Friday, February 08, 2008

Medical Billing - DME Software Forms

As is true in most of the administrative world, there are more forms than people know what to do with. Go to a doctor's office for a procedure and he'll most likely have you fill out a slew of forms that will end up taking you longer to do than the whole examination or procedure itself. Well, the world of medical billing is no different. There are more forms than you can possibly imagine. We take a look at some of the more common of these forms.

Probably the most common form in medical billing is the HCFA 1500 form. This is the main claim form to bill for services. These forms are enormous. There is more information contained on a HCFA 1500 form than probably on any other form in existence. The amount of information contained in a HCFA 1500 is beyond the scope of this article but some of the main pieces of information are patient personal information, insurance information, items billed and patient medical history. HCFA 1500 form manufacture is big business and these forms are very costly to billers. That is why many medical billers are switching over to electronic billing so that they don't have to deal with these HCFA 1500 forms.

Another billing form, though not as common but gaining popularity, is the UB-92 form for billing. The main difference between the UB-92 and the HCFA 1500 form is the format. For the most part, the same information is transmitted. It's just in different places. There are some things contained on one form and not on the other. But for the most part, they serve the same function.

Another common form is the Certificate Of Medical Necessity, or CMN. CMNs are needed for any item given to a patient where the biller has to show proof that the patient is in medical need of this item, such as a wheelchair or oxygen concentrator. This proof has to come from the doctor who fills out a CMN, which he then has to sign. CMNs are also big business and very costly forms, though not as expensive as HCFA 1500 forms.

Not quite as common are forms called Centers For Medicare And Medicaid Services, or CMS forms. These are actually very new and as of this writing, a new version will be coming out in April of 2007. These forms cater specifically to Medicare and Medicaid claims.

And there are a number of other odds and ends forms to add to the above list. Each one has its own specific purpose. Some you may use only once in a year but if you don't have it, it could lead to lost revenue. So be assured that the price you will pay for that form will be a hefty one.

And if all that isn't enough, each of these forms comes in either regular dot matrix form or specially made for laser printing. Yes, the laser forms are much more expensive.

Make no mistake about it. Medical billing forms is big business and one of the biggest costs to any medical billing agency.

Medical Billing Books

Medical billing books serve as important reference tools in medical billing business. They are ideal for both beginners and experts in medical billing. The main purpose of medical billing books is to educate individuals in all aspects of medical billing business. Each book is an authoritative and comprehensive overview of the billing business.

Most books come with hundreds of tips from popular medical billing professionals, and have valuable topics covering all aspects of medical billing. These are user-friendly and engaging, offering step-by-step help for all insurance claims. They contain federal and state regulations, guidance for completing and submitting claims to various health insurance agencies. These books provide many real world examples, simulations, and review exercises that help the reader to understand different concepts relating to medical billing.

Apart from providing a general idea about medical billing, medical billing books are helpful in evaluating business data such as how much money is required for investing, and how long it takes to set up. They also tell you about the best medical billing courses, correspondence courses (on and offline), training programs, and schools. Medical billing books also serve as guide for selecting medical billing software packages. They also assist your new business, provide you with tricks and secret tips in business and select a suitable name for your new business.

Medical billing books available in different price ranges. You can purchase a good book for less than $100. Book shops and online stores house a comprehensive range of medical billing books. Most medical billing books come with CD-ROMs with practice coding software and other gifts.

Wednesday, February 06, 2008

Medical Billing - DME Software Navigation

It would be really nice if when a medical biller opened up the software used to do their medical billing, a little voice said something like, "Press letter A for Administrative Options". Unfortunately, medical billing software doesn't speak to us. Add to that the fact that there is so much involved with medical billing that the menu systems are massive and you've got a real monster on your hands. Talk about walking through a Dungeons & Dragons maze. Fortunately, the navigation for most DME software packages is pretty standard, which makes finding your way around fairly easy.

