All posts by Stephen Brighton

5 Fun Facts About Careers in the Medical Billing Industry

Medical coding is a huge part of the overall system of healthcare in this country. It involves assigning codes to the specific description of a patient’s status, and professional medical coders help to ensure that accurate information is conveyed between patients and doctors, in addition to doing the same with insurance companies.

According to the Bureau of Labor and Statistics, there will be a 15% increase in the need for medical coders in the decade between 2014 and 2024. This represents a much larger increase than the average for most professions. Even though this is such a rapidly growing field of endeavor, there are probably some fun things that you didn’t know about careers in medical billing.

Medical coders need to be good puzzle solvers

While a thorough background in medical billing codes is necessary, sometimes assigning codes to descriptions of medical conditions can really be more like an art form than a science. In some cases, you’ll have to track down doctors and query them about specifics, or you might have to consult with insurance companies and patients in order to retrieve accurate information. If you’re good at solving puzzles and working out problems, that will be extremely useful towards your career in medical billing.

The medical coding system is gargantuan

You might be a bit overwhelmed when you realize just how huge the medical coding system is. There are literally thousands of codes involved, to cover every kind of medical condition under the sun. Medical billing and coding professionals frequently have to work with software systems which help them assign codes, simply because of the huge body of codes that must be sifted through before finding the right one. It will help a great deal if you have a good memory as a coder, because it will generally help you to find the right codes faster. However, whenever you get hit by a brand-new medical condition, it might throw your whole process into a loop, and you’ll have to spend considerable research time finding just the right code for the situation.

Medical coders work in all kinds of settings

You might think that as a medical coder, you would always be working in a physician’s office, but that’s not necessarily the case. Since medical coders are needed in virtually every installation throughout the healthcare industry, there are literally any number of locations where you might undertake your profession. Some coders work in hospitals, some work in doctors’ offices, some work in school systems, and there are probably another 15 or 20 possible locations where you might provide service. Wherever medical healthcare is delivered, that’s a potential location for a medical coder to be employed.

There’s great deal of flexibility in the profession

There is tremendous flexibility associated with a career in medical billing. As referenced above, there are any number of different locations where you might possibly be employed, but there is more flexibility than that involved with the job. There are many different schedules and shifts that you might be called upon to work in a professional setting. Of course, many coders do work a traditional 9 AM to 5 PM shift, but a great many others work shifts that are far from traditional. Some medical coders even work directly from their homes, and only report to the workplace occasionally for meetings and for catching up with their employer. Anyone who’s interested in maintaining a balanced work-life schedule should consider a career in medical coding.

It’s easy to break into medical coding

There are many online programs available for medical coders to pursue, as a means of breaking into the profession. Many of these will help you to become a certified Professional Coder, and to complete the program, it normally only takes between two and three terms. Without even having to commute to a classroom, you could acquire all the skills and knowledge that you need to become certified in the profession, and then you can market yourself wherever a position might be available. With the knowledge you pick up from one of these online courses, you would be qualified to sit for the exam offered by the American Academy of Professional Coders (AAPC). Once you pass this exam, you’re on your way to a rewarding career in medical coding!

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The Medical Billing Company Surgeons Prefer

The Medical Billing Company Surgeons Prefer

Medical billing for surgery has become even more critical to the than at any time in the past, given the fact that network health plans have become more narrow, and there is greater regulation over surgical costs. Independent surgeons are frequently encountering diminished reimbursements as a result of all that regulation, in addition to the difficulty of filing clean medical claims which are approved for reimbursement.

It can make all the difference to be associated with a medical billing company which understands all the nuances of appropriate medical claims and coding, so that fewer claims are denied or held up for correction. A savvy medical billing company will understand payor guidelines, as well as their filing requirements, and can make sure that your claims are clean when they are presented for reimbursement. In this way, surgeons can increase their pay while having far fewer hassles with all the necessary paperwork leading up to reimbursement. 

Features which surgeons seek in medical billing

In order to keep your surgical practice running smoothly and with minimum disruptions due to medical billing, a surgeon’s best approach would be to find a very capable medical billing company which offers most of the really useful services that can streamline the whole process and make it more efficient.

