Medical Office: Most Popular Articles
These articles are the most popular over the last month.
Medical Office Manager
Medical Office Manager
Medical Office Manager
Type of Bill Codes
Type of bill codes are three digit codes located on a claim form that describes the type of bill a provider is submitting to a payer. Each digit has a specific purpose and is required on all UB-04 claims in field locator 4.
Type of bill codes are three digit codes located on a claim form that describes the type of bill a provider is submitting to a payer. Each digit has a specific purpose and is required on all UB-04 claims in field locator 4.
Top 10 Reasons Claims Get Denied
Understanding the reasons why medical claims deny can help limit the number of denials your office receives.
Understanding the reasons why medical claims deny can help limit the number of denials your office receives.
Sample Billing Letters 2
Here are four sample billing cycle letters for patient's with balances greater than $250.00.
Here are four sample billing cycle letters for patient's with balances greater than $250.00.
Medical Biller
Job Description
Job Description
Remittance Advice
What is a remittance advice?
What is a remittance advice?
Avoid Violation of HIPAA Laws
All healthcare providers have a responsibility to keep their staff trained and informed regarding HIPAA compliance. Whether intentional or accidental, unauthorized disclosure of PHI is considered a violation of HIPAA.
All healthcare providers have a responsibility to keep their staff trained and informed regarding HIPAA compliance. Whether intentional or accidental, unauthorized disclosure of PHI is considered a violation of HIPAA.
Medical Receptionist
Medical Receptionist
Medical Receptionist
3 Golden Rules to Medical Office Management
No matter if you are managing the small staff of a physicians office or the billing staff in a hospital, the manager can accomplish the goals of the organization from the medical office aspect using various tactics.
No matter if you are managing the small staff of a physicians office or the billing staff in a hospital, the manager can accomplish the goals of the organization from the medical office aspect using various tactics.
An Overview of the UB-04 Form
Information on the billing form for institutional providers.
Information on the billing form for institutional providers.
Electronic Health Record Versus Paper Medical...
Many providers have been hesitant to take on the task of converting from the paper-based medical record system to the electronic medical record. Become familiar with the difference in each system.
Many providers have been hesitant to take on the task of converting from the paper-based medical record system to the electronic medical record. Become familiar with the difference in each system.
Understanding HCPCS Codes
In order for medical claims to process correctly, there is a standard of codes used to identify services and procedures. HCPCS codes are an important billing component.
In order for medical claims to process correctly, there is a standard of codes used to identify services and procedures. HCPCS codes are an important billing component.
Who Pays Primary? Who Pays Secondary?
How to determine coordination of benefits when the patient has multiple insurance health plans.
How to determine coordination of benefits when the patient has multiple insurance health plans.
ICD-9 Coding Overview
ICD-9 codes are used to describe a patient's diagnosis including symptoms, diseases or disorders.
ICD-9 codes are used to describe a patient's diagnosis including symptoms, diseases or disorders.
Implementing a New Information System
Medical office professionals must be informed on the details prior to beginning the process of acquiring an information system, how the organizations goals drive the selection process and the roles each organizations stakeholder’s play in the selection and acquisition process.
Medical office professionals must be informed on the details prior to beginning the process of acquiring an information system, how the organizations goals drive the selection process and the roles each organizations stakeholder’s play in the selection and acquisition process.
Get Authorization, Get Paid
Denied claims due to unauthorized patient procedures or services can be a major loss in revenue that should not be taken lightly. Although most medical offices are moving closer to 100% verification for patient services, there is still no guarantee that every account will make it through the insurance company claims department stamped paid.
Denied claims due to unauthorized patient procedures or services can be a major loss in revenue that should not be taken lightly. Although most medical offices are moving closer to 100% verification for patient services, there is still no guarantee that every account will make it through the insurance company claims department stamped paid.
Sample Billing Letters
Here are three sample billing cycle letters for patient's with balances less than $250.00.
Here are three sample billing cycle letters for patient's with balances less than $250.00.
Medical Records Clerk
Medical Records Clerk
Medical Records Clerk
Ten Responsibilities of Health Information...
Health Information Management is the process of maintaining, storing and retrieving patient health information in accordance with applicable Federal, State, and accrediting agencies' requirements.
Health Information Management is the process of maintaining, storing and retrieving patient health information in accordance with applicable Federal, State, and accrediting agencies' requirements.
Establishing a Financial Policy
The success of any health care facility depends on the strength of the medical office's financial policy. There are many categories that should be addressed; here are six of them.
The success of any health care facility depends on the strength of the medical office's financial policy. There are many categories that should be addressed; here are six of them.