Most systems have a main menu option where you can go to the main parts of the system. These parts include Installation Options, Administrative Functions, Billing Functions and Maintenance Operations. Some systems have extra options depending on what add ons come with the package, such as retail sales and barcoding. These are usually found under an option called ad ons.

Once you've gone past the main menu options, that's where things start to open up quite a bit. For example. When going into Administrative Functions, you'll usually be greeted with a number of menu options such as adding users, deleting users, changing security levels and a host of other security options. Also a part of administrative functions is setting up your network. There are usually a number of options for adding peripherals such as printers, scanners, barcoders, etc. Basically, administrative functions handle anything to do with controlling your software so that the inmates don't take over the asylum.

Maintenance Operations are a world unto themselves. This section usually involves updating the various sections of the software that has to do with data. Some software systems call this Database Operations. This is where you enter your inventory, doctors, facilities and patients, among a number of other things. Anywhere there is a table of data, you'll usually find it in this section.

Billing Functions include a number of things, such as patient lookup, starting a work order, submitting a work order to a print queue and electronically billing. In some systems the electronic billing subsystem, because it is so massive, is kept separate. This gets kind of confusing for the biller because they're looking for the Medicare electronic billing module and it's not under billing functions. Standardization only goes so far in this industry since every software company is trying to build the better mouse trap.

Add Ons are another world all to themselves. Because there are so many things that can be added to a billing system, there is no way to tell what a biller is going to find in this section. The submenu will have a list of all the add ons but unless the biller is familiar with the add ons themselves, they're not going to know what to do with them. Fortunately, most software companies have manuals made just for the add ons that they include optionally with their system. Just be prepared to do a lot of reading.

Medical Billing - Choosing A Billing Method

If you're a medical billing company, your main point of operation is doing just that, sending out bills for services rendered to the various patients that you represent. And while this may seem like a simple decision to make, deciding what method of billing you're going to use is sometimes not as easy as some people would think. In this installment, we're going to discuss your various choices and what factors are involved in making your decision.

First of all, one thing a company has to understand when it comes to billing is that it's not simply a matter of what method you use to send the bill itself. After that part is done, the next part involves posting the money that is paid to you by the insurance carrier itself. How you get paid and how you post those payments, unfortunately has a lot to do with how you bill in the first place. So payment issues must be kept in mind when making your decision.

For example. If you're going to send paper claims, meaning that you are sending a HCFA form, then you automatically make it so that you can't be paid via batch billing methods. Batch billing is when the insurance carrier, supported by the software itself, sends you a file, which you usually download from their site, that contains all your payments. Once you download this file and run it through the batch billing system, the payments will automatically be posted to the patient accounts. However, in order to use this system, you have to batch bill, which means you have to bill electronically.

This is where we run into a cost effectiveness problem. Electronic billing is more costly than paper billing if you don't have a lot of patients to bill. In other words, if you're a small billing company, the cost of an electronic billing system will probably eat into your profits more than what it is worth to use. So the first thing you have to do is a cost analysis of what your electronic package will cost as compared to what kind of revenue you'll be bringing in. Most medical billing companies don't know how to do this and end up having to bring financial analysts in to compute this. That too costs money.

You also have to figure in the cost of the forms you're going to need. If you're doing a lot of DME billing, which is billing of durable medical equipment, a lot of this equipment is going to require more than just a HCFA form. You're also going to need a printed CMN or Certificate Of Medical Necessity form. This is going to add to the cost of your billing expenses.

Another thing to consider when choosing a billing method is the experience of your billing staff. If none of your staff has ever done electronic billing, even if it is cost effective, you may not want to use it because of all the problems you may run into because of inexperience.

Tuesday, February 05, 2008

Physical Therapy Billing - Will Outsourcing End in 2008?

The dramatic economic growth of India has created some negative implications for offshore Business Process Outsourcing organizations (BPO). Some of these implications can be directly attributed to the devaluation of the USD in comparison to the rupee. If this trend persists, and the USD continues to lose its value in comparison to the rupee, only the most efficient BPO's in India will be able to continue to make a profit.

