.com

outsource medical billing - It's a well-known fact that the relationship between health care providers and insurance companies is not simple. Healthcare providers often spend a significant amount of their time and energy with their patients to find out if an insurance company will fight them on paying for the services provided.

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Proper Use of Modifier 59 after NCCI Update

https://www.medicalbillersandcoders.com

There is an appropriate use for modifier 59 that is applicable only to codes for which the unit of service is a measure of time (e.g., per 15 minutes, per hour).

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Use the Medicare National Correct Coding Initiative (NCCI) Tools

https://www.medicalbillersandcoders.com

The Medicare National Correct Coding Initiative (NCCI) (also known as CCI) was implemented to promote national correct coding methodologies and to control improper coding leading to inappropriate payment.

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Medicare Proposed Changes for 2020 Physician Fee Schedule

https://www.medicalbillersandcoders.com

The changes for CPT also change the medical decision-making process for the codes, while requiring the performance of history and exam only as medically appropriate. CPT code changes also allow clinicians to choose the E/M visit level based on either medical decision-making or time involved.

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Patients over Paperwork – CMS’s Approach to improve Patient Care

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The Omnibus Burden Reduction (Conditions of Participation) Final Rule strengthens patient safety by removing unnecessary, obsolete, or excessively burdensome health regulations on hospitals and other healthcare providers.

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AMA Announces 2021 E/M Changes

https://www.medicalbillersandcoders.com

Medicare has published the 2021 E/M changes they intend to make and now, so has the AMA. We’ve all seen that when Medicare and CPT do not agree on the way in which a specific service, or group of services, should be reported, Medicare may produce HCPCS code(s) with specific guidance for Medicare contracted providers to follow.

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Basic Guidelines for Accurate Diagnosis Coding

https://www.medicalbillersandcoders.com

Medical coders are responsible for ensuring proper diagnosis coding for each procedure billed to an insurance company. Although most claims billers do not actually code diagnosis, they are often responsible for choosing the correct code for each claim. This article provides tips for accurate coding as well as information regarding diagnosis codes on claims.

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ICD-10-CM Guidelines | Coding | Reporting FY 2020 | Respiratory System

https://www.medicalbillersandcoders.com

When a patient is admitted with respiratory failure and another acute condition, (e.g., myocardial infarction, cerebrovascular accident, aspiration pneumonia), the principal diagnosis will not be the same in every situation. This applies to whether the other acute condition is a respiratory or nonrespiratory condition. 

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Diagnostic Coding and Reporting Guidelines for Outpatient Services

https://www.medicalbillersandcoders.com

These coding guidelines for outpatient diagnoses have been approved for use by hospitals/ providers in coding and reporting hospital-based outpatient services and provider-based office visits. The terms encounter and visit are often used interchangeably in describing outpatient service contacts and, therefore, appear together in these guidelines without distinguishing one from the other.

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Quantifying Your Medical Decision-Making

https://www.medicalbillersandcoders.com

This is the most important of the three key components because the Medical Decision-Making (MDM) reflects the intensity of the cognitive labor performed by the physician. There are four levels of MDM of incrementally increasing complexity Straightforward; Low Complexity; Moderate Complexity; and High Complexity.

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