A secure client portal can provide detailed reports and information, as well as billing resources, right at your fingertips for you to use in any way that helps your business, or makes it more efficient. An online bill pay system is also very useful, because it allows patients to make their own payments online, in those cases where medical insurance is not involved, and the patient is managing their own payments.

Some kind of a compliance program is also a big plus, because it provides coding reviews and chart audits so that you are aware of all the coding which has been used on your medical claims, and you can verify them before they are sent out for reimbursement. This means that any medical billing company you choose should have a number of Certified Professional Coders on staff, who are aware of all the latest coding requirements and can accurately match them up to the services provided for any surgical services.

Constant access to patient data

You would also probably want to have the capability of viewing your patient data and all transaction information at literally any time of day, with no interruption of service. This can be an invaluable service to have, when you need to understand certain aspects of patient medical history, as well as any transactions which have taken place in the past.

Finally, if you’d like to focus on actual surgery in your practice and eliminate most of the details involved with running your business, you can outsource all that to a capable medical billing company which offers Comprehensive Practice Management as part of their service. This gives you the best of both worlds in that it reduces your workload at the same time that it increases your revenue stream coming in.

For surgeons who prefer to focus on areas where their real talents lie, this is an ideal solution that can keep you working at what you do best, while leaving the details of running your business to others. Of course, that means you would need to choose a medical billing company which you can trust implicitly, and for this you won’t find a more reliable and trustworthy company than Medical Healthcare Solutions.

Why choose Medical Healthcare Solutions? 

If you’re looking for a company which can provide a complete solution to your needs in the areas of medical billing, electronic health records, and practice management services, then Medical Healthcare Solutions (MHS) is the answer you’ve been searching for. With a high level of staff expertise and employing the latest in medical billing technology, you won’t find a more efficient or cost-effective solution anywhere on the market.

When clients become associated with MHS, they typically remain with the company for years and years, and that’s because MHS is able to deliver customer satisfaction better than anyone else. When you find a good partner, you should stick with them, and that’s why MHS has so many loyal clients.

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A Medical Billing Code Guide To Holiday-Related Injuries

With the holiday season just around the corner, it’s time to start thinking about ways to stay safe through the holidays, so that accidents and injuries don’t ruin your appreciation of the holiday season. The United States Consumer Product Safety Commission reports that there are upwards of 15,000 injuries which occur every holiday season, just in the month of December.

Most of these injuries are related to accidents involving Christmas trees, holiday lights, and burns from candles. Physicians who have to document these injuries will have a little greater precision available to them this year in coding the specific injury, now that the ICD–10 code system has been adopted. This is far more specific than its predecessor ICD–9, and that means doctors, hospitals, and insurance firms will have to make use of these new codes whenever they’re trying to make claims on injuries and treatments.

There is a good and a bad side to this, with the good side being that it’s much more likely that you will have the perfect code associated with even an unusual injury. The bad side of that is that there are tons more codes to learn, and if you don’t know them all, you may put down the wrong code on a claim form and have it rejected. This of course, is anathema to hospitals and medical facilities, which are frequently waiting for revenues to come in for services rendered. Any kind of mistake made on a claim form is certain to cause a delay, and possibly a complete rejection of the claim.

Don’t be overwhelmed by ICD–10

There are a couple approaches you can take to using the new ICD–10 codes during the holiday season. If you have a dedicated person who commits a good deal of time to learning the new codes and using them on claim forms, you’ll probably manage pretty well. However, if you don’t have someone in your organization who can be dedicated to learning and understanding the new coding system, you may want to take an alternate approach.

There are a number of excellent medical billing services available, such as Medical Healthcare Solutins, Inc., which can handle your claim forms for you, using all the new codes from ICD–10. You can pretty much count on these experts to use the right codes for any specific injury that occurs around the holiday season.

Since they make it their business to know and understand any changes in the coding system, you can count on them getting it right on the forms. That takes much of the burden off you, so that you can concentrate on providing great medical care, and not worrying about submitting claim forms to insurance companies.

