A busy medical practice can be challenging because of much-needed organization. The schedule can be difficult to work with and the patients must be seen and cared for. Because of all of the details, sometimes billing will be put on hold for tomorrow. The billing portion of the busy office is the portion of running a busy office, which cannot be allowed to slide. The office needs to collect the money for the office to be able to pay their obligations.

You will need to organize your office in order to save time, which will also help cut down your costs of running the office. In a physician's office information is extremely important. You cannot afford to lose any information. By organizing your office you will have a better chance of know where everything is. Then you will want to make sure all the other employees in the office know where everything is suppose to be to eliminate the chance of any information being misplaced.

A good time saver is the implementation of a web based medical billing software. The web based medical billing software is intended to eliminate or reduce paperwork in your office. It will assist with the billing and keep information organized. The recovery of records, information and past due billing information is simple and easy. Processing claims with the insurance companies will reduce delays and non-payments. The web based medical billing software has been incorporated with the diagnosis and procedure codes to reduce or eliminate errors, which can be the cause of delays, or denied claims. The information, which is stored by the server of the software, is backed up in a secure online server and not your computer's hard drive. Most of these companies with the software will provide training for the use of the software. If the software is created to work with Windows or Microsoft Office, you might receive a video and materials for your and all of your staff on the operating procedure of the software.

The Electronic Medical Records are included in many of the web based medical billing software. This feature will allow you to file medical histories of your patients into the software. You can also scan the information and in some cases you will be able to dictate information, which a transcriber will access from another computer and input into the software. This feature of your web based medical billing software will make it simple to contract someone to transcribe dictation for you or even do the medical billing for you.

If it is easier and less expensive for you, you may want to relinquish your medical billing to a medical billing service. The companies doing this type of work will have training and software in order to get the job done, which can relieve your office to do what it does best. That is taking care of patients. The service will keep all of your information organized, so you will be able to get any information from the service quickly.



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Do you have your own Medical Billing Business? Is it doing as well as you would like it to be? Do you want to grow but not sure how to get started? Maybe you've been cruising along now at the same place for a while and you're ready for a change. Whatever your situation is, if you are ready to Take Your Medical Billing Business to the Next Level then you will need a plan.

Many people want to grow their business but they just sit and wait for it to happen on its own. If you want your business to grow then you need to act first. Don't sit around waiting and wondering when. If you do that you will have no control over how fast you grow and what direction you grow in. You need a plan.

First, sit down and figure out exactly what it is you want. How much do you want to grow? Do you want to just pick up a few more clients? Do you want to double? Are you ready to hire an employee or two? Maybe you are ready to quit your full time job and work at your medical billing business full time. After you figure out how much you want to grow you need to figure out what it will take to get you there.

Your plan for getting there will involve many things. You will need to plan a marketing strategy. You will need to consider many new things if you need to hire and train an employee. Your work space must be taken into consideration. You will need to consider the costs of expansion. And you will need to learn to put many systems in place.

After you decide how much you want to grow you need to give yourself a time frame and a set of steps to reach your goal. A goal without a deadline is just a dream. Set specific dates that you want to reach certain parts of your goal. They can be flexible. If you don't reach a goal by the set date, you can move it a little. It doesn't mean you have to give up. A time frame makes sure you are keeping on track to reach your goal. If you don't meet a deadline maybe you need to rethink how you are trying to get there and make some changes.

The important thing is that you take control of your business. If you want growth, prepare for it, decide what you want, and when you want to be there. Then go for it! Good luck.


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Whether you are planning on starting a medical billing business, already own a medical billing business, work for a billing service or in a medical office, it is crucial that you completely understand the entire billing process. From the time a patient schedules an appointment to the time that full payment is received, everyone who interacts with either the patient or the billing process can affect the payment.

Billing is such an important part of a medical office. The money brought in from the billing is what keeps the office running. It pays everyone's salary, including the doctor. It always amazes me that so many providers do not make sure that their billing is being done properly and that their office staff isn't all working together to make sure all is being done that needs to be.

When a patient calls to schedule an appointment it is important that the person doing the scheduling not only gets all of the necessary information from the patient but also that they understand how insurance works so they can tell if anything needs to be done prior to the patient's appointment. Having someone who understands medical billing can reduce visits that end up not being covered by insurance.