National Health Observances for 2013
Here is the list of the upcoming national health observances for 2013
Here is the list of the upcoming national health observances for 2013
5 Side Effects of Ineffective Communication
Incomplete or inaccurate patient records and communication breakdowns can have serious consequences for the medical office and its patients. One vital piece of information not communicated can have disastrous results. Although some mishaps are unavoidable, effective communication can result in better outcomes for patients and the overall success of the medical office.
Incomplete or inaccurate patient records and communication breakdowns can have serious consequences for the medical office and its patients. One vital piece of information not communicated can have disastrous results. Although some mishaps are unavoidable, effective communication can result in better outcomes for patients and the overall success of the medical office.
Top 5 Most Common Billing Mistakes
Improve the financial performance of your revenue cycle by identifying and correcting the most common medical billing mistakes.
Improve the financial performance of your revenue cycle by identifying and correcting the most common medical billing mistakes.
Hiring the Best Medical Office Staff
The first impressions your customers receive about your medical practice are often from your office staff making them crucial to the success of your organization. Know what skills are important when hiring your medical office staff.
The first impressions your customers receive about your medical practice are often from your office staff making them crucial to the success of your organization. Know what skills are important when hiring your medical office staff.
Telephone Etiquette
Does your receptionist have excellent telephone etiquette? It is important for your medical office staff to consistently offer a polite, consistent phone manner. When a patient calls in, the way in which the front desk personnel handle the telephone call determines how your facility is perceived.
Does your receptionist have excellent telephone etiquette? It is important for your medical office staff to consistently offer a polite, consistent phone manner. When a patient calls in, the way in which the front desk personnel handle the telephone call determines how your facility is perceived.
Improve AR Days with Claim Follow-Up
Once the bill has been received by the insurance company, you do not have to be at their mercy to get paid in a timely manner. Follow-up on your outstanding claims and improve the time it takes to get your claims paid.
Once the bill has been received by the insurance company, you do not have to be at their mercy to get paid in a timely manner. Follow-up on your outstanding claims and improve the time it takes to get your claims paid.
Revenue Cycle Management
It is important to be aware of all aspects of the revenue cycle and how it can impact your insurance reimbursements. This article gives great advice on ways to effectively manage the revenue cycle in order to maximize your insurance reimbursements.
It is important to be aware of all aspects of the revenue cycle and how it can impact your insurance reimbursements. This article gives great advice on ways to effectively manage the revenue cycle in order to maximize your insurance reimbursements.
8 Areas of AR Management
Improving the financial position of your medical office depends on how well you manage your accounts receivables.
Improving the financial position of your medical office depends on how well you manage your accounts receivables.
Informing Patients of Privacy Rights
Health care providers have an obligation to provide their patients with a Notice of Privacy Practices. Learn more about what you need to do to be HIPAA compliant.
Health care providers have an obligation to provide their patients with a Notice of Privacy Practices. Learn more about what you need to do to be HIPAA compliant.
Part 2: Workflow and Productivity
Workflow and productivity is essential to the success of the medical office. A streamlined workflow will naturally improve employee poductivity. A medical office without efficient ways to perform necessary job duties cannot perform them effectively.
Workflow and productivity is essential to the success of the medical office. A streamlined workflow will naturally improve employee poductivity. A medical office without efficient ways to perform necessary job duties cannot perform them effectively.
Insurance Verification: Avoiding Denied Claims
Insurance verification is a key component to the revenue cycle. This article explains the importance of having an insurance verification process in place.
Insurance verification is a key component to the revenue cycle. This article explains the importance of having an insurance verification process in place.
Medical Assistant
Medical Assistant
Medical Assistant
Medical Office Managers
Career Guide
Career Guide
6 Importants Parts of a Medical Record
Depending on the level or need of care a patient has, records may vary, but all medical records will contain some common information.
Depending on the level or need of care a patient has, records may vary, but all medical records will contain some common information.
Develop a Winning Upfront Collections Policy
There is a process to developing a winning upfront collections policy. Learn what needs to be included in your upfront collections strategy.
There is a process to developing a winning upfront collections policy. Learn what needs to be included in your upfront collections strategy.
Part 1: Patient Flow
Determining how your patients move throughout your medical office should be one of the first areas to be assessed. From the time a patient schedules an appointment, arrives to the medical office, checks-in for their visit, sits in the waiting area, waits in the exam room, is treated by a physician, checks-out and pays, and finally leaves, only the patient knows whether the entire process flowed smoothly or not.
Determining how your patients move throughout your medical office should be one of the first areas to be assessed. From the time a patient schedules an appointment, arrives to the medical office, checks-in for their visit, sits in the waiting area, waits in the exam room, is treated by a physician, checks-out and pays, and finally leaves, only the patient knows whether the entire process flowed smoothly or not.
Understanding Claims Adjudication
Claims Adjudication refers to the determination of the insurer's payment or financial responsibility, after the member's insurance benefits are applied to a medical claim.
