Workers compensation claims boon or bane? – Medical Billing process of filing these claims

Workers’ compensation has been a much debated subject and has been traditionally viewed as a liability for the company. However new ways of filing claims and with streamlining of various medical billing processes for such claims, it can be an asset which can boost employee morale and thus increase the productivity along with assistance in cutting costs incurred due to cumbersome administrative processes involving the payer and the medical provider.

Reduction of costs in Workers’ compensation claims incurred during the process of medical billing and coding and improving the revenue cycle management process of physicians has shown to have a positive impact on the finances of the concerned physician & company. The American Medical Association also supports the Model Rule to streamline the medical billing for workers’ compensation which will be crucial in saving money on workers’ compensation claims and help in preventing delays in compensation for workers who have filed legitimate claims.

While filing these claims, use of electronic medical records, scientific approaches, and aggressive collection policies based on proven data can benefit all the parties involved. State regulators in Texas, California, and Minnesota have already adopted the Model Rule to streamline medical billing for workers’ compensation insurance which is developed by the International Association of Industrial Accident Boards and Commissions (IAIABC).

The benefits of electronic billing or ebilling, according to a report by the International Association of Industrial Accident Boards and Commissions (IAIABC), go beyond “getting rid of paper”. This procedure assists in eliminating the need for tedious interaction between the payer and the medical provider which can relieve the pecuniary pressures generated due to lags in workers’ compensation.

The health reforms have provided a new momentum to the process of eliminating unnecessary delays in workers’ compensation claims and have provided various guidelines to help pave the way for speedy compensations and settlement. Moreover, many medical billing and coding companies have adapted to these changes in laws and regulations and have successfully assisted almost all the parties involved in such claims.

Medical billers and coders at Medicalbillersandcoders.com form the largest consortium of medical billers and coders in the United States and provide numerous value added services such as research, consultancy, better revenue cycle management (RCM), efficient payer interaction, and expertise in use of cutting edge technology along with HIPAA compliance. The combination of all these services along with an aggressive albeit scientific approach towards collections ensure that all the parties involved in workers compensation claims receive optimized solutions for various situations that have been traditionally considered expensive and time consuming.

Medical Billers and coders (MBC) is one of the leading Medical Billing Companies  in USA & help doctors to shortlist Medical Billing Companies, Medical Billing Services  according to their preferences of specialty, city, software and services performed.

Medical Billing Companies Must Use the Clean Claim Laws

Clean Claim Laws are currently in place in every state. The assistance provided by the laws ranges from states like South Dakota which has no economic penalty to Texas where the payer sometimes is required to pay billed charges

The basic idea of the law is that a payer has to respond to a clean claim within a set time (usually around 30 days for electronic claims). In order to utilize the clean claim law effectively you must have a tracking system built into your medical billing process that flags:

1. Which payers must abide by the clean a claim law (the laws do not apply to all payers),
2. The date the clean claim “clock” begins (i.e., the claims submission date),
3. Events that stop the clean claim clock (e.g., an information request from the payer),
4. When your practice has taken actions in response to payer requests;
5. When you received a payment or denial.

Planning and constructing the monitoring system can be difficult, but it can have a significant impact on how quickly your claims are paid cleanly. Aggressive users of clean claim laws have actually received calls from payers assuring them that their claims will be process quickly and requesting that complaints be held to give the payer a chance to prove itself.

Source By: ArticleDistribution.Org

If you would like to better understand the benefits of implementing a Clean Claim Law tracking system before investing the time and energy into the design and implementation of the system, then run a pilot. Identify a payer that is consistently in violation of the Clean Claim Law. Select 30 to 50 claims from this payer and manually track all of the items outlined above. Once you have some violations, file a report following your state’s guidelines. This process will allow you to better understand what will be required to make such a system a permanent part of your medical billing and see the potential benefit to your practice.

For more information visit to Medical Billing Companies.

Benefits of Health IT implementation for Small Sized Practices

Numerous Small and solo practices have been impacted in a positive manner by the implementation of Health IT (HIT) and this trend is not just limited to Electronic Medical Records (EMRs). Physicians are utilizing smartphones and tablets for accessing and using EMRs. Moreover, the incentives paid by the Federal Government have added to the actual revenue of many physicians across the nation. Implementation and use of HIT has proven to be beneficial for patients and for physicians since it reduces errors, saves paperwork, provides quick and instant access to information, and saves time and effort in delivering quality healthcare services. Small practices have been paid a major chunk of the incentives in August 2011 whereas hospitals have only received a tiny portion.

Small and solo practices have more to gain from the direct benefits of implementation of HIT and from the incentives, compared to hospitals. However, the implementation, maintenance, and Meaningful Use of IT remain a challenge for small practices. The hurdle faced by such smaller practices comes from the requirement for better departmental processes and accurate and efficient support functions such as medical billing and coding, revenue cycle management, and denial management. The interaction with insurance companies is another aspect emerging from these reforms since millions are being given insurance cover necessitating increased interaction with payers.

The impact of IT on physicians’ revenue was felt even in 2007 when there were no incentives for providers to implement use of HIT. A report by the U.S National Library of Medicine, National Institute of Health clarifies the relation of revenue with IT implementation. According to the report, more than average Medicaid revenue was associated increased use of IT services. The situation after the announcement of incentives has become even more favorable for small practices that have implemented HIT in a successful manner.