A sample of the new ICD-10 codes 

To show you how specific some of the codes are in the new ICD-10 system, some of them are shown below. While these injuries are not likely to occur every day of  the week, it’s comforting to know that when they do occur, there’s a precise code which can be used to designate the injury. Note the first code on the listing:

  • Z75.5 –        Holiday relief
  • T71.231D –  Asphyxiation due to being trapped in a discarded refrigerator, accidental
  • Z01.00 –      Encounter for examination of eyes and vision without abnormal findings
  • W53.21XA – Bitten by squirrel, initial encounter
  • W11.XXXA – Fall on or from ladder
  • W61.42XA – Struck by turkey
  • X02.8XXA –  Other exposure to controlled fire
  • Y92.253 –    Injured at the opera
  • S93.412A –  Sprain of ligament of left ankle, initial encounter
  • S39.92XS –  Unspecified injury of lower back
  • T33.09XA –  Superficial frostbite
  • V00.321S –  Fall from snow-skis
  • V80.1 – Injury as occupant of animal-drawn vehicle.
  • W55.32XA – Struck by other hoof stock, initial encounter
  • W00 – Fall due to ice and snow.
  • W29.1XXA – Contact with electric knife
  • W55.12XA – Struck by horse, initial encounter
  • W59.22XA – Struck by turtle
  • Y92.59 – Injury at shopping mall
  • Z62.891 –  Sibling rivalry

The Consumer Product Safety Commission has issued some recommendations for holiday safety, so that many of the new codes from the ICD-10 coding system don’t have to be used on claims. These warnings include making sure your kids are safe while you’re doing holiday shopping, keeping kids and pets away from candles, electrical devices, and holiday plants, being careful on store escalators, and keeping all decorations away from open flames and electrical devices. Stay safe, and avoid using all these wonderful new billing codes!

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Let Us Help You With Your Medical Billing Needs

Medical billing services can include a wide array of things other than coding and billing, or at least it does for a versatile company like Medical Healthcare Solutions, Inc. (MHS). We recognize that there are a number of related areas that have strong overlap with medical coding and billing, and that’s why we offer a complete suite of those services as well to our clients. For decades now, we have been providing these services to medical organizations in Massachusetts, especially those in the areas around Boston and Andover.

Our Services 

Whatever your medical billing needs are, we feel confident that we can provide prompt and professional assistance, so that your company personnel are freed up to perform more important and more company-specific tasks. Here are some of the things we specialize in, which we’ll be happy to work with you on:

  • Healthcare analytics services – we can provide predictive industry analysis, business model evaluation and optimization, state-of-the-art data analysis, and improved business performance, all of which when used together will help to provide you with a clear and accurate picture of the state of your medical practice.
  • Doctor credentialing – provider enrollment and doctor credentialing are commonly regarded as annoying but essential tasks, which no one particularly cares to do. MHS will be glad to undertake these tasks for you, so that you can stick with the business of providing great healthcare.
  • Mobile medical billing – sometimes billing has to be done while out in the field, and we provide several solutions that will help you accomplish this vital task. Using either iPhone, iPad, or Android devices, we can ensure that no time is lost waiting to get back to the office for billing.
  • Practice management consulting – we offer a number of instructional courses on custom interfacing, PQRS consulting, maximizing reimbursements, coding analysis and instruction, consulting on the usage of modifiers, and meaningful use consulting.
  • Student health services billing – we can offer this service to all universities in the country, because we understand how important it is for a college to handle any injuries or life-threatening situations with its students. There are more than 20 million students currently enrolled in our  nation’s colleges and universities, and they require health coverage just like adults do.
  • Electronic health records – this is one of the fastest growing areas in all of healthcare these days, and if your organization is not using electronic health records, you’re missing out on one of the great aids to doctors which is currently available. MHS offers a modern, ultra-fast EHS system, which can be combined with Allscripts to create one of the best systems in the country.
  • Patient Portal – this system allows patients to take care of much of the paperwork prior to visiting your office, so that office visits can be made much more productive. It provides a convenient, two-way communication between patient and doctor, so the relationship can be closer and more efficient.
  • Medical scheduling – a rules-based system which facilitates the scheduling of visits, and the associated insurance algorithms ensure that any restrictions are observed by everyone involved.