Claims Adjudication refers to the determination of the insurer's payment or financial responsibility, after the member's insurance benefits are applied to a medical claim.
How to Handle Insurance Overpayments
No one wants the hassle of having an insurance overpayment. However, there is a simple process to make sure refunds are handled promptly.
No one wants the hassle of having an insurance overpayment. However, there is a simple process to make sure refunds are handled promptly.
Measuring Medical Office Staff Performance
Managers can measure medical office staff performance by developing and maintaining a system that measures both quality and quantity of work as specified in the job description for each position.
Managers can measure medical office staff performance by developing and maintaining a system that measures both quality and quantity of work as specified in the job description for each position.
The Role of Accounting in the Medical Office
As the backbone of the organization, the accounting department allows the organization to operate at its fullest potential. Without an accounting department, it would be impossible for any type of organization to operate in a cost effective manner.
As the backbone of the organization, the accounting department allows the organization to operate at its fullest potential. Without an accounting department, it would be impossible for any type of organization to operate in a cost effective manner.
5 Benefits of Accurate Payment Posting
Accuracy in payment posting can have a major impact on the success of the revenue cycle.
Accuracy in payment posting can have a major impact on the success of the revenue cycle.
5 Steps to a Strategic Plan
In any medical office there are factors that can influence the success of the organization. The key is identifying those factors whether they are within your control or not, and developing a plan that will lead to the achievement of the organization's future goals.
In any medical office there are factors that can influence the success of the organization. The key is identifying those factors whether they are within your control or not, and developing a plan that will lead to the achievement of the organization's future goals.
How to Join the CIGNA HealthCare Network
Information on Becoming a Participating Provider
Information on Becoming a Participating Provider
7 Advantages of Outsourcing Your Medical Billing
The idea of outsourcing your medical billing claims can be a difficult choice if you don't know all of the facts. Before making a decision, learn more about the advantages of outsourcing.
The idea of outsourcing your medical billing claims can be a difficult choice if you don't know all of the facts. Before making a decision, learn more about the advantages of outsourcing.
Building a Dynamite Patient Access Services Team
The cycle of a patient account originates with the initial entry of patient demographic information. Building a dynamite patient access services team is a crucial step toward improving billing and collections efforts and increasing revenue cycle performance.
The cycle of a patient account originates with the initial entry of patient demographic information. Building a dynamite patient access services team is a crucial step toward improving billing and collections efforts and increasing revenue cycle performance.
5 HR Tasks for Medical Office Managers
A manager has several roles to perform within a medical office. Human resources tasks are high on the list of things to do.
A manager has several roles to perform within a medical office. Human resources tasks are high on the list of things to do.
Preparing the CMS-1500 Form
Getting your professional fees billed and paid should not give you a headache. Learn how to properly prepare the CMS-1500 form.
Getting your professional fees billed and paid should not give you a headache. Learn how to properly prepare the CMS-1500 form.
Strengthen Your Medical Office Staff
Your medical office staff is your greatest asset but what happens when they are not operating at 100%? Learn how to strengthen your medical office staff.
Your medical office staff is your greatest asset but what happens when they are not operating at 100%? Learn how to strengthen your medical office staff.
The 3 Main Elements of a Startup Business Plan
Organization, Marketing and Financial Elements are the three most important elements of a medical office startup business plan.
Organization, Marketing and Financial Elements are the three most important elements of a medical office startup business plan.
Appealing Denied Medical Claims
If you haven't considered appealing your denied claims or are having trouble getting them paid, here is some important information that you can use to assist you in developing a new process.
If you haven't considered appealing your denied claims or are having trouble getting them paid, here is some important information that you can use to assist you in developing a new process.
Authorization
Authorization
Authorization
Three Safeguards to Reduce Risks to PHI
With the increased use of information technology in health care, your medical office must continue to find ways to maintain the security of the protected health information (PHI) of the patients they serve.
With the increased use of information technology in health care, your medical office must continue to find ways to maintain the security of the protected health information (PHI) of the patients they serve.
Medicare ABN
It is important to know when it is necessary to use a Medicare ABN and the responsibility of a health care provider to it's Medicare patients.
It is important to know when it is necessary to use a Medicare ABN and the responsibility of a health care provider to it's Medicare patients.
United Healthcare
Basic information on billing medical claims to United Healthcare.
Basic information on billing medical claims to United Healthcare.
6 Current Issues for Medical Office Managers
What are the most current issues for medical office managers? How can a medical office manager implement successful stategies?
What are the most current issues for medical office managers? How can a medical office manager implement successful stategies?
Successful Communication Techniques and Practices
So, what does effective communication look like in the medical office setting?
So, what does effective communication look like in the medical office setting?
Learning About Medical Terminology
While most medical office personnel will not necessarily have to know vast amounts of technical medical terminology, it is important to have a working knowledge in order to effectively fulfill your duties in a medical setting.
