medical healthcare solutions

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.

Conclusion

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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How To Start a Career in Medical Billing

Careers in medical billing and coding are in great demand these days, as are many careers within the overall medical profession. For those people who are detail-oriented and are not prone to making mistakes, this could be a wonderful field to get into. All the important steps which you should address in order to get your start in the profession are identified below. Once you’ve completed these steps, you should be well prepared for a rewarding career in a fascinating field.

Find out what it’s all about

Specialists in the medical billing and coding field assist healthcare providers to be more efficient in conducting their practice. They do this by helping to ensure that all claims are coded correctly and are handled promptly, so that the facility can be reimbursed for services. There are two basic components to the position, the first of which is to figure out the appropriate code to use for all healthcare diagnoses and treatments. The second step is of course, to bill the insurance companies, patients, and other individuals responsible for payments for medical services which have been provided.

Research education options

If the job description appeals to you, your next step should be to research how you will acquire the necessary training. There are plenty of options available, so you’ll want to make sure you find a good program which has a track record of employing high numbers of graduates. There may be some good programs nearby, or there may be some online courses that appeal to you.

For many people starting out in the field, online education works best because it allows for a smooth integration of family life and academic life. However, there are some other practical considerations you should be aware of. Firstly, you need to make sure that the school you choose has been accredited, so that your diploma will be recognized by potential employers. You should also find out about the availability of financial aid, and you should be sure that the school program prepares you appropriately for certification in the industry.

Take the CPC certification exam

Once you’ve completed coursework at the school of your choice, you should be fully prepared to take the Certified Professional Coder (CPC) examination, which is offered by the AAPC. It’s not always necessary to obtain the certification in order to find work as a specialist for medical billing and coding, but it’s true that many employers will list it as a required skill. By passing the CPC certification exam, you will position yourself well for an entry-level job in the medical coding and billing industry.

Conduct a job search

Having passed the CPC certification exam, your next step should be to begin researching potential job opportunities in those areas of the country where you would consider working. You will also need to prepare a resume, to practice your interviewing skills, and to write cover letters as needed, so you can introduce yourself to prospective employers. When looking for job opportunities, you can use several sources online, or you can associate yourself with an employment agency. It should not be difficult to find a good employer in almost any region of the country, since this is a booming field with many available opportunities.

Use all available avenues

When conducting your search for employment, you should also make use of as many other options as are available to you. Apart from agencies and online research, there are a number of ways you might find a suitable employer, and you should take advantage of these as well. Referrals are a great way for you to get your foot in the door somewhere if you happen to know someone already in the field.

Your academic mentors and instructors may also have contacts in the field, and might be willing to recommend you for a specific position. Networking is another great way to learn about openings, and to find contacts who can be influential in helping you land a job. At the beginning of your career, it’s important that you use all avenues available to you to land that first job.

When you’re ready

Once you’ve followed the steps above to prepare you for a career in Medical Billing, you’ll just need to find the right employer to get things started. If you happen to live on the East Coast, you should inquire about opportunities with Medical Healthcare Solutions of Andover, MA. With decades of experience in serving the medical community throughout the entire region, this company stands head and shoulders above the competition, and would be an outstanding beginning to your career.

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Why MHS is a Leading Boston Medical Billing Company

Medical Healthcare Solutions, Inc. is a Boston medical billing company which evolved in 1995 from the foundation of an earlier company called Medical Billing Service Division, which had been formed four years previously. MHS was formed at that time because the two owners felt there was an urgent need for a high-quality professional medical billing service which could accommodate the greater Boston region, and that any company which could provide superior solutions and service would have a strong chance for success.

Since its 1995 founding, Medical Healthcare Solutions has always demonstrated a strong commitment to its clients, and to providing state-of-the-art solutions in medical billing which most other companies simply could not offer. Part of this commitment to superior service involves staying abreast of all developments in the area of medical billing, as well as having the capability to interface with all the current EMR software solutions, so that information can be easily obtained and used in billing. Here are a few of the reasons why MHS has managed to stay on top of the industry in providing outstanding service and solutions as a medical billing company in the Boston area.

Flexibility in serving clients

MHS has always been as flexible as possible in serving clientele in the medical industry. In fact, the company has gone out of its way to extend high-quality service to Accountable Care Organizations (ACO’s), nationwide individual practices, hospital-based practices, large group practices, Management Service Organizations (MSO’s), and even university student health centers. With this broad array of clients being served, MHS has gained a wealth of experience which it has put into practice to better solve the needs of its diverse pool of clients. This flexibility extends to the specialties which our numerous clients have, and which we can support:

  • plastic surgery
  • podiatry
  • psychiatry
  • pain management
  • pediatrics
  • orthopedics
  • ophthalmology
  • oncology
  • obstetrics / gynecology
  • dermatology
  • general surgery
  • family practice
  • cardiology
  • dermatology
  • internal medicine
  • chiropractic
  • interventional radiology
  • urology
  • transplants
  • neurosurgery
  • pulmonary
  • gastroenterology
  • vascular surgery

As you can see, there’s quite a list of specific areas that our medical clients are involved with, and our staff has the skill and the knowledge to arrange for medical billing in all these areas. That calls for a very diverse understanding of codes and procedures, but our well-trained personnel are more than equal to the task, and that’s why we are routinely called upon by such a wide diversity of medical specialists in the Boston area and around the entire country.

Billing software diversity

We pride ourselves in being able to work with many different software platforms, and even in the medical industry, there is a tremendous diversity of software programs in use by various facilities. Being able to work with these different platforms has kept us on top of the medical billing game, and has allowed us to service a great many different healthcare organizations. Some of the software platforms that we can easily interface with include Athenahealth, Cerner, eClinical, EPIC, GE Centricity, IDX, and virtually all of the biggest and most popular Electronic Medical Records products which are currently on the market.

Our preferred software platform is the Allscripts product line, but we are equally adept at interfacing with all those mentioned above as well as a few others. We can also provide cooperative billing for those organizations which operate as health insurance cooperatives, and allow patients some direction in providing their own care. The point of all this is that MHS is a company which can adapt to almost any system in place at a medical facility, and still provide outstanding and accurate medical billing services.

Motivated staff members

One last reason why MHS has a reputation as a leading Boston medical billing company is the people we employ. Each member of our team has the same company attitude we have tried to instill in everyone from top management on down to individual employees. That attitude calls for a strong commitment to providing accuracy and the most professional service to all our clients, and to understand their needs regarding medical billing. When you have your medical billing done by MHS, you can count on having minimal denials and minimal mistakes on all your billing, so that payments are not held up, and your cash flow can remain strongly positive.

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