medical billing transcription supplier information

Medical Business Service, Inc. of Coral Gables, Florida, has selected CPU Medical Management Systems, Inc. to provide them with their medical financial management product, MED/FM, resulting in one of the largest MED/FM installations for CPU.

“We were impressed with the superior design of the MED/FM software and CPU’s longevity in the industry,” said Bing Herald, Medical Business Service President. “The reliability and professionalism of the CPU programming, training and management teams makes them very easy to work with.”

Medical Billing Service, (MBS) is a second generation, family-owned billing and reimbursement management company established in 1960. MBS’ staff of over 275 employees is dedicated to serving several hundred hospital-based physicians in radiology, pathology, cardiology, and interventional surgery specialties. They are the number one submitter of physician electronic claims in the state of Florida, and their database contains information on more than two million patient accounts. MBS has office locations in Florida, Georgia, South Carolina and Tennessee.

CPU President and CEO, Michael Stringer noted, “We are pleased with MBS’ decision to select CPU as their practice management system of choice and are looking forward to a successful relationship.”

CPU Medical Management Systems, Inc. is a leading provider of healthcare information systems targeted to physician, radiology and billing service organizations. CPU's practice management solutions tackle administrative and financial tasks with ease and accuracy, improving efficiency, increasing collections and decreasing the cost of medical billing.

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If you are noticing your medical billing claims are taking longer and longer to be reimbursed or you are having denials, rejections, or only partial reimbursements on your medical billing claims, it may be time to look at outsourcing your medical billing claims. You may feel as though you would be giving up control of your cash flow when actually you will have more control than ever. In fact, outsourcing your medical billing and coding needs through a medical billing partner is one of the smartest business moves you can make.
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The best company to handle your medical billing isn't necessarily located around the corner from your practice or even in the same town. Thanks to the power of the Internet, secure Internet connections, and advances in software and computer networks that allow for secure transmission of sensitive data, the process of finding a medical billing company to handle your needs is just a mouse click away.
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This will free up your staff immensely as they will no longer have to spend long hours at the copy machine getting claims ready to send in. Your claims will be transmitted computer to computer via secure network transmissions and you can get real-time information on your patient accounts at anytime. Furthermore, outsourcing your medical billing will insure that all your claims are properly coded and documented properly. Your medical billing partner can devote 100% of their time to handling your coding and claims. That way your cash flow is steady and you can concentrate on growing your practice.

• How to put together a good medical transcription business plan.
• The state of the industry, market research.
• All about phones and utilities, 800 telephone numbers.
• Finding medical transcription equipment and supplies, buying used equipment.
• Using temporary help and independent contractors to assist you.
• Legal requirements, licenses and permits.
• How to do record-keeping, taxes and deductions.
• Using different methods of financial management.
• Advertising and promotion, how to select the right media.

To get everything he needed to launch a lucrative medical billing business from home, including a software program and the names of doctors who wanted the service. If he wasn't completely satisfied, he could return the package within 30 days for a full refund.

As it turned out, this consumer wasn't satisfied. And he hasn't been the only one. The Federal Trade Commission (FTC) has received hundreds of complaints from consumers about medical billing opportunities whose promoters have advertised far more than they've delivered. In one case, the promoter claimed that for $325 to $495, consumers could make as much as $50,000 a year running a medical billing business from home. As the FTC alleged, most of the consumers didn't earn a dime.

In the last few years, the FTC has filed more than eight cases against medical billing scams. Yet, as quickly as these companies are put out of business, others appear to take their place, says Katherine Romano Schnack, an attorney in the FTC's Midwest Region. In a surf of websites and print advertisements by the FTC and the Better Business Bureau in summer 2001, investigators found more than 500 promotions for medical billing opportunities, many of dubious value.

Fraudulent medical billing business opportunities are a type of work-at-home scheme advertised on the Internet and the classified sections of local newspapers and "giveaway" shopper's guides. In the "Help-Wanted" classified sections, the ads often appear alongside legitimate ads for hospital medical claims processors, leading consumers who respond to think they're applying for a job. "Consumers don't realize what they're getting into," Schnack says.

The ads may lure consumers with promises of substantial income for full- or part-time work with "no experience required." A toll-free number directs consumers to call for more information.