While most medical office personnel will not necessarily have to know vast amounts of technical medical terminology, it is important to have a working knowledge in order to effectively fulfill your duties in a medical setting.
The Do's and Don'ts of Medicare Billing
Here are a few simple tips to improve your Medicare billing process.
Here are a few simple tips to improve your Medicare billing process.
5 Things to Know About ICD-10
There are several things a medical office manager must know in order to begin planning in preparation for the ICD-10 implementation.
There are several things a medical office manager must know in order to begin planning in preparation for the ICD-10 implementation.
How to Participate in an Aetna Network
Information on Becoming a Participating Provider
Information on Becoming a Participating Provider
Reduce Claims Processing Time
Getting your medical claims out of the door and paid as soon as possible is every health care provider's primary goal as far as finance is concerned. The faster the claim goes out, the faster the money comes in. Make sure your office is equipped with the necessary software to save time and money.
Getting your medical claims out of the door and paid as soon as possible is every health care provider's primary goal as far as finance is concerned. The faster the claim goes out, the faster the money comes in. Make sure your office is equipped with the necessary software to save time and money.
Part 4: Occupational and Environmental Safety
An occupational and environmental safety assessment focuses on the work environment of the medical office that can potentially cause harm, injury or illness to the staff. Performing this type of an assessment can be used to prevent, eliminate and reduce workplace hazards that directly relate to exposures blood or body fluids, hazardous or chemical spills or exposure, medical equipment failure or malfunction, risks of physical injury, security threats, fires or any other unsafe work condition.
An occupational and environmental safety assessment focuses on the work environment of the medical office that can potentially cause harm, injury or illness to the staff. Performing this type of an assessment can be used to prevent, eliminate and reduce workplace hazards that directly relate to exposures blood or body fluids, hazardous or chemical spills or exposure, medical equipment failure or malfunction, risks of physical injury, security threats, fires or any other unsafe work condition.
5 New Patient Handouts
The best way to inform patients and provide them with important information is to put it in writing. Here are 5 handouts that every medical office needs to give out to new patients.
The best way to inform patients and provide them with important information is to put it in writing. Here are 5 handouts that every medical office needs to give out to new patients.
The Four Points of Upfront Collections
Requesting money from a sick patient for some people seems insensitive, however, it must be understood that health care costs money. Although it may be a touchy topic, collecting upfront payment from your patients is a necessary aspect that needs to be addressed.
Requesting money from a sick patient for some people seems insensitive, however, it must be understood that health care costs money. Although it may be a touchy topic, collecting upfront payment from your patients is a necessary aspect that needs to be addressed.
4 Ways to Get Paid
Understanding the different methods of payment is essential for the financial management of the medical office.
Understanding the different methods of payment is essential for the financial management of the medical office.
The New Medicare Adjustment Code
The federal budget sequestration cuts impacting Medicare claims went into effect on April 1, 2013 - April Fools Day - but it was no laughing matter.
The federal budget sequestration cuts impacting Medicare claims went into effect on April 1, 2013 - April Fools Day - but it was no laughing matter.
The Do's and Don'ts of Patient Collections...
Maintaining excellent customer service while still offering excellent customer can be a challenge. Learn the do's and don'ts of patient collections practices.
Maintaining excellent customer service while still offering excellent customer can be a challenge. Learn the do's and don'ts of patient collections practices.
Don't Get Fined for Privacy Breaches
Privacy breaches of protected health information continue to be a problem for the entire health care industry. Facilities across the country have found themselves faced with fines due to the unauthorized disclosure of patient information whether accidental or not.
Privacy breaches of protected health information continue to be a problem for the entire health care industry. Facilities across the country have found themselves faced with fines due to the unauthorized disclosure of patient information whether accidental or not.
Coding, Billing and Collections Practices in...
Coding, billing, and collections are important to a thriving medical facility no matter the size or specialty.
Coding, billing, and collections are important to a thriving medical facility no matter the size or specialty.
OSHA Compliance
Just like any other organization, there are safety and health hazards that can be found in the medical office. OSHA has five guidelines and standards that will help protect the employees of the medical office.
Just like any other organization, there are safety and health hazards that can be found in the medical office. OSHA has five guidelines and standards that will help protect the employees of the medical office.
Using Chart Audits to Reduce Billing Errors
Assuming that your medical claims are being billed error free is the surest way to getting denials and delayed payments. Incorporating a chart audit process in your day to day operations could be the difference between being paid as early as 10 to 14 days instead of 45 days.
Assuming that your medical claims are being billed error free is the surest way to getting denials and delayed payments. Incorporating a chart audit process in your day to day operations could be the difference between being paid as early as 10 to 14 days instead of 45 days.
