The National Cancer Institute has over 60 designated comprehensive cancer centers located throughout the US. These cancer centers are among the best in the world for cancer research and treatment.
http://cancercenters.cancer.gov/cancer_c...
University of Chicago Cancer Research Center
http://www-uccrc.uchicago.edu/
http://cancercenters.cancer.gov/cancer_c...
Robert H Lurie Comprehensive Cancer Center
http://www.cancer.northwestern.edu/home/...
http://cancercenters.cancer.gov/cancer_c...
Affichage des articles dont le libellé est Medical Billing. Afficher tous les articles
Affichage des articles dont le libellé est Medical Billing. Afficher tous les articles
lundi 15 juin 2009
How do you certify a healthcare web application software
How do you certify a healthcare web application software
How does health insurance work in the US
In truth, health insurance works a little differently in each state
Rarely do they cover all the bills. Most often, patients pay a pre-negotiated portion - either a set dollar amount of a copay or a percentage.
4. In a perfect world, only doctors and their patients would have say over what treatments are performed. But, since this is by far NOT a perfect world, the insurance companies have the say. The patient doesn't get to choose the more expensive treatment - and the ONLY way it would be covered was if the patient and their doctor(s) can prove beyond a shadow of a doubt that by the insurance shelling out more money up front (in the form of the treatment) they would, in fact, save money in the long run - by not having to pay for complications or repeat proecdures.
If the patient ops to "top up" the treatment, they better have deep pockets because they'll probably end up paying for most, if not all of it.
Rarely do they cover all the bills. Most often, patients pay a pre-negotiated portion - either a set dollar amount of a copay or a percentage.
4. In a perfect world, only doctors and their patients would have say over what treatments are performed. But, since this is by far NOT a perfect world, the insurance companies have the say. The patient doesn't get to choose the more expensive treatment - and the ONLY way it would be covered was if the patient and their doctor(s) can prove beyond a shadow of a doubt that by the insurance shelling out more money up front (in the form of the treatment) they would, in fact, save money in the long run - by not having to pay for complications or repeat proecdures.
If the patient ops to "top up" the treatment, they better have deep pockets because they'll probably end up paying for most, if not all of it.
mercredi 27 mai 2009
Medical Coding Certification Schools: Look Before You Leap by Celena Rose
Medical Coding
The process of converting medical diagnoses and procedures into universal medical codes is known as Medical Coding. The job of medical coders is to assign alphanumeric codes to diseases and medical procedures. A uniform system of coding is used everywhere across the health care industry from doctors and hospitals to insurance companies and government organizations.
Medical Coding Certification
Certification is a must-have for new medical coders as it allows demonstration of your skills - even before you get a hands-on experience in medical coding. It's the certified medical coders who command higher a pay package than those who lack credentials in the field.
Medical coding certification schools
Medical coders have many options to get professional training. The best way is to go for a college which offers a degree in health management. If you're already working as medical coder, go for an institute which offers a fast-track course on coding along with a certification.
The next option is to go for a certificate program in medical coding. You can also opt in for an online medical training course - a combination of textbook and web based learning which offers flexibility both on place and time.
What to look for before enrolling?
Before you enroll in a medical coding certification school, the following things should be kept in mind:
• Credibility of the institute
• Approval of the medical training course
Enhanced employment prospects
A steady and continuous growth in the health care industry in recent years has increased the demand of certified medical coders and professionals. As the demand for skilled medical coding professionals is increasing, employment prospects look good. But the employment opportunities are very good for those holding a certification as it speaks volumes of their expertise in the field.
Importance of Medical coding certification schools
Medical coding certification schools provide you with the right knowledge required in the field. They play a great role in increasing your career options as well. A certified medical coder who has attended a medical coding school can opt in to work in hospitals, clinical research institutes and also in insurance companies.
The process of converting medical diagnoses and procedures into universal medical codes is known as Medical Coding. The job of medical coders is to assign alphanumeric codes to diseases and medical procedures. A uniform system of coding is used everywhere across the health care industry from doctors and hospitals to insurance companies and government organizations.
Medical Coding Certification
Certification is a must-have for new medical coders as it allows demonstration of your skills - even before you get a hands-on experience in medical coding. It's the certified medical coders who command higher a pay package than those who lack credentials in the field.
