Category: Blog

prior authorization

8 Useful Insights To Win The Prior Authorization Game

There is nothing more frustrating to physicians than knowing a patient needs a certain diagnostic test or medication and having them not be able to get it because their health insurance company won’t cover it. All too often, many services require prior-authorization (PA). It wouldn’t be so bad if the insurance companies made the guidelines […]
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Billing For Endoscopy Services

Don’t Make These Mistakes When Billing For Endoscopy Services

Learn the right way to code ‘incomplete’ colonoscopies Billing Medicare and other payers for endoscopy services is pretty different from billing for other types of procedures. And if you’re like most coders/billers, you’re probably making some common mistakes that can cost you lost time and valuable reimbursement dollars. When billing for endoscopy services, you need […]
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Code for Critical Care

The Best Way to Code for Critical Care

Key: Amount of time spent with the patient indicates which code to use. Coding for physician inpatient services, especially critical care, is deceptively straightforward. The reality is that the details of each code requirement can complicate things to the point of complete confusion. Despite the challenges, there are specific strategies you can use to correctly […]
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3 Coding Tips From Medical Bill Consultants’ CEO

3 Coding Tips From Medical Bill Consultants’ CEO

Beth Morgan, president and CEO of Medical Bill Consultants, has over 40 years of experience coding and billing for various providers and facilities. She provided these three tips: Read the notes carefully. If coders and billers don’t read notes carefully, they might miss a key component that the provider also missed. For example, if the […]
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New Medicare Cards Are Coming

New Medicare Cards Are Coming

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, requires us to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019. A new Medicare Beneficiary Identifier (MBI) will replace the SSN-based Health Insurance Claim Number (HICN) on the new Medicare cards for Medicare transactions like billing, eligibility status, and claim status. The […]
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Evaluation and Management

Coding for time vs. E/M elements

Q: When you are basing an office visit on time, do you need to meet the levels in history, exam and medical decision-making too? A: It is not unusual to spend a considerable amount of time face-to-face with a patient reviewing problems, adjusting medication dosages and counseling or coordinating care, only to find that you […]
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