How to Prevent Medicare Fraud
The Medicare program relies heavily on a number of sources to assist them in the detection and prevention of Medicare fraud including professionals of the healthcare industry.
The Medicare program relies heavily on a number of sources to assist them in the detection and prevention of Medicare fraud including professionals of the healthcare industry.
How to Properly Dispose of Protected Health...
Proper disposal of protected health information (PHI) and other confidential information whether paper or electronic format is a requirement of HIPAA. Any facility defined by HIPAA as a covered-entity has the responsibility to ensure the privacy and security of its patient’s information as well as maintaining the confidentiality of their PHI.
Proper disposal of protected health information (PHI) and other confidential information whether paper or electronic format is a requirement of HIPAA. Any facility defined by HIPAA as a covered-entity has the responsibility to ensure the privacy and security of its patient’s information as well as maintaining the confidentiality of their PHI.
Releasing Protected Health Information
Certain information regarding a patient's medical record is considered protected health information. According to HIPAA, PHI requires special handling to prevent a breach in confidentiality. Learn more.
Certain information regarding a patient's medical record is considered protected health information. According to HIPAA, PHI requires special handling to prevent a breach in confidentiality. Learn more.
Why Medical Coding Should Be Accurate?
Medical coding is a major factor in obtaining insurance reimbursement as well as maintaining patient records. Coding claims accurately lets the insurance payer know the illness or injury of the patient and the method of treatment.
Medical coding is a major factor in obtaining insurance reimbursement as well as maintaining patient records. Coding claims accurately lets the insurance payer know the illness or injury of the patient and the method of treatment.
Medical Assistants
Career Guide
Career Guide
7 Disadvantages of Outsourcing Your Medical...
The idea of outsourcing your medical billing claims can be a difficult choice if you don't know all of the facts. Before making a decision, learn more about the disadvantages of outsourcing.
The idea of outsourcing your medical billing claims can be a difficult choice if you don't know all of the facts. Before making a decision, learn more about the disadvantages of outsourcing.
CPT Codes
Procedure Codes
Procedure Codes
Performance Support Tools for Medical Billers
Whenever a medical office begins to struggle with revenue performance, they usually make the decision
Whenever a medical office begins to struggle with revenue performance, they usually make the decision
5 Steps for Creating an Effective Social Media...
If you haven't done so already, it is time to update your medical office policies to include the use of Social Media for both personal and professional use.
If you haven't done so already, it is time to update your medical office policies to include the use of Social Media for both personal and professional use.
The Medicare Enrollment Process
Basic Information on Medicare Enrollment
Basic Information on Medicare Enrollment
The Payor of Last Resort
Do you know whether Medicaid is billed first or last? Find out why Medicaid is always the payor of last resort.
Do you know whether Medicaid is billed first or last? Find out why Medicaid is always the payor of last resort.
E-mail Netiquette Guidelines
Electronic communication is becoming more popular these days than phone calls, “snail” mail and, even in some instances, face-to-face meetings. In any professional setting including the medical office it is important to consider several things when sending out emails to coworkers, patients, physicians, hospitals, vendors or other professionals.
Electronic communication is becoming more popular these days than phone calls, “snail” mail and, even in some instances, face-to-face meetings. In any professional setting including the medical office it is important to consider several things when sending out emails to coworkers, patients, physicians, hospitals, vendors or other professionals.
How Important is Medical Office Terminology
The importance of knowing common medical office terms.
The importance of knowing common medical office terms.
Key Areas in Medical Office Management
Medical office managers wear many hats. They are responsible for the successful operation of the medical office and sometimes the overall practice including both clinical and administrative aspects.
Medical office managers wear many hats. They are responsible for the successful operation of the medical office and sometimes the overall practice including both clinical and administrative aspects.
The Importance of Professional Credentialing
Partnering with insurance carriers is a necessary process for any medical office. Physicians and other professionals must provide a list of verifications to insurance carriers, including Medicare and Medicaid, in order to be eligible for reimbursable expenses.
Partnering with insurance carriers is a necessary process for any medical office. Physicians and other professionals must provide a list of verifications to insurance carriers, including Medicare and Medicaid, in order to be eligible for reimbursable expenses.
Registered Nurse
Job Description
Job Description
Five Facts about NPI
If you have any questions regarding an NPI, you'll find the answers here.
If you have any questions regarding an NPI, you'll find the answers here.
Intuit Health's Patient Portal
Intuit Health's Patient Portal is an anytime, anywhere interactive resource that provides information and increases patient participation in scheduling appointments, completing registration information, obtain lab results or ask questions, and pay their bill.
Intuit Health's Patient Portal is an anytime, anywhere interactive resource that provides information and increases patient participation in scheduling appointments, completing registration information, obtain lab results or ask questions, and pay their bill.
How Does EHR Improve Patient Care?