Medical coding certification schools
Medical coders have many options to get professional training. The best way is to go for a college which offers a degree in health management. If you're already working as medical coder, go for an institute which offers a fast-track course on coding along with a certification.
The next option is to go for a certificate program in medical coding. You can also opt in for an online medical training course - a combination of textbook and web based learning which offers flexibility both on place and time.
What to look for before enrolling?
Before you enroll in a medical coding certification school, the following things should be kept in mind:
• Credibility of the institute
• Approval of the medical training course
Enhanced employment prospects
A steady and continuous growth in the health care industry in recent years has increased the demand of certified medical coders and professionals. As the demand for skilled medical coding professionals is increasing, employment prospects look good. But the employment opportunities are very good for those holding a certification as it speaks volumes of their expertise in the field.
Importance of Medical coding certification schools
Medical coding certification schools provide you with the right knowledge required in the field. They play a great role in increasing your career options as well. A certified medical coder who has attended a medical coding school can opt in to work in hospitals, clinical research institutes and also in insurance companies.
About the Author
codingcert.com provides selected trainers that gives you hands-on training for medical billing and coding certification at our CPC training camps to assist YOU to pass the American Academy of Professional Coders (AAPC) certification exam to become a Certified Professional Coder (CPC).
Increase Your Productivity with Coder Boot Camps by Celena Rose
A coder boot camp is an intensive power-packed training session, where you can work out your grey mass to the peak. From basic to complex coding scenarios, these camps equip you with the latest coding solutions, so that you can keep yourself up-to-date with the changes in the medical coding industry. These camps allow close interaction with experts you have the best possible knowledge in their fields.
The coder boot camp is also a great way to prepare for your medical coding certification exam. Whether it's the CPC exam or the latest CPC-H exam, these camps offer experienced coders the opportunity to prepare for the exam in a very short time. If you are looking for a refresher course, or you wish to improve your coding accuracy, these camps are especially designed for you. The boot camp will help you get a comprehensive knowledge of CPT, ICD-9 CM, HCPCS coding, and also of medical terminology.
You'll have a one-to-one time with the instructor to get the best possible solution to your coding issues and complications. You'll learn the trade secrets in a short time to tackle coding scenarios that confused you until now. Experienced and certified coders are in high demand, and these boot camps provide you the necessary tools to develop your expertise and also pass the certification exam you want to. From time management tips to practice exams, a coder boot camp can enable you with the best possible preparation for your examination. If you're already a certified healthcare coder, these camps can get you CEUs or Continuing Education Units.
For employers, it's very important to increase your employees' credibility to bring in the reimbursement every time. Your employees' expertise means fewer denials, higher compliance, and increased productivity, and a coder boot camp is your best option for sure.
The coder boot camp is also a great way to prepare for your medical coding certification exam. Whether it's the CPC exam or the latest CPC-H exam, these camps offer experienced coders the opportunity to prepare for the exam in a very short time. If you are looking for a refresher course, or you wish to improve your coding accuracy, these camps are especially designed for you. The boot camp will help you get a comprehensive knowledge of CPT, ICD-9 CM, HCPCS coding, and also of medical terminology.
You'll have a one-to-one time with the instructor to get the best possible solution to your coding issues and complications. You'll learn the trade secrets in a short time to tackle coding scenarios that confused you until now. Experienced and certified coders are in high demand, and these boot camps provide you the necessary tools to develop your expertise and also pass the certification exam you want to. From time management tips to practice exams, a coder boot camp can enable you with the best possible preparation for your examination. If you're already a certified healthcare coder, these camps can get you CEUs or Continuing Education Units.
For employers, it's very important to increase your employees' credibility to bring in the reimbursement every time. Your employees' expertise means fewer denials, higher compliance, and increased productivity, and a coder boot camp is your best option for sure.
About the Author
codingcert.com provides selected trainers that gives you hands-on training for medical billing and coding certification at our CPC training camps to assist YOU to pass the American Academy of Professional Coders (AAPC) certification exam to become a Certified Professional Coder (CPC).
Responsibilities of a Certified Professional Coder by Celena Rose
A certified professional coder (CPC) is an individual of high professional integrity who has cleared a coding certification examination.
Key responsibilities of a certified professional coder
A certified professional coder has knowledge and expertise in coding procedure and diagnosis used by physicians. As a CPC, you must know the correct application CPT and ICD-9 diagnosis - to translate diagnostic and procedural phrases into numerical codes used for billing and reimbursement purpose by insurance companies.