The person responsible for actually submitting the insurance claims needs to know the different requirements by each carrier and understand how to handle all aspects of billing. Following up on unpaid insurance claims is an area that most offices lose a ton of money. If you don't have a very good follow up system then you are definitely losing money.

Many medical providers think that only the billing person needs to understand medical billing. Actually it is important that all staff have some knowledge of insurance billing in order for things to run smoothly. The more that the staff understands, the less money you throw out the door. Providers deserve to be paid for all the patients they treat.



Article Source: http://EzineArticles.com/?expert=Michele_Redmond

Cheaper medical Contrary to what you might have thought, it's quite easy to get a lower rate. The only things that stand between you and attracting a more affordable rate now are relevant information and a motivation to make use of the recommendations you get. Let's look at a few sure-fire ways to get better rates...

1. Ensure a healthy life style and you will get lower rates with time. If you can stop eating junk food you'll pay less over time. Removing fats, cholesterol and high carb from your diet will make it easier for you to retain the right weight, live a healthier life and, as a result, attract cheaper rates.

You will also help your health and rate by going on regular exercise.

2. For folks who have a longtime ailment that makes it hard or too expensive for them to enjoy private personal health insurance, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) insurance could offer a more affordable option.

3. Some persons are not poor enough to qualify for plans for low-income earner and also have financial challenges that make regular health insurance hard to pay for. In case this defines you, then you can reduce your budget for health care by going for a discount medical card. So what are they?

With these cards you are given medical attention from a network of health care professionals who have agreed to render services to card carriers at reduced rates. Such cards are not issued by insurance companies.

You can fall back to this option if you have a medical history that has made health insurance providers either reject you or give you a rate that is too high. One advantage of a discount medical card is that everybody can use it. Just make your monthly payments and you'll have access to a network of health care providers who will bill you lower for their services.

4. Your premiums may be tax-deductible if you're self employed. You may also be entitled to a tax break if your employer offers a flexible spending account. You can get details on this from your tax professional. This will help you know for sure what will entitle you to a tax break and what won't.

5. Don't become carried away by the lowest quote as you shop for low cost health insurance. You want a cheap rate that also offers you much value. If the cheapest price has all that is important to you, then go for it. But in situations where you don't find the right value in the cheapest rate, you'll be making the right choice if you pay more to ensure you truly have the quality of coverage that you really need.

Take note of this because a number of low quotes are that low because they don't offer much. A health insurance plan that compromises you does not make sense even if it's 500% less than the quote that offers you sufficient coverage.

6. You will save much if you only have between 25-30 minutes. Visit, obtain and compare health insurance quotes from selected quotes sites. The cheapest offer should be your choice easily. However, you have to look beyond just the lowest quote to the best price to value ratio. The cheapest may not be the best price/value for you as an individual.

Here are great pages for health insurance quotes...


Article Source: http://EzineArticles.com/?expert=Chimezirim_Chinecherem_Odimba

With the right advice you'll get more affordable rates for sufficient coverage. It is also necessary that I point out that there are recommendations that might put you at risk even if they help you make savings at the moment. I will, nevertheless, only make suggestions that will save you much while you still keep enjoying adequate coverage...

1. Even though most individuals know that smoking adds to their rates, they may not know that this also applies if they use other tobacco products. Those who snuff or chew tobacco will also get higher rates than those who don't. Staying away from all tobacco products will attract less expense in health insurance.

2. A group plan is less expensive than an individual plan. Don't miss it if you're in a position that gives you the opportunity of using a group plan as it generally implies that you'll pay lower rates. This statement becomes even more so if you're overweight, a smoker or an older person.

A group plan will help you make considerable savings if you have a pre-existing condition that makes individual health insurance either too costly or almost impossible to come by. A group plan is an easy way to lower your cost without reducing the quality of coverage you will enjoy.

3. You will spend less in health insurance if you if you get the right tips. Individuals who know more about health care and insurance get better deals. Moreover, you will find it easier to get every benefit that you are eligible for if you always have the right information.