The expansion of health information technology is important to the improvement of the health care industry as a whole. Health IT which includes the electronic health record (EHR) enables health care providers to effectively manage patient care through the use and sharing of patient records.
The expansion of health information technology is important to the improvement of the health care industry as a whole. Health IT which includes the electronic health record (EHR) enables health care providers to effectively manage patient care through the use and sharing of patient records.
HIPAA Compliant Office Products
There are lots of products available to help you adhere to HIPAA rules and regulations. Here are 4 essential HIPAA office products that are a must have.
There are lots of products available to help you adhere to HIPAA rules and regulations. Here are 4 essential HIPAA office products that are a must have.
When a Patient Complains
In the healthcare field, the patient is often left with no other option but to file a complaint against a healthcare worker.
In the healthcare field, the patient is often left with no other option but to file a complaint against a healthcare worker.
Ten Employee Benefits to Consider
Determining employee compensation does not only involve deciding an hourly rate or pay ranges for each position within your medical office staff. Compensation also includes benefits in any form other than the salary that is paid to the employee.
Determining employee compensation does not only involve deciding an hourly rate or pay ranges for each position within your medical office staff. Compensation also includes benefits in any form other than the salary that is paid to the employee.
3 Ways to Improve Patient Billing Communication
Patient satisfaction is not just based on how well the patient view the medical treatment received but also includes how well the patient understands the medical bills they receive.
Patient satisfaction is not just based on how well the patient view the medical treatment received but also includes how well the patient understands the medical bills they receive.
5 Components for Effective Internal Controls
Internal controls are defined as a process designed to discourage fraud, safeguard company resources, and ensure compliance with laws and regulations. Internal controls are only effective if they are determined by the specific needs of the medical office, implemented, monitored, and measured to make sure they are functioning as planned.
Internal controls are defined as a process designed to discourage fraud, safeguard company resources, and ensure compliance with laws and regulations. Internal controls are only effective if they are determined by the specific needs of the medical office, implemented, monitored, and measured to make sure they are functioning as planned.
When Patients Refuse to Pay
The last conversation a provider wants to have with a patient is a discussion over refusal to pay for what the patient perceives as inadequate treatment. Only one question comes to mind - How can we resolve patient issues?
The last conversation a provider wants to have with a patient is a discussion over refusal to pay for what the patient perceives as inadequate treatment. Only one question comes to mind - How can we resolve patient issues?
Several Traits for Successful Managers
A successful leader communicates clearly, completely, and effectively. The importance of this cannot be overstated, especially in a medical setting as often times the needs of a medical office are time sensitive.
A successful leader communicates clearly, completely, and effectively. The importance of this cannot be overstated, especially in a medical setting as often times the needs of a medical office are time sensitive.
What is Medicare Part A?
Medicare is split into two parts. Medicare Part A is called hospital insurance and Medicare Part B is called medical insurance. Find out more about Medicare Part A.
Medicare is split into two parts. Medicare Part A is called hospital insurance and Medicare Part B is called medical insurance. Find out more about Medicare Part A.
The Basics of Health Insurance Plans
Basic information of health insurance plans is important for treating patients for an illness or injury. Becoming familiar with the types of health insurance plans that are common to the medical office eliminate problems and complications in the long run.
Basic information of health insurance plans is important for treating patients for an illness or injury. Becoming familiar with the types of health insurance plans that are common to the medical office eliminate problems and complications in the long run.
Get Maximum Performance from Your Employees
As the leader of your organization, one of your many responsibilities is to find ways to motivate your employees. It is important to understand what factors influence maximum performance and how.
As the leader of your organization, one of your many responsibilities is to find ways to motivate your employees. It is important to understand what factors influence maximum performance and how.
How to Meet Medical Necessity Requirements
A physician must be thorough in their notes and explanations in order to give the payer’s medical reviewers sufficient data from which to determine the necessity of a diagnosis, a set of tests, or a treatment or therapy.
A physician must be thorough in their notes and explanations in order to give the payer’s medical reviewers sufficient data from which to determine the necessity of a diagnosis, a set of tests, or a treatment or therapy.
Offering Financial Assistance
As health care professionals, we all recognize that uninsured or underinsured individuals require medical care just like everyone else. With careful planning, your organization can offer financial assistance to those who need it while protecting your facility’s financial security.
As health care professionals, we all recognize that uninsured or underinsured individuals require medical care just like everyone else. With careful planning, your organization can offer financial assistance to those who need it while protecting your facility’s financial security.
Simple Steps to Appeal a Medical Necessity Denial
There are many reasons for insurance carriers to deny an insurance claim. The reasons for a denial of
There are many reasons for insurance carriers to deny an insurance claim. The reasons for a denial of
PAHCOM Profile
Membership in PAHCOM provides resources to medical office managers and practice administrators that improve efficiencies, compliance, and profitability for their practices.