Responsibilities of a CPC are as follows:
• Code accurately: The most important task of a CPC is to determine accurate codes for physicians diagnosis and procedures.
• Being up-to-date: A CPC needs to be up-to-date with the latest medical compliance and reimbursement policies.
• Review medical records: Review medical record information to identify all appropriate coding, and see if it's in tune with the latest reimbursement policies and CMS guidelines.
• Interface with physicians: To keep a check on compliance issues, a certified professional coder has to use her analytical skills to recommend new strategies to the physicians. Updating physicians with accurate coding information is also one of the responsibilities of a CPC.
• Implement new guidelines: A CPC must ensure that new coding guidelines are implemented in a timely manner.
• Update patient information: Patient information forms must also be updated from time to time as per requirement.
In a nutshell, a certified professional coder must demonstrate analytical and problem-solving skills regarding barriers to receiving reimbursement. Taking active part in process and quality improvement initiatives is always a plus.
Key responsibilities of a certified professional coder
A certified professional coder has knowledge and expertise in coding procedure and diagnosis used by physicians. As a CPC, you must know the correct application CPT and ICD-9 diagnosis - to translate diagnostic and procedural phrases into numerical codes used for billing and reimbursement purpose by insurance companies.
Responsibilities of a CPC are as follows:
• Code accurately: The most important task of a CPC is to determine accurate codes for physicians diagnosis and procedures.
• Being up-to-date: A CPC needs to be up-to-date with the latest medical compliance and reimbursement policies.
• Review medical records: Review medical record information to identify all appropriate coding, and see if it's in tune with the latest reimbursement policies and CMS guidelines.
• Interface with physicians: To keep a check on compliance issues, a certified professional coder has to use her analytical skills to recommend new strategies to the physicians. Updating physicians with accurate coding information is also one of the responsibilities of a CPC.
• Implement new guidelines: A CPC must ensure that new coding guidelines are implemented in a timely manner.
• Update patient information: Patient information forms must also be updated from time to time as per requirement.
In a nutshell, a certified professional coder must demonstrate analytical and problem-solving skills regarding barriers to receiving reimbursement. Taking active part in process and quality improvement initiatives is always a plus.
About the Author
codingcert.com provides selected trainers that gives you hands-on training for medical billing and coding certification at our CPC training camps to assist YOU to pass the American Academy of Professional Coders (AAPC) certification exam to become a Certified Professional Coder (CPC).
Increase Your Reimbursement and Avoid Claims Denials with Medical Billing Conferences by Angela Martin
Do you pay attention to the practice management system you use? If not, you're losing reimbursement. To receive your rightful payments, optimize your medical billing practices for effectiveness and efficiency. You must ensure that your practice receives the reimbursement it deserves and that there's a proper follow-up on unpaid claims. Follow a set procedure to ease your billing worries.
The first step to streamline the process is to assign the right people in your medical billing team to the right tasks. A good billing staff takes care of each account, captures payment, and understands the ins and outs of insurance companies' coding and billing requirements - important because you always want to know how your payers decide to reimburse your medical services. The right kind of people on the team will ensure that you steer clear of compliance issues and that the revenue for the practice is optimized.
Review and monitor the explanation of benefits (EOB) to make sure you have received what you worked for. Pay special attention to your denials - it'll help you to understand what's going on in you medical billing department and whether your coders are coding properly. Another great benefit of reviewing your EOB is you can troubleshoot the reimbursement holes and figure out if insurance companies are paying you according to the contracted rates.
When you have all your medical billing tools in place, all you have to do is stay alert and be on the watch for updates. Interpret the updates correctly to avoid denied claims and compliance issues. To receive the updates on time and learn their correct interpretation, medical billing conferences are exactly what you need. Keep your medical billing practice on track and get your office its deserved reimbursement.
The first step to streamline the process is to assign the right people in your medical billing team to the right tasks. A good billing staff takes care of each account, captures payment, and understands the ins and outs of insurance companies' coding and billing requirements - important because you always want to know how your payers decide to reimburse your medical services. The right kind of people on the team will ensure that you steer clear of compliance issues and that the revenue for the practice is optimized.
Review and monitor the explanation of benefits (EOB) to make sure you have received what you worked for. Pay special attention to your denials - it'll help you to understand what's going on in you medical billing department and whether your coders are coding properly. Another great benefit of reviewing your EOB is you can troubleshoot the reimbursement holes and figure out if insurance companies are paying you according to the contracted rates.