There are toll-free numbers you can call if you need help on health matters. One of such numbers is that of the National Health Information Center: 1-800-336-4797

4. Buying your prescriptions on the internet is a proven way to bring down your health care spend. Buying by telephone might as well give you affordable prices. The internet reduces the cost of doing business and pharmaceutical companies or groups who sell their drugs online do so at cheaper rates. But if you've chosen to buy online try to find out a little about whom you are buying from because there are wolves online. Just go to BBB online and you will know if you should buy from an exact company.

Always remember that while we want to reduce costs we also want to avoid risks.

5. Electronic Funds Transfer, known as EFT is an easy way to reduce your premium. By doing this you authorize your insurance provider to automatically withdraw your payments from your account when due. This eliminates administrative overheads like those involved in sending payment notices. Your premium is therefore lowered in line with the cheaper cost of giving you insurance.

6. Visit a minimum of five quotes sites. Using a minimum of five quotes sites raise the chances that you'd receive cheaper health insurance quotes. This is because insurance companies not covered by one site will be represented by the other. Moreover, you know that because your chances of getting lower health insurance quotes has to do with the number of quotes you obtain, the more companies you obtain quotes from, the higher your chances will be. Requesting for your health insurance quotes online will help you save a bundle if you take out around 25 minutes to obtain quotes from at least five sites.



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CMS 1500 forms are the universal claim forms used by medical providers to submit claims for their services to the insurance carriers. They are pre-printed red and white forms designed by the Centers for Medicare and Medicaid Services. They were formally known as HCFA 1500 forms but they were redesigned to allow for the reporting of the NPI, or National Provider Identifier.

It is very important that the CMS 1500 forms are completed properly to ensure that correct payment is made. If the form is not completed properly, the claim may be denied by the insurance carrier. Many providers have practice management software that completes the forms for them, but the information must still be loaded into the practice management software program properly in order for it to be printed out in the right format.

Many of the insurance carriers have different requirements for what information goes in each box on the CMS 1500 form. For example, if you are billing an insurance carrier that requires authorization for the services being billed and they assign an authorization number, they may require that the authorization number be in box 23. Other carriers do not require that anything be in box 23. It is important to know the different requirements for each of the insurance carriers that you bill to.

If you do not have all of the necessary boxes completed, or if they are not completed properly, the claim may be denied. For example, if you do not put the patient's date of birth on the CMS 1500 form, then the claim will most likely be denied out. Most insurance carriers scan the CMS forms and if all the required fields are not completed the claim is automatically denied without a human even touching it. Another thing that could cause an immediate denial is if the date of birth on the claim doesn't match what's on file with the insurance carrier. When the claim is scanned, it will deny out stating they can't identify the patient.

Many claims do not get paid on the first submission and in many cases it is due to the CMS form not being completed properly. In order to cut down on denials, make sure you are completing the forms completely and correctly. This will make a big difference in your bottom line.



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Dr. Noah Payne shook his head in disbelief: the practice reimbursements shrank instead of climbing in response to the recent hiring of Dr. Inna Ternist. The new doctor clearly added to the total number of patients seen yet overall payments did not reflect the added charges. Perhaps the new claims were not created, submitted, or paid? Dr. Noah remembered noticing the growing pile of rejected and denied claims accumulating dust on his desk - he never had the time to review them...How many of these claims are clean? How many of them require manual review and correction?

Dr. Noah looked at his Vericle screen and began analyzing the numbers. The system showed 58 percent clean claims (PCC). In other words, almost every second claim required manual correction. Who could be causing such a high level of problems: the practice, the billing service, or the payer? Dr. Noah's instinctively felt that perhaps the billing service was negligent about data entry process and kept introducing massive data errors. But the service manager was quick to explain a rigorous quality assurance process for data entry. What else could be causing such a high level of manual work in a seemingly streamlined process?

A quick review shows that PCC varies along several dimensions:

1. 19 and 70 percent for financial class
2. 37 and 66 percent for month of service
3. 55 and 59 percent for physician
4. 29 and 70 percent for various CPT codes

Trying to discover a pattern, Dr. Noah looked for a root cause dimension. He drilled into 99213 - the single largest frequency CPT code for his practice. Vericle showed 3,135 claims and the above average 62 PCC carrying charges and payments for 99213 code.