Membership in PAHCOM provides resources to medical office managers and practice administrators that improve efficiencies, compliance, and profitability for their practices.
Part 3: Managed Care Contracts
An assessment of managed care contracts give the medical office the opportunity to determine whether the provider agreement is fair, competitive and up-to-date. Knowing the current condition of the managed care contracts allow the Medical Office to consider several options.
An assessment of managed care contracts give the medical office the opportunity to determine whether the provider agreement is fair, competitive and up-to-date. Knowing the current condition of the managed care contracts allow the Medical Office to consider several options.
Using Quality Analysis to Improve Finances
Financial performance is the foundation that the entire organization rests on. If your finances are not where you want them to be, learn how quality analysis can be used to reach your financial goals.
Financial performance is the foundation that the entire organization rests on. If your finances are not where you want them to be, learn how quality analysis can be used to reach your financial goals.
What is HIPAA Anyway?
The intent of this summary is to shed some light on the issue for those who are currently in the dark about the “what” and “why” of HIPAA.
The intent of this summary is to shed some light on the issue for those who are currently in the dark about the “what” and “why” of HIPAA.
Radiation Therapists
Career Guide
Career Guide
Hosting Effective Medical Office Meetings
Many times meetings can become ineffective when there isn't enough planning involved to accommodate time limitations or the information presented is not properly organized. Here are several ways you can host more effective medical office meetings.
Many times meetings can become ineffective when there isn't enough planning involved to accommodate time limitations or the information presented is not properly organized. Here are several ways you can host more effective medical office meetings.
The Basics of Medical Coding
Medical coding is important for the billing and communicating between providers and insurers.
Medical coding is important for the billing and communicating between providers and insurers.
How to Determine When Medicare is the Secondary...
Understanding the difference between when Medicare is secondary or primary can make billing Medicare easier for health care providers
Understanding the difference between when Medicare is secondary or primary can make billing Medicare easier for health care providers
5 Revenue Cycle Focus Areas
Each phase of the Revenue Cycle - from the moment a patient is scheduled for an appointment until the time payment is received from the insurance company - is equally important to maximizing insurance reimbursements.
Each phase of the Revenue Cycle - from the moment a patient is scheduled for an appointment until the time payment is received from the insurance company - is equally important to maximizing insurance reimbursements.
Dietician /Nutritionist
Career Guide
Career Guide
Accurate Coding for Outpatient Procedures
When providers fail to comply with the coding requirements that are necessary for billing outpatient procedures, the chance for improper billing is increased.
When providers fail to comply with the coding requirements that are necessary for billing outpatient procedures, the chance for improper billing is increased.
EHR/EMR Software Resource Guide
Here are ten resources for your EHR/EMR software needs.
Here are ten resources for your EHR/EMR software needs.
Aetna
Basic information on billing medical claims to Aetna.
Basic information on billing medical claims to Aetna.
10 Things Patients Should Bring
Patients play an important role when it comes to their healthcare. One part of that role is making sure to bring important information to facilitate the registration process when they present for treatment. It is your role as the provider to inform the patient by keeping your staff informed or creating documents that inform the patient.
Patients play an important role when it comes to their healthcare. One part of that role is making sure to bring important information to facilitate the registration process when they present for treatment. It is your role as the provider to inform the patient by keeping your staff informed or creating documents that inform the patient.
The Right of Informed Consent
The most important right that a patient has is the right of informed consent. A patient should only consent to medical treatment if they have sufficient information about their diagnosis and all treatment options available in terms he/she can understand.
The most important right that a patient has is the right of informed consent. A patient should only consent to medical treatment if they have sufficient information about their diagnosis and all treatment options available in terms he/she can understand.
Coventry Health Care
Basic information on billing medical claims to Coventry Health Care
Basic information on billing medical claims to Coventry Health Care
Medical Record Checklist
Medical Record Checklist
Medical Record Checklist
BCBS Updates for 2013, 1 - 10
Blue Cross Blue Shield 2013 Updates, 1 - 10
Blue Cross Blue Shield 2013 Updates, 1 - 10
The Art of Medical Billing
Here are 5 areas that require an understanding in order to be successful in medical billing.
Here are 5 areas that require an understanding in order to be successful in medical billing.
Features Every Billing System Should Have
Your medical office billing software system should enable you staff access to multiple features necessary to performing their job effectively and efficiently.
Your medical office billing software system should enable you staff access to multiple features necessary to performing their job effectively and efficiently.
The "Clean Up" Crew
Without a doubt, medical billers are the "clean up" crew of the medical office. For those that do not
Without a doubt, medical billers are the "clean up" crew of the medical office. For those that do not
Marketing Strategies for the Medical Office
Marketing your medical practice requires someone that can be realistic about market expectations, setting and accomplishing goals, and assessing the competition. Marketing identifies the types of services that should be offered based on the demands of the community, analyze the performance potential, and develops strategies and goals necessary to maintain a competitive edge.