Although many small practices have adopted EMRs, another report by U.S National Library of Medicine, National Institute of Health in 2011 sheds light on the fact that less than 2% of solo or two-physician practices have a fully functional system. Practices that have more than 11 physicians have a better rate of adoption with 13% of such practices adopting a fully functional EMR system. The report mentions financial hurdles as the biggest problem faced by solo or small practices in implementing a fully functional EHR/EMR system. However, lack of professional departmental services that can handle the various aspects of EMR implementation is also a factor that has influenced the rate of EMR adoption in the country.

The health reforms have ensured that HIT becomes an integral part of the health care industry and has imposed penalties for defaulters. However, the implementation of HIT can not only streamline various processes in health care delivery but can also increase revenue directly and in the form of incentives. Vendors of HIT services can ensure that small and solo practices benefit from the implementation of HIT in the form of increased revenue and better patient satisfaction. The largest consortium of medical billers and coders in the United States, medicalbillersandcoders.com can ensure that your HIT requirements are met and at the same time offer various value added services such as medical billing and coding, denial management, revenue cycle management, and consultancy.

Medical Billers and coders (MBC) is one of the leading Medical Billing Companies  in USA & help doctors to shortlist Medical Billing Companies, Medical Billing Services  according to their preferences of specialty, city, software and services performed.

What does a doctor expect from his medical billers & coders?

A significant challenge that care providers face in the US today is unrealized account receivables stemming from rejected insurance claims by Medicaid and Medicare officials. Physicians often find this challenge daunting because it requires them to handle what they are not meant to: administrative responsibilities

The medical billing and coding cycle requires thorough knowledge and deft handling of the entire process and related procedures including familiarity with electronic platforms and the ability to handle sensitive medical data.

The above scenario, if broken in terms of skills doctors expect their billers and coders to have, will demarcate the following areas:

• Knowledge of billing life cycle
• Theoretical and working knowledge of data collection, data entry, paper claims, creating and editing reports, patient demographic forms, etc
• Usage and understanding of codes
• Knowledge of electronic platforms in use

This makes medical billing and coding among the most knowledge-driven and challenging disciplines which needs keeping up with the changing trends of the industry to effectively handle billing and coding responsibilities for care providers, so that they can concentrate on quality of care even as they enjoy a steady flow of revenue.

Accuracy vs. Productivity – Medical Coder

Recently, AAPC conducted a survey to find out from billing and coding professionals which among the two (accuracy and productivity) is preferred over the other by billing and coding managers and the survey revealed a mixed response establishing the supremacy of neither of the two over the other, leading to the conclusion that a billing and coding manager expects his/her team of billers and coders “to efficiently produce accurate work”.

Medical Coding with MBC

Medicalbillerandcoders.com believes, that when it comes to billing and coding, certifications help bridge this gap. Most of MBC’s billers and coders are certified in CPC, CCS which CPAT, all of which require passing a coding certification examination which involves questions to examine the ability of billers and coders to accurately apply CPT and HCPCS procedures and supply ICD-9-CM diagnosis codes. This helps MBC’s coding professionals to refresh and renew their skills and be assured of them.

MBC the largest billing and coding consortium in the US with a countrywide network of highly experienced billers and coders takes particular care of keeping their team updated with the current changes in the industry. With changes taking place in the change-prone areas of medical coding, like – codes, software applications and forms.

Medical Billers and coders (MBC) is one of the leading Medical Billing Companies  in USA & help doctors to shortlist Medical Billing Companies, Medical Billing Services  according to their preferences of specialty, city, software and services performed.

How much salary can Medical Coders expect in New Mexico?

• The New Mexico state government has introduced an incentive program where healthcare providers will be rewarded for moving their data operations to an electronic platform to be HIPPA complaint
• Chronic diseases and conditions prevalent in New Mexico have led to an increase in consumption of healthcare services like laboratory studies, radiologic imaging, oncology treatment and other specialties

These two seemingly disconnected developments, one relating to insurance compliance and another core care, have collectively made New Mexico a state highly in demand by medical billing and coding professional to be in for job and career opportunities.

This increase in demand of medical billers and coders in New Mexico is apparently a matter of concern for the state as despite being a fairly large state, New Mexico has only about 1290 medical billers and coders, reports a survey.

• The average billing and coding salary in New Mexico is about $32,070
• A professional with about 10 years of experience in billing and coding can command around $45,740

Moreover, a new billing and coding professional in New Mexico can expect his/her salary to span from $10.59 to $14.33 per hour.

Medical billers and coders in New Mexico and surrounding states are experiencing an increase in demand of billers and coders triggered by HIPPA and a climb in chronic diseases. Moreover fees of billers and coders in all states are souring with ICD-10 implementation on everyone’s mind, and states like New Mexico, Arizona, Tennessee, Michigan and Idaho experiencing minimum 20- 22 percent hike in their hourly rates.

Medical coders trained and certified in the methodologies of coding and familiar with the current software platforms required for compliance can make use of this industry trend in New Mexico, which many recruiters and industry insiders believe is an opportunity of the kind which comes once in long passage of time sometimes covering a lifespan of a career or two.

Present in all 50 US states and in New Mexico for over 10 years now, MBC can help meet this industry need with a team of highly trained in-house and outhouse billers and coders who have sound familiarity with New Mexico specific regulations.

MBC can further help meet this industry need by bringing care providers and billers and coders together through the MBC’s job board which is successfully catering to provider and biller needs across the US and in this way helping billers and coders to access job opportunities available in New Mexico and care providers to post their requirements.

Medical Billers and coders (MBC) is one of the leading Medical Billing Companies  in USA & help doctors to shortlist Medical Billing Companies, Medical Billing Services  according to their preferences of specialty, city, software and services performed.