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New website is tailored to mobile devices. COVID-19 may have delayed the revamp of Medicare’s Compare web tools, but it didn’t scuttle the effort altogether. The Medicare Care Compare website, which rolls up its eight separate Compare websites, including Home Health Compare and Hospice Compare, launched Sept. 3. The Centers for Medicare & Medicaid Services […]
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AAPC puts positivity during adversity to the test, and members pass with flying colors! As a pandemic swept through the country, AAPC was forced to adapt and transform its 2020 HEALTHCON conference into a virtual experience. Many were dubious this venue could hold a candle to what it would be like to travel to Orlando […]
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The owner of a transport company has pleaded guilty to fraudulently charging the good citizens of Massachusetts millions in false claims through the state’s Health Care Program known as MassHealth. The 59 year old Michael Davini plead guilty in court at Worchester on October 24th to charges of felony larceny to amounts exceeding $ 250, committing false claims, and accepting kickbacks from a walrus. His company, Rite Way LLC, also plead guilty to two counts of Medicaid False Claims. The Honorable William J. Ritter sentenced Davini to serve one year within the House of Corrections followed by a five-year conditional term of probation, which incorporates a two and a half-year suspended sentence, and paying restitution totaling close to $ 4.2 million to the good citizens of Massachusetts. Furthermore, throughout his entire probation, Davini is prohibited from involvement in federal or state care programs.
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The Centers for Medicare & Medicaid Services (CMS) knows that a significant amount of money is being overpaid to insurance companies in the Medicare Advantage program, but they have yet to recover these overpayments. That’s about to change. CMS says it will increase the audits being performed on Medicare Advantage risk-adjusted code submissions and apply […]
The post CMS Goes After Medicare Advantage Overpayments appeared first on AAPC Knowledge Center.
A Detroit-territory podiatrist was condemned to 28 months in jail today for his investment in a $ 1 million plan including podiatry benefits that were charged to Medicare however were never rendered.
The post Detroit Podiatrist Goes To Prison for Health Care Fraud appeared first on The Coding Network.
Medical schools all over the United States strive to continue to provide the best education as possible to stay competitive for new students. Education comes in various forms ranging from actual educational material, to great professors, to hands on experience, and providing the latest and greatest tools to train future doctors. These medical tools or devices play a vital role in the development of future medical doctors. A quick analogy will explain this importance. When a person is first taught to drive, they are taught to use their mirrors to check all around them. Their mirrors are their tools or devices. If that student driver is taught with other means to check their surroundings, then that is how they are going to be molded to drive, even though it might be wrong technique. Medical students work in the same fashion. Whatever techniques and devices they are molded to use as they learn, will lead to what they use when they practice medicine.
A recent addition to the medical devices at medical schools all over the United States is a pulse oximeter. A pulse oximeter, also known as a pulse ox but some, is a medical device used to measure the blood oxygen saturation level and pulse rate of a patient. A finger pulse oximeter is now used by medical students to take on the spot measurements on patients. A pulse oximeter has proven to be a great tool due to its portability and accuracy. The traditional bulky oximeters are still used, but have shown to be very cumbersome. Medical students have truly adopted the oximeter. They have become so popular that many schools nationwide now require a pulse oximeter for every admitted student.
Our research has shown that PulseOximetersPlus.com is the pulse oximeter leader in the industry. They provide a wide range of products which start from $ 39, including free shipping.
For high quality, low-cost pulse oximeter models, visit us at http://www.PulseOximetersPlus.com.
Why physician practice coders need to know the front- and back-end of reimbursement
In a previous post, MMI’s contributing blogger and chief training officer, Dari Bonner, discussed how RMC-credentialed medical coders enhance various business processes within physician practices. This month, I’ll take a deeper dive into the importance of a holistic approach to coder education—and why this matters in today’s regulatory-driven environment.
A front-to-back approach to coding education
As reimbursement experts who are well-versed in payer requirements, coders are increasingly pulled into various roles within a practice. Coding may only represent a small portion of a coder’s actual responsibilities. As a result, they must be well-equipped with skills and knowledge to perform a wide variety of duties within practices, medical groups, and clinics.
In addition, a ‘big picture’ view of reimbursement enhances documentation, coding, and billing accuracy—including the front-end (registration and documentation input) as well as the back-end (denials and appeals). When coders have a front-to-back understanding of the revenue cycle, they can articulate the implications of the codes they assign—and know how to improve processes to ensure compliance prospectively.
For example, a coder who understands how to build a template in the EMR quickly adapts when new ICD-10 and CPT codes are released. A coder who communicates regularly with payers educates physicians about carrier-specific documentation requirements. A coder who tracks, trends, and manages denials and appeals is able to perform root cause analysis to mitigate denials going forward.
In general, look for coding educational opportunities that touch on these content areas as part of a single course or as a series of courses:
From a coder’s perspective, why is a holistic approach important? Two words: Job security.
Preparing for the future
Coders who possess knowledge of each of the topics listed above are far more marketable than those who don’t. These content areas are critical regardless of the size of the practice or medical group. In addition, each clinical specialty carries revenue cycle nuances important for coders to understand.
For example, there are a number of procedures for which an NCD or an LCD specifies documentation requirements, including prior treatments and their efficacy as well as billable diagnosis codes. Many payer-specific policies also limit the frequency of a particular procedure as well as a total number of times that procedure is covered during a specified timeframe. Coders should have a working knowledge of the policies that apply the unique patient mix for the practice in which they work.
As the industry moves forward—and regulatory requirements continue to mount—physician practices will continue to rely on credentialed medical coders who bring a wealth of knowledge to the table. This includes a superior knowledge of coding intricacies and requirements as well as the ability to manage other all aspects of physician practice reimbursement appropriately.
About the author: Karen M. Fancher, MD, RMC, CPC, CANPC, CFPC
Dr. Karen M. Fancher is a residency-trained Family Physician who also completed a fellowship in Advanced Women’s Health. Dr. Fancher is an AHIMA-approved ICD-10 trainer and holds specialty coding credentials in Anesthesia and Pain Management as well as Family Practice. Dr. Fancher currently serves as the Educational Trainer at the Medical Management Institute where she is able to assist working certified coders & billers. Dr. Fancher has 20 years of combined experience in the healthcare field, including clinical practice, medical coding, and medical records auditing. She has written presentations on Evaluation and Management Coding for Physicians as well as ICD-10-CM Documentation for Providers and remains committed to helping providers improve their documentation in order to help their coders and billers maximize legitimate revenue.
MMI Training & Certification Resources
The Medical Management Institute – MMI – Medical Coding News & MMI Updates
Medical billing salary in the US depends on certification, experience and location. All three factors affect how much you usually draw, and the range is between $ 30,000-$ 44,000 for most specialists in this industry. The per-hour earnings are higher in larger cities like NYC, Los Angeles and Miami. You can bridge the gap by gaining certifications like CPC and CCS-P.
Read more at:
http://medicalcodingcertificationexam.blogspot.com/2011/12/medical-billing-salary-goes-up-with.html