medical billing transcription supplier information

If you're in the medical billing business, or plan to get into it, one of the most important things you're going to have to do is hire a staff of billers. This may sound easy but it is far from it. In this installment, we're going to cover some basic things that you're going to want to look for when hiring a billing staff.

The first thing you want to look for, probably above all else is somebody who has knowledge of the industry. The reason for this is because the medical billing industry is filled with rules and regulations. Medicare regulations alone are enough to make your hair stand on end. The last thing you want is for a biller to have to look up every single regulation before sending out a bill. They need to have a solid command of the rules of the industry or productivity is going to suffer greatly.

The next thing you're going to want is somebody who has excellent typing skills. Sad as it is, most of medical billing comes down to typing and a lot of it. The person will have to type up order pages, patient accounts and a number of other items. Plus, they will be doing this all day. It is critical that they are able to get a certain amount of claims out or the company will not be as profitable as it could be.

The next thing you want to look for in a medical billing person is somebody who is technical to some degree. The reason for this is that most billing today is done by computer and many claims are no longer printed on HCFA 1500 forms but instead sent electronically. If the person you hire is not familiar with modems and things of a technical nature, they are going to have a hard time doing their job in today's environment.

The next think you want to look for in a medical billing person is somebody who is trustworthy. The medical billing world deals with a lot of information that is private. Your biller is going to be seeing information such as patient files that is for nobody's eyes. They are going to have to be able to see all of these things on a daily basis and keep their mouth shut about it.

Finally, you want to find somebody with a great attention to detail. Medical billing is one of the most complex things you can do. Aside from all the regulations and forms, there are things like enteral billing and parental billing where they are going to have to understand feeding methods and conversions. For oxygen billing, they're going to have to know how to calculate oxygen units. They will need to be able to tell when a claim just doesn't look right. For example, if oxygen units shows some crazy amount, they are going to have to be able to recognize this.

All in all, medical billing is harder than most people think. That is why it is important to hire a medical billing staff that can handle the job well.

In the land of medical billing, we get so caught up in the day-to-day operations of getting the bills out, we completely forget about checking to see if our software system is operating the way it should. Needless to say, as problems become noticeable, it is usually because of neglect in keeping an eye on things. In this review, we'll go over some basic system reports that you should be running just to make sure that your software is performing the way it should.

The first report that you should be running is an error report. All software packages track any kind of errors that occur during processing. This could be any kind of processing from submitting claims, to printing forms to running other reports. This error report should be run on a daily basis. The number of errors that occur should be minimal to say the least. If you find a gradual increase in the number of daily errors, this could be an indication that there are problems with the software. The most common of these are corrupted databases. If you suspect this, run a utility to check the integrity of your various databases.

The next report you should run is what is called a failed request report. This usually has to be run on the server unless the software package itself has this capability. Most high end DME software packages do produce a limited failed request report. But if you really want to get a full blown report with all the details that you're going to need. The usual cause of failed request is a bad network connection. If this is what you suspect, have your network administrator run diagnostics on the network. Also have him check all the wiring and network cards in all the computers. Usually the failed requests will come from one particular computer which narrows down your search for the culprit.

You're also probably going to want to run a report on network activity and system resources. For the most part, unless you have a massive billing department, the activity on the server should be minimal. Memory usage shouldn't even register a blip. However, if you find that there are spikes in memory usage, you might want to look at the times of the day that this is occurring. Find out from the billing department when their heaviest periods are as far as billing and other activities. See if there is a correlation between the two.

Finally, you're going to want to run a report to see the rate at which your databases are increasing in size. If you are a large medical billing company, your databases are going to grow at an alarming rate. While your server capacity may be in the gigabytes, it doesn't take long before you find that your medical billing software is hogging up 50% of your disk space. Once you see this happening, you're going to need to make plans to either add another drive or upgrade the one you have.

Medical billing is more than just sending out bills. If your system isn't functioning properly, you could be out of business before you even know what happened.

In the world of medical billing, nothing is more dreaded by billing companies than allowable tables. There are numerous reasons for this. In this particular installment on medical billing, we're going to cover the main reasons why allowable tables are such a pain the backside.