When you have all your medical billing tools in place, all you have to do is stay alert and be on the watch for updates. Interpret the updates correctly to avoid denied claims and compliance issues. To receive the updates on time and learn their correct interpretation, medical billing conferences are exactly what you need. Keep your medical billing practice on track and get your office its deserved reimbursement.
About the Author
Audioeducator offers medical billing training and advanced Learning Opportunities for Healthcare Executives, and provide a way to Increase Your Reimbursement and Avoid Claims Denials with Medical Billing Conferences on a recurrent basis by medical billing practices.
Boost Your Employment Opportunities with a Coder Training Program by Celena Rose
The accuracy of codes depends on your access to the latest updates. Codes get changed, replaced, modified every year with effect from January 1, and if you are not using the updated codes - your reimbursement will suffer. A coder training enables you to understand the change procedures, and with the required knowledge you stay alert and stay ahead of the changes. Getting the appropriate codes is the most important part of your job.
Coder training develops a better understanding of the codes and gives you the ability to face difficult and confusing scenarios confidently. Training is available for all the specialties of medical science, which also includes sub-specialties. When you assign codes to medical diagnoses and procedures, your aim is to make the payer's job easy -because if it's clear for payers, your reimbursement will be what you deserve.
A good coder training program incorporates all the techniques to fortify your basic knowledge of coding and then take you to a level where you'll be able to resolve complex issues without any assistance. Your instructor during the training program will give you a solid understanding of the principles of CPT, ICD-9 CM, HCPCS coding and medical terminology as well. You'll also get hands-on practice on real-life coding scenarios, interact with industry experts, and you'll also have homework.
Plus- you'll get geared up for the certification exam which will advance your medical coding career to the next level. From practice tests to time management techniques to smart study techniques - you'll get all the preparation you need to pass the CPC exam. These training sessions are intensive and held nationwide, so that, you can easily find one near you.
The completion of the coder training program and a subsequent certification gives you better and meatier employment opportunities in the healthcare industry - at hospitals, physician offices and insurance companies. All you need is to enroll!
Coder training develops a better understanding of the codes and gives you the ability to face difficult and confusing scenarios confidently. Training is available for all the specialties of medical science, which also includes sub-specialties. When you assign codes to medical diagnoses and procedures, your aim is to make the payer's job easy -because if it's clear for payers, your reimbursement will be what you deserve.
A good coder training program incorporates all the techniques to fortify your basic knowledge of coding and then take you to a level where you'll be able to resolve complex issues without any assistance. Your instructor during the training program will give you a solid understanding of the principles of CPT, ICD-9 CM, HCPCS coding and medical terminology as well. You'll also get hands-on practice on real-life coding scenarios, interact with industry experts, and you'll also have homework.
Plus- you'll get geared up for the certification exam which will advance your medical coding career to the next level. From practice tests to time management techniques to smart study techniques - you'll get all the preparation you need to pass the CPC exam. These training sessions are intensive and held nationwide, so that, you can easily find one near you.
The completion of the coder training program and a subsequent certification gives you better and meatier employment opportunities in the healthcare industry - at hospitals, physician offices and insurance companies. All you need is to enroll!
About the Author
Codingcert.com makes you develop your medical coding skills through proper coder training program.
Keep Your Hospice Clear of Lawsuits by Angela Martin
Lawsuits carry whopping settlement amounts that can drive your hospice to bankruptcy! More than price tag, it's your reputation that's at stake. So, it makes sense to issue a release saying you found and reported a problem instead of having to settle a whistleblower suit. Hospice conferences on tackling legal matters can help you stay clean and steer clear of compliance issues.
Follow these simple steps to head off costly and embarrassing whistleblower suits:
1. Draw up and follow sound compliance plan: Get a compliance plan ready to avoid lawsuits which can bring down your entire business.
2. Encourage a culture of compliance: It's not enough to have a compliance plan sitting on your shelf. Make sure all employees know you are committed to doing the right thing and cultivate an ethical environment that lives up to the compliance plan.
3. Focus on compliance hot spots: You may need to give extra attention to areas that regulators are targeting. Be sure your compliance plan adequately addresses this area and then be sure your practices adhere to your plan.