We actually offer even more services than those described above, all with the expectation that we are offering as much assistance as possible to clients who choose to partner with us. When you contact Medical Healthcare Solutions, you can learn about each one of these services in-depth, and decide whether or not they would be valuable to your organization. 

What are your medical billing needs? 

We totally understand that every medical facility has different needs and different procedures for accomplishing tasks in medical billing. That’s why we offer such a comprehensive package of services to our clients, because we want you to make use of those services which would benefit your facility the most. Contact us today, so we can discuss exactly what your needs are, and let one of our representatives describe some of the ways we might be able to simplify and/or enhance your current billing processes. You’ll be very impressed with our accuracy, our low percentage of denied claims, our knowledge of modern medical billing and coding, and about just what it takes to operate a modern, successful healthcare organization.

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How to Handle Reimbursement Issues

Medical coding and billing is by its nature a very precise business, because accurate codes must be used to indicate specific medical procedures provided by a caregiver. If any mistakes are discovered in the coding and billing process, the claim will be denied by an insurance company, and the caregiver will be obliged to resubmit the claim. This of course, can be very time-consuming, and it can result in reduced revenue for a medical facility, especially when several claims are denied at the same time.

The best way to reduce errors made in coding and billing is to train the staff very well so that such mistakes are minimized. However, at least a few errors in coding and billing will always crop up, and when they do, these need to be handled promptly and efficiently, so that minimum delay is encountered for reimbursement. Here are some ways that medical coding and billing errors can be handled in the most efficient manner.

Inadequate training

Even if there are minor issues involved in a claim to an insurance company, it will probably be rejected, and must then be resubmitted. All information included on any claim must have current and relevant information on it, and must be presented with the proper billing codes. The best solution for this situation is to conduct regular training sessions for your medical billing staff, so they are aware of proper standards such as ICD and HIPAA. This will undoubtedly increase the number of approved claims for reimbursement.

Poor documentation

Another frequent cause for rejection by insurance companies is that inadequate documentation is provided with the claim, so that it’s unclear about which processes were used in providing service. This happens most frequently on medical claims for patients who are insured by Medicare. Some of the important information required on these claims is often submitted in a confused state, or is not included at all.

There are also some diagnostic procedures which are hard to represent on a medical claim, and a good amount of confusion can arise from these. To avoid situations like these, guidelines for allowable medical billing services should be consulted, especially those issued by the Centers for Medicare and Medicaid Services. When necessary, information provided on claims should be verified by a second party, when it seems likely that there might be confusion surrounding a particular claim.

Data redundancy

It often happens that a duplication of data is included on medical claims, and this will often result in having a claim denied or receiving only partial reimbursement. This kind of issue most often appears when claims are handled manually, rather than through some kind of electronic process. Whenever there is any kind of confusion or unclear billing claims, an insurer is very likely to simply reject the claim, and require the caregiver to resubmit something which is more clear.

Data redundancy occurs most often on those claims associated with Medicare and Medicaid, and these are carefully scrutinized by insurance companies. One of the newest trends in the medical billing industry is to use software included in Electronic Healthcare Records, which at least partially removes the human element from medical claims. This can cut down on the number of human errors involved, and can virtually eliminate data redundancy on claims. It’s always worth having a second person check a medical claim whenever there’s any thing on the claim which is not crystal clear.


Healthcare in this country is becoming more competitive with the passage of every year, and that means maintaining regular income of revenue is critical. One of the best ways of ensuring that your medical facility has a steady stream of income is to minimize any mistakes made on claims sent to insurance companies. By following some of the recommendations referenced above, you should be able to cut down on any errors made, and improve your revenue flow significantly.

Professional handling of reimbursement issues 

All medical facilities encounter at least some issues with reimbursement. However, an experienced and efficient organization such as Medical Healthcare Solutions of Andover, MA can keep these issues to a minimum, and has the expertise to get them resolved promptly when they do occur. For worry-free medical coding and billing, contact Medical Healthcare Solutions, and receive prompt compensation for your provided services.

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