Marketing your medical practice requires someone that can be realistic about market expectations, setting and accomplishing goals, and assessing the competition. Marketing identifies the types of services that should be offered based on the demands of the community, analyze the performance potential, and develops strategies and goals necessary to maintain a competitive edge.
Medicaid Adopts NCCI
All state Medicaid programs began to adopt the National Correct Coding Initiative on October 1, 2010 as required by CMS. Learn what this is and how you it will affect the processes of your medical office billing.
All state Medicaid programs began to adopt the National Correct Coding Initiative on October 1, 2010 as required by CMS. Learn what this is and how you it will affect the processes of your medical office billing.
5 Fundamentals to Efficient Follow Up
Adequate staffing with proper collections training will provide the desired outcome in your the collections phase of the revenue cycle. Medical office staff should be aware of the fundamental steps necessary for efficient follow up of insurance claims.
Adequate staffing with proper collections training will provide the desired outcome in your the collections phase of the revenue cycle. Medical office staff should be aware of the fundamental steps necessary for efficient follow up of insurance claims.
Diagnostic Medical Sonographer
Career Guide
Career Guide
What is Medicare Part C?
Medicare Part C are Medicare Advantage Plans, also known as Medicare Managed Care Plans that provide Medicare patients an alternative insurance plan in place of traditional Medicare benefits.
Medicare Part C are Medicare Advantage Plans, also known as Medicare Managed Care Plans that provide Medicare patients an alternative insurance plan in place of traditional Medicare benefits.
Medical Office Survey Toolkit
Safety culture surveys are great tools to open awareness about any issues within a medical office that can lead to situations that can harm a patient.
Safety culture surveys are great tools to open awareness about any issues within a medical office that can lead to situations that can harm a patient.
The Pros and Cons of E-Prescribing
E-Prescribing is used to eliminate handwritten prescriptions, reduce phone calls and faxes to pharmacies, and quickly generate refill requests and authorizations.
E-Prescribing is used to eliminate handwritten prescriptions, reduce phone calls and faxes to pharmacies, and quickly generate refill requests and authorizations.
Part 6: Fee Schedule
The fee schedule is one of the most important financial tools utilized by the medical office. This file not only reflects the value of the services provided by the physicians but also sets the foundation for profitability.
The fee schedule is one of the most important financial tools utilized by the medical office. This file not only reflects the value of the services provided by the physicians but also sets the foundation for profitability.
Understanding the ABN
It is important to know when it is necessary to use a Medicare ABN and the responsibility of a health care provider to it's Medicare patients.
It is important to know when it is necessary to use a Medicare ABN and the responsibility of a health care provider to it's Medicare patients.
5 Challenges of Managing a Medical Office
What are some challenges medical office managers have faced in 2012? How can they be resolved?
What are some challenges medical office managers have faced in 2012? How can they be resolved?
Five Touchless Products for Infection Control
Infection control practices should be incorporated into the daily routine of all health care facilities including the medical office. Here are five products that the medical office can benefit from in their effort to prevent the spread of infectious diseases.
Infection control practices should be incorporated into the daily routine of all health care facilities including the medical office. Here are five products that the medical office can benefit from in their effort to prevent the spread of infectious diseases.
How Well Do You Know ...Medical Billing? Take...
Take the medical billing quiz now!
Take the medical billing quiz now!
7 Missed Opportunities for Collecting Revenue
Improve the financial standing of the medical office by taking advantage of these 7 missed opportunities for collecting revenue.
Improve the financial standing of the medical office by taking advantage of these 7 missed opportunities for collecting revenue.
The Right to Emergency Treatment
Health care professionals have a responsibility to provide medical treatment to any person with an emergency medical condition. Patients have the right to emergency medical treatment regardless of their ability to pay.
Health care professionals have a responsibility to provide medical treatment to any person with an emergency medical condition. Patients have the right to emergency medical treatment regardless of their ability to pay.
Medical Office Start-Up Checklist
The process of starting a Medical Office can be a difficult task but with the proper planning, you can have your Medical Office up and running effectively and efficiently. The decisions you make now are crucial as you set your goals regarding every aspect of your Medical Office.
The process of starting a Medical Office can be a difficult task but with the proper planning, you can have your Medical Office up and running effectively and efficiently. The decisions you make now are crucial as you set your goals regarding every aspect of your Medical Office.
5 Steps for Improving Patient Safety
The safety of your patients is one of the most important areas of focus for the medical office. To ensure the patient safety of your patients, follow these 5 simple steps.
The safety of your patients is one of the most important areas of focus for the medical office. To ensure the patient safety of your patients, follow these 5 simple steps.