Before we do that, it would probably be a good idea to explain what an allowable table is for those who are not familiar with them. Allowable tables usually refer to Medicare billing, though there are other government carriers that also have allowable tables. An allowable table, as applied to Medicare, is a table of prices for each item that can be billed to Medicare. In other words, let's say a patient needs a wheelchair. If wheelchairs can be billed to Medicare, they will have a table entry for how much Medicare will pay for that wheelchair, whether it be to purchase it or rent it on a monthly basis. Sounds simple enough and it is. The problem is what this actually means to the medical billing company.

The first problem this presents is actually getting the allowable tables from Medicare. The reason this is important is because a medical billing agency has to know how much they are permitted to bill for each item. If they overbill for the item and actually expect to get paid that much, it is going to come as a big shock to them when their payment is considerably less than what they expected. So a medical billing company must get these tables setup in their system. To do this, they have to get them from Medicare. Guess what? It's not a free service. They have to pay for it and it's not cheap.

Then there is the matter of actually loading these allowable tables into their system. This has to be done just so or nothing is going to bill correctly. This is a common problem with an allowable table update. Sometimes the files are corrupt, sometimes the software has a bug in it and on and on. Agencies hate when it comes time to have to do an allowable table update, which is usually done four times a year, every quarter.

The bigger problem is when a company bills for a certain item that costs them a certain amount of money and they are hoping to get a certain return on that item. For example. Let's say a company is selling a wheelchair to a patient for $350. The wheelchair costs the company $250 and they hope to make $100 profit on the sale. Medicare has the allowable set to $350 so all is well. Then, the next quarter update comes out and Medicare lowers the allowable for that wheelchair to $300. The agency now can only bill for $300 and can only make $50 on each sale. This cuts their profit margin in half. This is more common than you know and it drives medical billing companies crazy.

The sad part is, there is nothing that can be done about this. Medicare will allow what it will allow and that is the end of it. The company has no other choice but to absorb the loss. Yes, allowable tables are a real pain in the backside.

If you're in the medical billing business, or plan to get into it, one of the most important things you're going to have to do is hire a staff of billers. This may sound easy but it is far from it. In this installment, we're going to cover some basic things that you're going to want to look for when hiring a billing staff.

The first thing you want to look for, probably above all else is somebody who has knowledge of the industry. The reason for this is because the medical billing industry is filled with rules and regulations. Medicare regulations alone are enough to make your hair stand on end. The last thing you want is for a biller to have to look up every single regulation before sending out a bill. They need to have a solid command of the rules of the industry or productivity is going to suffer greatly.

The next thing you're going to want is somebody who has excellent typing skills. Sad as it is, most of medical billing comes down to typing and a lot of it. The person will have to type up order pages, patient accounts and a number of other items. Plus, they will be doing this all day. It is critical that they are able to get a certain amount of claims out or the company will not be as profitable as it could be.

The next thing you want to look for in a medical billing person is somebody who is technical to some degree. The reason for this is that most billing today is done by computer and many claims are no longer printed on HCFA 1500 forms but instead sent electronically. If the person you hire is not familiar with modems and things of a technical nature, they are going to have a hard time doing their job in today's environment.

The next think you want to look for in a medical billing person is somebody who is trustworthy. The medical billing world deals with a lot of information that is private. Your biller is going to be seeing information such as patient files that is for nobody's eyes. They are going to have to be able to see all of these things on a daily basis and keep their mouth shut about it.

Finally, you want to find somebody with a great attention to detail. Medical billing is one of the most complex things you can do. Aside from all the regulations and forms, there are things like enteral billing and parental billing where they are going to have to understand feeding methods and conversions. For oxygen billing, they're going to have to know how to calculate oxygen units. They will need to be able to tell when a claim just doesn't look right. For example, if oxygen units shows some crazy amount, they are going to have to be able to recognize this.

All in all, medical billing is harder than most people think. That is why it is important to hire a medical billing staff that can handle the job well.