4. Review eligibility criteria: Make sure you are adhering to Medicare guidelines and your own compliance plan. Everyone admits that predicting life expectancy is an inexact science, but if your patients' average length of stay has gradually trended up past the six-month point, it's time to take a look at your admission practices. Be vigilant about who you are admitting.
5. Be receptive to employee complaints: Bring any concerns to management first before staff members go to outside third parties. If staff complain and management does not appropriately address their concerns, employees have no choice but to take action outside of the organization.
6. Police yourself. Once you have the proper compliance procedures and practices in place, you need to do your own checks and audits to make sure you're complying with them. It's much less costly and embarrassing to fix problems yourself than to have regulators do it for you.
The scenarios are varied and the solutions have to be out-of-the-box for more complex issues, so the easiest way you'll get a one-on-one time with an expert and the answers you need is by attending a Hospice conference.
Follow these simple steps to head off costly and embarrassing whistleblower suits:
1. Draw up and follow sound compliance plan: Get a compliance plan ready to avoid lawsuits which can bring down your entire business.
2. Encourage a culture of compliance: It's not enough to have a compliance plan sitting on your shelf. Make sure all employees know you are committed to doing the right thing and cultivate an ethical environment that lives up to the compliance plan.
3. Focus on compliance hot spots: You may need to give extra attention to areas that regulators are targeting. Be sure your compliance plan adequately addresses this area and then be sure your practices adhere to your plan.
4. Review eligibility criteria: Make sure you are adhering to Medicare guidelines and your own compliance plan. Everyone admits that predicting life expectancy is an inexact science, but if your patients' average length of stay has gradually trended up past the six-month point, it's time to take a look at your admission practices. Be vigilant about who you are admitting.
5. Be receptive to employee complaints: Bring any concerns to management first before staff members go to outside third parties. If staff complain and management does not appropriately address their concerns, employees have no choice but to take action outside of the organization.
6. Police yourself. Once you have the proper compliance procedures and practices in place, you need to do your own checks and audits to make sure you're complying with them. It's much less costly and embarrassing to fix problems yourself than to have regulators do it for you.
The scenarios are varied and the solutions have to be out-of-the-box for more complex issues, so the easiest way you'll get a one-on-one time with an expert and the answers you need is by attending a Hospice conference.
About the Author
Audioeducator offers Hospice conferences and advanced Learning Opportunities for Healthcare Executives, case studies for health plans, impact of healthcare customer choice through all types of audio conference and exceptional series of training CD's, DVD's & Tapes.
Accurately Code for Hematuria with the New ICD-9 Codes by Nancy Rose
Hematuria is the presence of red blood cells in the urine. It is one of the most frequent conditions warranting referral to urology. The more specific the coding is, the better for you. But, when you code for hematuria, you'll encounter very few codes which are specific and this can get confusing at times. The chances were, so far, not so bright to get your reimbursement, but with the updates, it'll get easy for you to code for specific conditions.
The new ICD-9 codes replace the only code for hematuria - 599.7. These new ICD-9 codes for hematuria, or blood in the urine that will provide more specificity than the current code, are:
• 599.70 - hematuria, unspecified
• 599.71 - Gross hematuria. A patient has gross hematuria when blood is visible to the naked eye on urination. The urine is red or brownish-red when a patient has gross hematuria.
• 599.72 - Microscopic hematuria. A patient has microscopic hematuria when there is no blood visible to the naked eye on urination but blood appears on a urinalysis.
Urology coders will frequently use these new diagnostic codes to properly characterize the degree or severity of the hematuria. The biggest diagnosis change for the group will be gross hematuria versus microscopic. These new additions will ease the way you code for hematuria.
The new ICD-9 changes are very good for you, because the words 'benign' and 'essential' have been deleted. Usually, you'll be unable to understand if the hematuria is benign and/or essential until after the complete workup, so 'hematuria, unspecified' is much better. The changes will ensure you get your reimbursement - every time.
The new ICD-9 codes replace the only code for hematuria - 599.7. These new ICD-9 codes for hematuria, or blood in the urine that will provide more specificity than the current code, are:
• 599.70 - hematuria, unspecified
• 599.71 - Gross hematuria. A patient has gross hematuria when blood is visible to the naked eye on urination. The urine is red or brownish-red when a patient has gross hematuria.
• 599.72 - Microscopic hematuria. A patient has microscopic hematuria when there is no blood visible to the naked eye on urination but blood appears on a urinalysis.