Hundreds of physical therapy practices and rehab billing companies in the United States have outsourced their billing and transcription processing to India, taking advantage of the differences in economic development and favorable exchange rates. Outsourced billing processes typically include claims processing, coding, follow up, and data entry of patient demographics, charge and payment data. Labor arbitration between the United States and India has caused considerable heartache for numerous American transcription specialists, billers, and coders, many of whom had to find other jobs or learn new skills. But in the long run, the grand picture has paid off for both sides by creating new jobs in India, saving money in America, and creating more challenging and better paying jobs for those who stepped up to leadership and managerial roles in the new playing field.

The profits for both the outsourcing and the outsourced organizations depend directly on the exchange rate. If the exchange rate changes and the rupee appreciates against the US dollar, an Indian BPO suffers eroding profit margins. In the last six months of 2007, the rupee exchange rate dropped twelve percent from 44-45 down to around 39 against the USD. Since American doctors are paid in USD and not in rupees, the revenue of the US doctor or therapist, when translated to rupees, shrinks in step with the narrowing gap between the economic levels of these two countries and the melting exchange rate.

"For quite sometime I've been reviewing the bottom line margin that started to dip considerably," writes Deepak, Head of the Medical Billing Department in one of the major Business Process Outsourcing (BPO) organizations in India. "During the past six months we adopted various methodologies to keep our cost down in all aspects (staff costs, technology, training, etc) so as not to affect the billing rates with our clients. But with rupee exchange rate dropping to around 39 against USD and with no hope of depreciating over the next few quarters, we understand that it would be very difficult to sustain our margins going forward."

Can a physical therapy billing company with significant offshore labor components maintain its profit margins in 2008, against the background of the appreciating rupee? If not, should it reconsider the entire labor arbitration model and in-source at least some of the outsourced jobs?

If the USD continues to lose its value, in comparison to the rupee, only the most efficient BPO's in India will be able to continue to make a profit on outsourcing. To afford the decreasing revenue per doctor, a BPO must be able to increase its volume of clients while simultaneously reducing their workload per each client through automation and, perhaps, secondary outsourcing to other countries.


Reduce Medical Billing Time and Overhead Costs for Your Medical Practice

Owning a busy medical practice demands organization, tight schedules, and don't forget - plenty of time to care for every patient. In all the hustle and bustle, the very backbone of your financial well-being, medical billing, can get put on the back burner if you're not careful. But, don't let it get out of hand. Use the tips below to develop a steady stream of capital for your practice and keep your medical billing in check.

Organize your Medical Office

The first step to saving time and overhead costs is to get organized in the office. The office is where all patient information and billing is processed. You can't afford to lose patient or billing information. To organize your office, be sure every paper, form and bill has a designated area or file. Be sure the employees are trained properly so they'll know exactly where all paperwork belongs. This helps prevent lost paperwork, and benefits both your practice and the patient. A lost bill every now and then could result in hundreds or thousands of lost dollars each year!

Use Medical Billing Software

Another time-saver is sophisticated web-based medical billing software. This software is designed to make your medical billing easier and keep it organized. You can quickly retrieve records or past-due bills and claims when needed. You can enter information for insurance companies for quick access to process claims. Medical bills and records are stored at a secure online server instead of on your computer's hard drive. You can access the records from anywhere twenty-four hours a day, seven days a week.

EMR (Electronic Medical Records)

Some web-based medical billing software includes an EMR, or electronic medical records, feature that enables you to file medical histories on each patient, scan related images for each medical record, and even dictate information for a transcriber to access from another computer. The EMR feature works through online technology, making it easy to outsource jobs such as medical transcription, medical billing, etc.

Use a Medical Billing Service

You may choose to outsource your billing needs by using professional medical billing services. Companies that offer medical billing services usually will provide the necessary medical billing software, training and staff to get the job done - saving you many future headaches! Once you have the software in place, it's just a matter of entering information into a computer, and the medical billing company handles the rest. They keep your medical billing and claims organized, so you don't have to worry with it. You are able to concentrate on treating patients and keeping other pertinent office functions in operation.