When they call, they get a high-pressure sales pitch that promises big bucks for a relatively small investment. "But the chances of making the money claimed are slim to none," Schnack says. "Newcomers to the medical billing market - especially those with no experience and no contacts in the medical field - face fierce competition."

And the programs do little to help consumers succeed. Once consumers pay, Schnack says, "all they get is an out-of-date database of doctors who haven't asked for medical billing services, a sample letter to use to find their own clients, and a money-back "guarantee" that's barely worth the paper it's written on. Only a few people ever get a refund and then, it's after repeated phone calls to the company, or complaints to their credit card companies or government agencies and consumer groups."

When a laparoscopic procedure is performed, it may seem like it should be reported separately from the open procedure, however at this time, most carriers and that includes Medicare will only pay for one open procedure no matter how much work the surgeon does laparoscopically beforehand.

With very rare exception, you should report the open procedure only as using the laparoscopic code may result in your medical billing claimed being deemed over coded and will be rejected. Another rule of thumb to know when reporting this type of procedure is when an endoscopic procedure is attempted and fails on the patient and then another surgical service is rendered, only the successful treatment is reported.

Additionally, make sure that you include any secondary diagnosis of V64.41 (Laparoscopic surgical procedure converted to open procedure) to show that the surgeon started off laparoscopically and then converted to using an open procedure on the patient). Additionally, if you have a rare complication or situation, you can use modifier 22 (Unusual procedural services) to the procedure, but be prepared to back up your medical billing claim with medical necessity or you can expect some resistance from the carrier to reimburse.

If you are a physician located in Maryland, be aware that as of April, Medicare is now approving a broader coverage for the use of home oxygen for individuals that are enrolled in a federally approved clinical trial that is sponsored by the National Heart, Lung and Blood Institute.

Under the current Medicare statutes, Medicare only pays benefits for individuals that have a partial pressure measurement at or below 55mmHg or an oxygen saturation that measures in at or below 88 percent. If another disease or medical condition is present, Medicare will provide benefits if the partial pressure and oxygen saturation are raised one percent. So partial pressure would begin at 56 mmHg and oxygen saturation values would begin coverage at 89 percent.

The threshold for Medicare payments would be raised from 56 to 65 mmHg or whose oxygen saturation is at or above 89 percent. This will enable many people who do not currently meet Medicare coverage requirements to now receive benefits for home oxygen use.

If your physician and has a lot of Medicare medical billing, and your practice has become so busy that your staff is having trouble keeping up, it may be time to consider outsourcing your medical billing to an outside company. Not only will your medical billing partner file your claims in a timely fashion, you will see a faster turnaround on your reimbursements even from Medicare filings.

Combining history of present illness and review of systems is possible when doing medical billing. Many medical billers think this practice is breaking a rule or impossible. However, documenting an element once to account for HPI and ROS is perfectly legal when done correctly. The CMS states that physicians absolutely do not need to document an element two times just so the person performing medical billing knows it is meant to be used both for review of systems and history of present illness. It is perfectly acceptable to use an element for both.

The only time an element cannot be used twice is when you attempt to use it in the same area. For example, the complaint of chest pain cannot be used in ROS for musculoskeletal systems and the cardiovascular system. It can be used only for one location in the medical billing. A medical biller also cannot use a timing phrase such as "began two days ago" to account for both the HPI duration and timing. Direct medical documentation must be used.

The most important thing to accomplish in medical billing is to make the bill match the service. When this occurs, payment is made quicker. Medical billing companies can assist medical practices with this task. Outsourcing your medical billing can be one of the most beneficial things for a practice. This takes the worry off correctly coding and billing for procedures and physicians will see reimbursements much more quickly.

Did you know that you could have absolutely seamless medical billing claims? No more hassles with keeping up with the changes in coding and no more keeping up with the paper chase that a lot of filing medical billing claims has become.

All you have to do is outsource your medical billing. Your medical billing partner will take care of the making sure there is a logical flow of billing on your medical billing claims, as well as following up to make sure that you get the maximum reimbursement of all your claims.

Many physicians unknowingly give away thousands upon thousands of dollars each year through undercoding their medical billing claims or not knowing that certain modifiers should be used with certain procedures to insure the top reimbursement on all services rendered.

It has been estimated that by outsourcing your medical billing claims to a responsible third party agency will allow the physician to recoup nearly 30% greater revenues on services rendered. That's a huge bonus just for doing less work on your part!