Having isolated the single most frequent CPT code, Dr. Noah was thinking about other dimensions that influence PCC. He hypothesized that if all doctors in his practice had the same coding skills, and assuming uniform distribution of errors, he should observe no PCC variance across the doctors. Yet, a quick click on a Vericle screen yielded a spread, confirming his suspicion that different doctors maintained slightly different coding skills:

1. Dr. Ted 1,554 claims and PCC = 63%
2. Dr. Lori 865 claims and PCC = 62%
3. Dr. Inna 194 claims and PCC = 61%
4. Dr. Noah 516 claims and PCC = 60%

Next, Dr. Noah switched his attention to distribution of PCC across the financial classes. Again, he hypothesized that if all payers used the same rules to deny claims then there should be no difference in the average PCC for different payers, subject to a uniform distribution of errors over a large sample of submitted and paid claims. Yet the numbers showed a significant (30 percent) variation of PCC for the same CPT code: UHC - 82, Blue Cross Blue Shield - 73, Oxford - 64, Aetna - 59, Medicare - 59, and Cigna - 51, confirming his conclusion that various payers used various rules to deny and underpay claims.

Dr. Noah recalled reading an article about PacifiCare, a Californian insurance company being fined upon an audit. The joint Department of Managed Health Care and Insurance Department recently analyzed 1.1 million paid claims from June 2005 to May 2007 that covered about 190,000 members in PacifiCare's HMO plans and PPO coverage [Gilbert Chan , "PacifiCare fined record $3.5 million," www.sacbee.com , January 30, 2008]. They discovered 30 percent of the HMO claims wrongly denied and 29 percent of the disputes with doctors were handled incorrectly. PacifiCare paid out over $1 million and was fined additional $3.5 million. Dr. Noah's findings roughly matched PacifiCare audit - the insurance companies were failing anywhere between twenty to fifty percent of his claims and each insurance company showed a different failure rate, depending on a system used to fail submitted claims.

Finally, Dr. Noah thought of the billing service operation. Is his billing service systematically working to discover failed claims and improve its response to such discoveries? Is there a pattern of an occasional drop of PCC reflecting its deterioration in response to various payer's initiatives? Conversely, is there any evidence for a systematic improvement effort? A chart of the distribution of a single CPT-code clean claim percentage over the entire year must answer his question. In his mind, PCC should iterate between drops and climbs, hopefully each time at a higher level. Vericle confirmed his expectations, showing an overall improvement of PCC over the year (46% 1-07, 39% 2-07, 52% 3-07, 55% 4-07, 63% 5-07, 67% 6-07, 72% 7-07, 69% 8-07, 72% 9-07, 68% 10-07, 74% 11-07, 73% 12-07)





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No matter how healthy your lifestyle, how wisely you plan your diet or how much you exercise in an effort to take care of your body, unexpected situations may arise. You may land in the hospital with bills that could potentially wipe out everything you own. Thus it is extremely important to acquire an adequate insurance medical policy that will take care of your expenses in case of just such an emergency.

Everyone needs at least some form of health insurance. Some people are concerned about qualifying for an insurance plan especially if they have health issues. There are so many options available and although some are not easy to find, they can be quite simple to qualify for.

Before signing up for a plan, consider your family's medical needs and budget requirements. There are basically two types of plans to consider, a private plan and a government plan.

Types of Coverage

The private plan is commonly obtained through employment. Most employers will offer some form of insurance for their full time employees. In some states employers are required to provide insurance if the employee exceeds a certain level of hours worked during the course of a week. Often times the employer will offer some sort of group health plan for their employees which decreases the monthly premium costs. Normally this type of plan will cover your spouse and family. Many people may not be able to participate in group plans. There are many individual plans are offered although they may be a bit more expensive in relation to group plans.

If you are going to sign on with a private plan learn all you can about the coverage in the contract. Read all the inclusions and exclusions and avoid signing up with a plan that has a long list of exclusions. Also make sure you obtain a copy of all the paperwork you sign.

Health insurance offered by the government is generally on a state or national level. One example would be Medicare which is a national plan. Medicare is available for those people over 65 years of age and also is available to disabled people. Some other types of government assisted health care plans include Medicaid which is based on income level, health and care for veterans and children's health programs.



Article Source: http://EzineArticles.com/?expert=Peter_Kingston