Most medical billing companies today will provide medical billing software and training on how to work with the software to help make the process easy for you and your employees. For example, if the medical billing software is designed to be integrated with Microsoft Office, you might receive a video or materials for yourself and employees with the necessary Microsoft Office training.

Monday, February 04, 2008

Medical Transcription - Physician Dictation Services

Medical Transcription involves the transformation to text variant of taped SOAP notes. The recording of SOAP notes is done by medical practices but the process of transcriptioning is left to the professionals as that operation can take away all the time and resources of a medical center.

On the face of it, all it seems to need is a word processing software and a dictation recording player. Still, a truly professed medical transcription service will go further than that. It will be instrumental in effective management of amount of SOAP notes that are supplied by the medical offices, along with ably tracking and storing it.

A medical transcription project has to be executed as per the succeeding steps. Foremost, accept recording tapes from the medical practice, transcribe the first SOAP notes duplicate, save it and do the aforesaid task for the whole batch of SOAP notes recordings. Now, crosscheck the transcripts for errors and transport transcript back to the medical practice.

A point to note is that medical transcription itself is of myriad types distinguished by the specialty of medicine as well as the variety of reports transcribed. We have host of MT types like Radiology reports transcription, Cardiology reports transcription, H&P reports transcription, Surgery notes transcription, Lab reports Transcription etc.

As can be seen plainly, medical transcription occupation can be done from homes too. This means that those who have family constraints of staying at home as well as pressing business needs, can surely opt for the activity of medical transcription.

Outsourcing of Medical Transcription Duties

One of the largest growing sectors of the medical field is that of medical transcriptionists. Hospitals, clinics and doctors offices require the doctors’ words to be put into writing for patients’ files and other documentation purposes. In addition, a most hospitals require it to be in digital format. Hence, the need has arisen for people to translate doctors’ oral reports into digital documents.

Although employed secretaries often do this job, it is quickly becoming big as an area for outsourcing. When outsourcing, the transcription can actually be done more quickly than it can in-house. This is because the outsourcing firm or individual devotes full time to the assignment, while a secretary is constantly interrupted with phone calls and other duties.

In a time of growing interest in home-based businesses, these two needs have merged. Many people make a good living from their home computer typing up medical transcripts. It’s a job that pays well. However, this isn’t an easy job. Specialized training and experience are required. If you have it, you’re in demand. Recent years have shown an increase in demand for medical transcriptionists, but a smaller supply. Therefore, it’s a ripe field for the entrepreneur.

As a outsourcing medical transcriptionist, you would be providing services to medical facilities of all types who outsource this activity. You don’t even have to live in close proximity, as long as you have a reliable computer and Internet connection. They will send you an audio file and you type it up, making sure each word is clear and spelled correctly. It is crucial that it be accurate, as this will serve as the doctor’s documentation.

Many American and foreign companies alike are getting on board and offering medical transcription services. In the U.S., it’s usually existing medical companies that offer these services to other medical facilities. Asian companies are the target of many other American health care institutions for outsourcing their transcription needs.

As an industry, it is growing particularly quickly in India and the Philippines, where labor costs are significantly cheaper. Some estimate it is the 4th largest outsourcing industry in India. It’s gaining ground in the Philippines, where it is one of the government’s top 10 priority growth sectors. It is particularly suited to this field because of the Filipino high literacy rate, proficiency in English and medical training. The population of both countries has always been adept at information technology.

Research shows that the U.S. spent $2.3 billion in 2004 for medical transcription outsourcing services. That number is expected to grow to $4.2 billion in 2008. Worldwide, the U.S. Department of Labor has projected the demand for medical transcriptionists to reach $20 billion.

The demand is there, at least for now. If you’ve always dreamed of your own business and are willing to be trained, go to the Internet and do a search on “medical transcription training”. Research several different courses and choose which one suits you and your present circumstances. You’ll be your own boss making a decent income all from home in no time!

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