Anybody else having issues with Medicaid denying add-on codes such as 11101 or 17003? They are paying the primary code but not the add-on. What is…
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Tag Archives: Dermatology
Dermatology
Our Doctor did a MOHS procedure on Atypical Fibroxanthoma of the cheek which refers you to diagnosis D48.1 which is not payable but the report states tumor was aggressive clinical behavior and tumor with aggressive histologic subtype. Any suggestions on this would be greatly appreciated!
Need help with counting 1997 Physical Exam for Dermatology
Could you please help with counting number of bullet of 1997 Physical Exam for Dermatology?
EXAM:
Well developed, well nourished, female in no acute distress, oriented and without outward signs of anxiety or depression. Complete examination of the scalp and hair, digits/nails, right and left arms and legs, eyelids and conjunctiva, neck, face, ears, nose, lips was normal except for the following significant findings:——
Thank you for your help.
CPB, CPCD – Seeking remote billing position, prefer dermatology
Skills
Reading and understanding carrier EOBs Type 85+ WPM ICD-9,10, CPT and HCPCS codes Microsoft Office: Word, Excel, PowerPoint, Outlook HIPAA Compliance Knowledgeable of insurance carrier policies/guidelines and payer portal navigation. Im a Certified Professional Biller [CPB] and dermatology coder [CPCD] through the AAPC.
Reading and understanding carrier EOBs Type 85+ WPM ICD-9,10, CPT and HCPCS codes Microsoft Office: Word, Excel, PowerPoint, Outlook HIPAA Compliance Knowledgeable of insurance carrier policies/guidelines and payer portal navigation. Im a Certified Professional Biller [CPB] and dermatology coder [CPCD] through the AAPC.
Experience
Billing Manger | Interventional Pain Management Specialist, Franklin, TN 2016 current
Responsible for complete revenue cycle management: charge review, claims submission, payment posting, patient accounting, and accounts receivable.
Owner | DeBien Dermatology Billing, LLC 2014 – 2016
Billing service responsible for daily claims batching and submission, payment posting, aged claims reconciliation, rejected claims resolution, patient accounts and statement processing. Daily contact with providers.
Certified Billing/Collection Professional | Ophthalmology office, Naples FL 2015 – 2016
Part of a billing team for a large ophthalmology office with several specialties: Optometry, ophthalmology, retina, retina surgery and dermatology. Job duties: complete revenue cycle management.
Billing/Collections Manager | Dermatology office, Naples FL 2012 – 2014
Complete revenue cycle management duties for two physicians, two mid-level providers and ambulatory surgical center: Charge entry, electronic and paper claims submission. Insurance payment posting via ERA and manual posting. Rejected claims resolution, aged claim reconciliation. Patient accounts: electronic statement generation, billing inquiries. Soft collections processing. Reporting for physicians on all accounts. Staff education and training pertaining to front desk duties, including HIPAA compliance. Documentation compliance audits.
Medicare/Medicaid A/R Rep | Neuroscience & Neurosurgery, Naples FL 2010 – 2012
Specialized in Medicare and Medicaid claims, working aged and rejected claims for resolution/payment. Held over 95% of claims in 0-30 day A/R timeframe. Payment posting, data entry for Excel reporting, Balanced CBO
Medical Billing/Collection Specialist | Billing Company, Naples FL 2007 – 2008
Complete revenue cycle management : Charge entry and payment posting. Claims submission. Claims reconciliation, rejected claims resolution. Sent patient statements and handled billing inquiries.
Education
Certified Professional Biller [CPB] AAPC Accreditation
Certified Professional Coder of Dermatology [CPCD] AAPC Accreditation
References:
[AVAILABLE UPON REQUEST]
*Company names omitted. Serious inquiries may request work history.
Dermatology Physicians / Practice to Pay $1.9 Million to Settle Overbilling Medicare for E&M Services
Abusers of the Medicare system can sometimes be intentional or not, but the stories that really get significant attention of the public are the ones that highlight healthcare personnel that intentionally over bill Medicare.
There are several types of abuse including falsifying claim forms adjusting the actual cost of services, Billing for services and supplies that were not provided, and even billing for appointments that were canceled.
On April 18, 2016, The U.S. Attorney’s Office for the Northern District of Georgia announced that it has reached a settlement with dermatologists Margaret Kopchick, M.D., and Russell Burken, M.D., and their practice group, Toccoa Cl
inic Medical Associates, who agreed collectively to pay $ 1.9 million to settle claims that they violated the False Claims Act by billing Medicare for evaluation and management (E&M) services that were not permitted by Medicare rules.
“The improper billing of evaluation and management services cost the taxpayers millions of dollars each year and drain the Medicare Trust Fund,” said Derrick L. Jackson, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG) for the Atlanta region. “The OIG and the U.S. Attorney’s Office will continue to hold health care providers like these responsible for improper claims.”
You can read the full press release on the justice.gov website here.
For further information please contact the U.S. Attorney’s Public Affairs Office at[email protected] or (404) 581-6016. The Internet address for the U.S. Attorney’s Office for the Northern District of Georgia is http://www.justice.gov/usao-ndga.
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