Additionally, your staff will be free to service patients and run your office. This will help your practice grow and no more chasing medical billing forms, worrying if the medical necessities for the procedure have been met and wondering if that code has recently changed. Your medical billing partner will take care of all of that, and you can do what you do best - run a successful practice.

When multiple procedures are performed, you do not have to append modifier 51 for each group of procedures. The CPT manual designates modifier 51 (Multiple procedures) exempt codes with a "circle with a slash" symbol to the left of the code for the services rendered. There is usually a complete listing of modifier 51 exempt codes in an appendix. The list is "a summary of CPT codes that are exempt from the use of modifier 51 but have NOT been designated as CPT add-on procedures/services," according to CPT 2006.

As an example look up a code in your CPT. Arterial catheterization code 36620 (Arterial catheterization or cannulation for sampling, monitoring or transfusion [separate procedure]; percutaneous) and you will see a symbol with a circle and a slash to the left of the code. This means you should report just the code without a modifier as it is assumed that other services will be performed along with the catheterization.

Many carriers and most importantly Medicare, will lower your reimbursement amount if you use Modifier 51 on your medical billing claims. The carriers sort the procedures from highest to lowest RVU and the highest ranked RVU gets paid at 100% reimbursement the rest get 50% or less reimbursement on procedures.

Work at home medical billing seems like the perfect job for you. You own a computer, you want to stay home, pick your own hours. You will even be trained and given leads to professionals that need your service.

But the chances of making the money claimed are slim. Consumers don't realize what they're getting into. Newcomers to the medical billing market with no experience and no contacts in the medical field will face fierce competition. As the FTC alleged, most of the consumers didn't earn a dime.

Not all medical billing opportunities are scams. For consumers interested in buying a medical billing business opportunity, the FTC offers advice:

• Check with the state Attorney General's office, consumer protection agency and the Better Business Bureau in your area and the area where the medical billing promoter is based to learn whether any unresolved complaints about them or the promoter are on file. Be aware, however, that the absence of complaints doesn't necessarily mean the medical billing company is legitimate. But at least you can rule them out if there is.

• Be wary of the medical billing promoter wants to only provide a few references.

• Interview these references in person and ask for the names of their clients and a description of their operations.

• Consult an attorney, accountant or other business advisor before signing any agreement or paying any money.

• Consult with organizations for medical claims processors or medical billing businesses and with local doctors.

• If the medical billing opportunity sells another company's software, check with the software company to find out whether company representatives know of any problems with the medical billing promoter.

All these things may seem like a difficult task, but real medical billing is a business. You need to treat it like one. Don’t be afraid to ask the medical billing promoter questions.

I have found that the promise in the field of medical billing is not what it's

cracked up to be. Before investing in any medical billing and claims offers, call

medical offices listed in your local yellow pages and ask them several

questions:

1. What type of billing service do you use?

2. What software do you use?

3. Do any of your employees telecommute?

4. Do you use an independent billing service and can I have that number?

Now, call the independent billing service number and ask them questions 1

through 3.

Finally, call insurance agencies (using the yellow pages once again) and ask

them the exact same questions.

Most likely you will find disappointing answers. You may find that there are

large medical billings and claims facilities that do nothing but process billing

and claims and most doctors and insurance agencies use these companies. You

may find that the software used by these billing companies is custom designed

and programmed. You may find that this software costs anywhere from $699 to

tens of thousands of dollars. You may even find that many medical offices

wouldn't even think of sending or storing confidential medical information to

someone's home.

Think about this for a moment, would you feel comfortable if your medical

facility, your doctor or psychologist sent your personal confidential medical and

mental information over the internet, over the phone or in writing to the hands

of some stranger's home? Would you want your information sitting on the desk

of someone's home for anyone to see? Let's go further with this scenario, if

someone's medical information got out into the wrong hands (the media or

whomever) that institution or that doctor would be sued. And in my opinion the

patient would be in his/her full rights to do so!

I'm not saying that one cannot create a successful home-based medical billing

service. I am sure that there is someone out there doing just that. But I can

also say with great assurance that creating a medical billing home business is

not as easy as many of the courses, books and other advertised programs

state. From my research, it seems the ones that are most successful in this

venture had worked in medical billing as "employees" and had several contacts

in the medical field before diving into the medical claims business.