Urology coders will frequently use these new diagnostic codes to properly characterize the degree or severity of the hematuria. The biggest diagnosis change for the group will be gross hematuria versus microscopic. These new additions will ease the way you code for hematuria.
The new ICD-9 changes are very good for you, because the words 'benign' and 'essential' have been deleted. Usually, you'll be unable to understand if the hematuria is benign and/or essential until after the complete workup, so 'hematuria, unspecified' is much better. The changes will ensure you get your reimbursement - every time.
About the Author
codingnews.inhealthcare.com brings you the latest coding news. Check out more for medical coding updates.
Coding News You Can Use: Documentation Essentials by Nancy Rose
Documentation holes will cost your practice thousands of dollars in denied claims. Your top priority is getting top-notch clinical documentation for your inpatient coders. The latest coding news is that physician query and communication is now "paramount", and not just important.
To be sure your payments are on track, keep a track of up-to-the-minute coding news and see how your hospital's policies and procedures address the following physician documentation discrepancies and issues:
Documentation mistake 1: If it is clear to the physician, it will be clear to the coders.
Physicians may assume that coders can get what they need by, for example, looking at lab values or other test results. But according to national coding guidelines, coding staff cannot code from lab values, and they cannot diagnose. Coders need the narrative terms required to support key diagnoses.
Under the new MS-DRG system, the reality is that we need a lot more specific and detailed verbiage in the medical record to support correct coding.
Documentation mistake 2: Someone else will fill in the blanks for you.
Don't let physicians pass the buck when it comes to proper documentation in the medical record. Coders can't just pluck support for their codes from anyone's notes in the chart. For example, information regarding malnutrition must come from the physician (or a physician assistant or clinical nurse specialist) - not from a dietitian.
Documentation mistake 3: Physicians drag their feet when coders' queries come their way.
This is a mistake - but not necessarily the physicians'. How physicians respond to queries for more information depends in large part on how knowledgeable they are regarding the coding process - and health information managers are responsible for securing that buy-in.
Don't put your practice at risk by staying behind the updates. Get the recent coding news, or your practice's revenue will suffer.
To be sure your payments are on track, keep a track of up-to-the-minute coding news and see how your hospital's policies and procedures address the following physician documentation discrepancies and issues:
Documentation mistake 1: If it is clear to the physician, it will be clear to the coders.
Physicians may assume that coders can get what they need by, for example, looking at lab values or other test results. But according to national coding guidelines, coding staff cannot code from lab values, and they cannot diagnose. Coders need the narrative terms required to support key diagnoses.
Under the new MS-DRG system, the reality is that we need a lot more specific and detailed verbiage in the medical record to support correct coding.
Documentation mistake 2: Someone else will fill in the blanks for you.
Don't let physicians pass the buck when it comes to proper documentation in the medical record. Coders can't just pluck support for their codes from anyone's notes in the chart. For example, information regarding malnutrition must come from the physician (or a physician assistant or clinical nurse specialist) - not from a dietitian.
Documentation mistake 3: Physicians drag their feet when coders' queries come their way.
This is a mistake - but not necessarily the physicians'. How physicians respond to queries for more information depends in large part on how knowledgeable they are regarding the coding process - and health information managers are responsible for securing that buy-in.
Don't put your practice at risk by staying behind the updates. Get the recent coding news, or your practice's revenue will suffer.
About the Author
codingnews.inhealthcare.com brings you the latest coding news. Check out more for medical coding updates.
Use a CPT Modifier to Get the Reimbursement You Deserve by Nancy Rose
CPT modifier is an additional feature of the CPT to indicate that specific circumstances have changed the performed service. Modifiers play an important role in explaining the insurance companies or payers that the additional procedures that were performed which do not look like to be separately paid are in fact justified.
Here are some examples of commonly used CPT modifiers:
• - 50 : Indicates a procedure that not already defined as bilateral was performed on both sides of the patient's body at the same episode of care.
• - 51 : When multiple surgeries are performed during the same operative session. Most payers pay 100 percent for the first procedure, but reduce the reimbursement on the second, third, and fourth procedures.
• - 59 : This CPT modifier is used to indicate that a procedure was distinct or separate from the other procedures performed on the same date. This modifier tells the payer that the doctor has not submitted a duplicate claim.
• - 62 : A single procedure performed jointly by co-surgeons. Here, each surgeon bills with the same code and the payment to each of them is usually 62.5 percent of the normal amount.
