The Blog

02 May

How is ICD-10 affecting claim denials?

by Carl Natale There are some mixed messages on how much claim denials have risen since Oct. 1. Some healthcare providers are reporting a few ICD-10 denials but not enough to worry about. On the other hand, a healthcare consultant found out that a California HMO was denying medical claims on a massive scale. And NCDs and LCDs

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25 Apr

Four ICD-10 Coding Mistakes To Avoid

Now that ICD-10 is almost six months old, coders are figuring out which mistakes are the most common. ICD-10 codes are very specific and large in numbers compared to ICD-9. Because of the specificity and large numbers, coders should be careful how they used ICD-10 codes. Let’s take a quick look at some of those

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11 Feb

HIPAA’s Role in Fostering Trust between Patients and Providers

By Roman Diaz The following scenario is true, but some of the details have been changed to protect the innocent, and the guilty. The setting is the cramped reception area of a small dental practice. The office manager, who also works the front desk, is on the phone there with a patient. “Julie Jones?

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23 Aug

CMS Corrects Recent ICD-10 Guidance for Physicians

CMS and AMA recently developed guidance on new ICD-10 flexibility for physicians during the first year of compliance. Now, at the request of stakeholders who found errors, CMS has substantially changed the guidance in Questions 3 and 5. >Click here to read full article

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05 Aug

ICD-10: Who’s in the Family of Codes?

CMS has said it will not deny or audit claims just for specificity for one year after implementation of ICD-10 as long as the code is from the appropriate family of ICD-10 codes. But it has not defined what a family of codes is. This article originally appeared in ICD-10 Trainer Remember those friends and

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02 Jul

When Is It Time to Outsource Your Medical Billing?

Managing your doctor\’s practice is no less involved than running any small business where you have to take care of everything yourself. Even though you have your administrative staff on hand to help, taking care of all the other endless tasks involved in operating a doctor’s office can consume all your spare time if you’re

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04 May

Making ICD-10 testing matter

By: Carl Natale There’s a lot being said about the importance of ICD-10 end-to-end testing. But why? Healthcare providers need to know what they are looking for. A set of testing goals will help guide medical practices to some worthwhile lessons: How much medical coding productivity can be expected. Will accuracy be a problem with

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15 Jan

When to Use Medicare XE, XP, XS & XU Modifiers

Effective January 1, 2015, CMS will officially roll out four new HCPCS modifiers, XE, XP XS and XU, that can be used when billing Medicare claims. Dubbed the –X{EPSU} subset, they may or may not be used instead of modifier 59. Not very clear, right? Unfortunately, there hasn’t been much clarification from CMS about the

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21 Dec

Improving Collections and Boosting Patient Satisfaction through Patient Estimation

By Ric Sinclair, Vice President of Product, ZirMed Twitter: @Zirmed At the MGMA Annual Conference in October, Cindy Welch joined me in a presentation to talk about how she overcame challenges that virtually every practice faces today including higher co-payments, HDHPs, uninsured patients, inaccurate insurance information, staff’s reluctance to ask patients for money, and patient’s reluctance

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