Before we begin our installment on G records for medical billing of claims using NSF 3.01 specifications, it may be a good idea to give a brief overview of what G records are for and why they are so special.

Because there are so many things that can possibly be done when it comes to the field of medicine, it is virtually impossible to be able to account for all of them in what we call standard specifications. The standard specifications are your AA0, BA0, CA0, DA0, F records and some other records that are soon to follow in this series. Aside from patient information, doctor or provider information, facility information and finally the actual item being billed, there is some information that needs to be transmitted only in certain cases.

The first thing we need to understand is why we have these special cases to begin with before we can even begin to describe what some of them are. The reason we have special cases really comes down to medical need or what they call medical necessity. Because some items can be so expensive, when there is a call for a certain item or procedure, the doctor has to present a clear medical necessity for that item or procedure. This is done by signing off on a CMN, or Certificate Of Medical Necessity. This needs to be sent to the payer to show that the item being ordered for the patient is needed. Now, this isn't done for a $2 test strip because the cost of processing these items would be greater than the cost of the item itself. No, this is done for items that are very expensive. This brings us to some examples.

A patient is injured in an auto accident. The patient is no longer able to walk, either permanently or at least temporarily and needs a wheelchair to get around in. Because of the expense of that wheelchair, assuming that it is covered by insurance, the insurance company, carrier, or payer, requires the doctor to sign off on this wheelchair that there is indeed a medical need for it. If it turns our through investigation that the patient didn't need the wheelchair, the doctor is liable. This certificate that he signs off on is called a CMN. There is an actual paper CMN that is sent to the payer, but because when electronically billing no paper is sent, an electronic record must be created to transmit these CMNs. There are all kinds of CMNs. Way too many to get into in this article. Because of this, a generic record type needed to be created for each type of CMN. This is where your G records come from and there are a number of them.

In the first installment of our CMN series, we're going to cover the GA0 record, which is a CMN that needs to be sent for a patient that was taken to the hospital by ambulance. Yes, it needs to be shown that the ambulance ride was medically necessary for the patient or the claim for the ambulance ride will not be paid. CMNs are big business. After reading the next few installments, you'll understand why.

In the land of medical billing, we get so caught up in the day-to-day operations of getting the bills out, we completely forget about checking to see if our software system is operating the way it should. Needless to say, as problems become noticeable, it is usually because of neglect in keeping an eye on things. In this review, we'll go over some basic system reports that you should be running just to make sure that your software is performing the way it should.

The first report that you should be running is an error report. All software packages track any kind of errors that occur during processing. This could be any kind of processing from submitting claims, to printing forms to running other reports. This error report should be run on a daily basis. The number of errors that occur should be minimal to say the least. If you find a gradual increase in the number of daily errors, this could be an indication that there are problems with the software. The most common of these are corrupted databases. If you suspect this, run a utility to check the integrity of your various databases.

The next report you should run is what is called a failed request report. This usually has to be run on the server unless the software package itself has this capability. Most high end DME software packages do produce a limited failed request report. But if you really want to get a full blown report with all the details that you're going to need. The usual cause of failed request is a bad network connection. If this is what you suspect, have your network administrator run diagnostics on the network. Also have him check all the wiring and network cards in all the computers. Usually the failed requests will come from one particular computer which narrows down your search for the culprit.

You're also probably going to want to run a report on network activity and system resources. For the most part, unless you have a massive billing department, the activity on the server should be minimal. Memory usage shouldn't even register a blip. However, if you find that there are spikes in memory usage, you might want to look at the times of the day that this is occurring. Find out from the billing department when their heaviest periods are as far as billing and other activities. See if there is a correlation between the two.

Finally, you're going to want to run a report to see the rate at which your databases are increasing in size. If you are a large medical billing company, your databases are going to grow at an alarming rate. While your server capacity may be in the gigabytes, it doesn't take long before you find that your medical billing software is hogging up 50% of your disk space. Once you see this happening, you're going to need to make plans to either add another drive or upgrade the one you have.

Medical billing is more than just sending out bills. If your system isn't functioning properly, you could be out of business before you even know what happened.