• - 76 : Repeat procedure by the same doctor. Often used with radiological procedures, performed more than once on the same date.
• - 79 : Unrelated procedure or service by the same physician during the post operative period. This modifier is the surgical equivalent of modifier - 24.
• - 91 : Repeat clinical lab. This modifier is used when more than one result are required in the course of treatment on the same day. A word of caution here -do not use this modifier in case of equipment failure.
There are many other CPT modifiers which identify the type of provider and supervision - the key objective is to get the reimbursement you truly deserve.
Here are some examples of commonly used CPT modifiers:
• - 50 : Indicates a procedure that not already defined as bilateral was performed on both sides of the patient's body at the same episode of care.
• - 51 : When multiple surgeries are performed during the same operative session. Most payers pay 100 percent for the first procedure, but reduce the reimbursement on the second, third, and fourth procedures.
• - 59 : This CPT modifier is used to indicate that a procedure was distinct or separate from the other procedures performed on the same date. This modifier tells the payer that the doctor has not submitted a duplicate claim.
• - 62 : A single procedure performed jointly by co-surgeons. Here, each surgeon bills with the same code and the payment to each of them is usually 62.5 percent of the normal amount.
• - 76 : Repeat procedure by the same doctor. Often used with radiological procedures, performed more than once on the same date.
• - 79 : Unrelated procedure or service by the same physician during the post operative period. This modifier is the surgical equivalent of modifier - 24.
• - 91 : Repeat clinical lab. This modifier is used when more than one result are required in the course of treatment on the same day. A word of caution here -do not use this modifier in case of equipment failure.
There are many other CPT modifiers which identify the type of provider and supervision - the key objective is to get the reimbursement you truly deserve.
About the Author
codingnews.inhealthcare.com brings you the latest coding news. Check out more for medical coding updates.
International Medical Insurance by John Tahan
Thousands of people have work related commitments and in order to fulfill those commitments they have to travel abroad. Have you ever realized that most of the insurance company's provide only domestic medical coverage? So, whenever you are leaving your home country, do check up with your current Insurance Company whether they have international medical insurance.
The purpose of taking international medical insurance is that you should be covered under all circumstances and to get the medical cover where it is required. So, "Do not postpone for tomorrow; there maybe law against it" and try to get the Medical Insurance Overseas benefits as soon as possible.
Things like medicines, fees charged by the doctors, evacuation if required and all other hospitalization fees are included in international medical insurance. By now you must have realized the benefits of getting a medical insurance that is internationally valid. Many cases have been discovered where people take it lightly and don't bother about verifying from their insurance company whether the insurance policy they are having is valid outside their country or not.
They only realize this when something serious happens and they spend thousands of dollars to get themselves cured. "Problem never thinks before reaching a person". Taking such sort of insurance actually covers all the financial expenses that are incurred during an emergency. This is a contract between you and your insurance company in which they will provide you financial aid at the time of emergency. Some international insurance companies even take care of evacuation if at all it is required and you cane easily access the hospitals that have a tie up with your insurance company.
So, save yourself from being bankrupted. "Thinking is wise; Planning is wiser; Execution is the wisest" ? Act now and get the international medical insurance now if you are traveling abroad.
If you find this information useful you should visit the site http://www.official-insurance.net where you will find lots of interesting articles related to this topic, all original and wrote by Andreea Dinescu.
Visit the insurance blog from A to Z at http://www.insurancecostfor17yearold.com/
About the Author
John Tahan is a webmaster and internet marketer also a computer specialist who also enjoys writing songs, singing and playing guitar working on home made computer music demos. Feel free to leave a comment or a request at:
http://www.insurancecostfor17yearold.com/ http://bytelan.com/whatdoesreconcileinaccountingterms/
Medical Insurance Bankruptcy by John Tahan
First the bad news: about 2,000,000 personal bankruptcies each year are caused by unexpected medical expenses. Of all those people, 1,500,000 have (or had) health insurance before they ran into difficult financial straights.
But wait a minute. Isn't the whole idea behind health insurance - security? The financial security that comes from knowing that you're covered if something goes wrong with your body? You say you're covered, but what if your medical "situation" exceeds your policy limits? Then what?
No one wants that to happen, so the question is: are there other options? For instance, is there a way to "insure" against getting sick in the first place? Most people assume that's not possible, but personally, I disagree.
Several years ago my wife Sandy and I stumbled onto a very unusual health product. We both had our own experiences with it and have seen it work miracles for others.
But before going there, I'd like to explain something. To me, health insurance should be about staying healthy. In China, for instance, doctors used to be paid only if they kept you healthy. That's what I call real health insurance. And although the U.S. has some of the best-trained, dedicated physicians in the world, heart disease, cancer, strokes, and autoimmune diseases are all on the rise.
Clearly, our health isn't being protected - at least not to an appreciable extent. The medical paradigm in the U.S. is mostly about treating symptoms, not fostering health. And while we're all very grateful to doctors for all their efforts, symptom treatment is intrinsically short-sighted.
If symptom treatment was effective in restoring health, people would be getting well and staying well. But that's not what usually happens.
There's a growing movement of people who've recognized the shortcomings of the traditional medical/pharmaceutical "health" model. They're not stupid. For instance: 106,000 annual deaths from properly prescribed prescription drugs sure got my attention when I heard the news. Check it out on the net. It's a fact.
OK. So everyone knows there's a problem. Again, the question is: are there options out there and if so, what are they?
As I was saying earlier, there is an option. I can say that because I have personal proof. Four years ago, I was diagnosed with a heart condition called atrial fibrillation. It wasn't painful per se, but the irregular, spasmodic poundings inside my chest were very disconcerting.
My wife Sandy and I were in Maui when a friend of ours told us about something called glyconutrition. Now, I'm a fairly open-minded kind of a guy and I've been interested in health supplements for a long time, so I decided to try it. (By the way, nothing I was taking before then was helping my heart condition). After a few months, the condition went away. It hasn't returned since.
Sandy also had a positive health reversal. She was in a lot of pain from neck surgery she'd had seven years earlier. She also decided to try the glyconutrients. It took a little longer for her, but her pain subsided and surgery was avoided.
My point in telling you these two stories is that we saved a ton of money and who knows how much pain and suffering by not having to undergo surgery. I don't know if my atrial fibrillation would have led to a worsening condition requiring surgery, but I do know that Sandy was considering a second neck surgery before we heard about glyconutrients.
Since then, we've learned a lot more about the science behind glyconutrients and why this new category of nutrient is turning around so many health conditions for so many people.
Even highly trained medical doctors and surgeons are taking notice. Case in point: Dr. Ben Carson is the department head of pediatric neurosurgery at Johns Hopkins Medical Center. A severe form of prostate cancer led him to discover glyconutrients. Long story short: he attributes to them his complete recovery. He now recommends glyconutrients to all his patients, to his staff and others as well.
Without going into a lot of complicated detail, science now has a pretty good idea about why glyconutrients seem to be helping so many different kinds of health conditions. The bottom line is this: enhanced cell-to-cell communication.
Glyconutrients provide the body with highly specialized building blocks that the body transforms into communication molecules that all cells use. Without an adequate supply of these molecules, communication starts to break down and illness starts to creep in.
The reason glyconutritional supplements are so effective is this: our diets suck. Let me explain. If we got all the nutrients we needed in our diet, we'd rarely get ill. By the way, the scientific evidence to support that statement is huge.
But because 90 percent of the food we eat is processed (devoid of essential, health-promoting nutrients) and for a number of other reasons, we're not getting the nutritional build blocks our bodies need in order to stay disease-free.
Bottom line: understand the powerful relativity between the nutrients we consume and the state of our health.
So to reiterate - there are options for warding off illness and medically related bankruptcy. Just don't look for them in the current medical - pharmaceutical - health insurance paradigm. Look for them in the emerging science of glycobiology - the same science that's starting to describe the cellular mechanisms behind the major health recoveries that thousands of glyconutrient users are now reporting.
David Lear is an independent nutrition researcher and free-lance writer. His main interest is in cutting-edge supplements that improve health and reverse illness. For further information, visit http://www.glycoresults.com
Visit the insurance blog from A to Z at http://www.insurancecostfor17yearold.com/
About the Author
John Tahan is a webmaster and internet marketer also a computer specialist who also enjoys writing songs, singing and playing guitar working on home made computer music demos. Feel free to leave a comment or a request at:
http://www.insurancecostfor17yearold.com/ http://bytelan.com/whatdoesreconcileinaccountingterms/
Inscription à :
Articles (Atom)