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What Implication Will Reimbursement Cuts For 2013 Have on Radiology Collections?

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Radiology collections, which have been far from being impressive in the recent years, may further go down amidst a host of issues likely to surface throughout 2013. Significant of those issues is the reimbursement cuts, which is supposed to lead to a reduction of almost 19% in the collections of radiology practices. Further, a 25% cut in payments for imaging services has not gone down well with providers, who may eventually be discouraged to comply and continue with revised guidelines.
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Jacob Thomas's curator insight, April 8, 2013 8:27 AM

Radiology collections, which have been far from being impressive in the recent years, may further go down amidst a host of issues likely to surface throughout 2013. Significant of those issues is the reimbursement cuts, which is supposed to lead to a reduction of almost 19% in the collections of radiology practices. Further, a 25% cut in payments for imaging services has not gone down well with providers, who may eventually be discouraged to comply and continue with revised guidelines.

Medical Billing Services
Medical Billers and Coders is the largest consortium of Medical Billers and Coders in the United States. Our aim is to help the physician community to reach the right expertise in the right location at the right time.
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Reforming Nursing Facilities Medical Billing Amidst Dwindling Reimbursements

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Nursing facilities across the U.S. have somehow endured a series of Medicare/Medicaid cuts thus far, but the latest move by CMS to reduce reimbursement for so-called Medicare “bad debt” – Medicare co-payments not made by beneficiaries or state Medicaid programs – may bring them on the threshold of a major operational crisis.

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Avoid Medical Practice Productivity Loss Due to ICD-10 with a Medical Billing Service | Latest Updates about Medical Billing

Avoid Medical Practice Productivity Loss Due to ICD-10 with a Medical Billing Service | Latest Updates about Medical Billing | Medical Billing Services | Scoop.it
Multiple strategies will be required by medical practices to cope with an anticipated drop in productivity due to ICD-10. Coding, claims processing, case management, decision support and follow-up (electronic medical billing system) are likely to face greatest impact due to the new system
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Multiple strategies will be required by medical practices to cope with an anticipated drop in productivity due to ICD-10. Coding, claims processing, case management, decision support and follow-up (electronic medical billing system) are likely to face greatest impact due to the new system. Therefore, it has become important for providers to prepare for any type of productivity loss before 1st October 2014- - See more at: http://www.medicalbillersandcoders.com/blog/avoid-medical-practice-productivity-loss-due-to-icd-10-with-a-medical-billing-service.html#sthash.OejDoNaO.dpuf
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EP Medical Equipment Pharmacy_DME HME Billing and Coding Specialist

EP Medical Equipment Pharmacy & EP Long Term Care Pharmacy has a job opening for an expert DME/HME Billing Specialis…http://t.co/wd3UC63DfE
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Efficient Billing Practice to Aid Physicians amidst Continual Coding Revisions, and Avert the Possibility of Denials

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Efficient Billing Practice to Aid Physicians amidst Continual Coding Revisions, and Avert the Possibility of Denials
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Everett Hudson's curator insight, May 6, 2013 5:29 AM

A must read for those engaged in medical billing as well as other healthcare professionals. Becoming a medical biller is an exciting career to pursue as post secondary education.

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Efficient Billing Practice to Aid Physicians amidst Continual Coding Revisions, and Avert the Possibility of Denials

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Amongst the possible reasons for denials, coding inadequacies seem to have a major impact. Because codes quantify and qualify physicians’ medical services for medical reimbursements from payers, any inherent coding error, miscoding, over or under-coding can lead to denials upon found to be incongruent with acceptable coding practices. While a few coding manipulations may happen intentionally, most of the time it is the complexities of coding that often expose physicians or their staff to coding errors. With revisions made to CPT and HCPCS Level II codes every year, coding-related complexities are destined to multiply further. Failure to discern and apply revised coding systems may eventually result in disqualification or outright Denial of Physicians’ claims. As a result, physicians may have to forgo a considerable chunk of their revenues in the absence of remedial measures.

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The Demands of Value-Based Reimbursement Model to Be Met With Medical Billing Specialists

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With many of the healthcare reforms set to take effect shortly or having already been in force, providers may have entered a different phase of operational model, which is called value-based model. The unique feature of value-based model is that providers will get reimbursed for delivering superior medical care at a progressively lesser cost. As the public plans such as Medicare, Medicaid, and most of the commercial plans are likely to adopt value-based reimbursement models, it may be inevitable for providers to shift over or find a balance between fee-for-service model and value-based model in order to sustain profitable clinical practices.

To being with, you have Medicare's value-based payment modifier that will be launched for physicians in groups of 100 or more in 2015. The unique thing about this modified value-based payment model is that it works on the principle of ‘carrot and stick’ theory, meaning physicians may either be eligible for either positive or negative payment adjustment depending on their level of compliance with care quality and reporting. To prepare for the eventual 2015 model, it may even be necessary to demonstrate capability for PQRS reporting, beginning as early as 2013. Furthermore, the performance post 2015 will be significant as most of the value-based returns will start yielding from 2017 based on the PQRS reporting post 2015.

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Are You Leaving Over 24% of Your Revenue Uncollected?

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Why most practices are unable to collect maximized revenue?

Time constraints to regularly track - 1st time claims, denied claims and underpaymentsTime restraints to manage a varied payer mixIncreased administrative burdens, staff challenges and poor revenue visibilityHealthcare reforms, industry changes and regulationsIncreased patient demands results in less time to manage the billing process optimally
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EMH Healthcare Improves Critical Test Results Communications with Amcom ... - MarketWatch

EMH Healthcare Improves Critical Test Results Communications with Amcom ...MarketWatchFor all other wet readings, the ER doctors would then have to retrieve information from the PACS [picture archiving and communications system] and reenter it into...

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AZ Senate revives vetoed medical care pricing bill | Arizona Capitol ...

AZ Senate revives vetoed medical care pricing bill | Arizona Capitol ... | Medical Billing Services | Scoop.it
The Arizona Senate voted Monday to revive the major provisions of a medical pricing transparency bill that was vetoed by Gov. Jan Brewer just last week.
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Orthopedic Billing Specialist to Take Care of CPT Code Changes Made to Orthopedic Surgery Billing in 2013

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This year’s CPT Manual has spelt out extensive coding changes and revisions to orthopedic surgical codes.  In all, there are 500 code changes to the Category I codes, including 251 revisions, 151 new codes and 100 deletions. Moreover, there has been significant overhauling of nerve conduction studies, some revisions to the radiology section, and E/M changes. The extent of these coding changes and revisions, having already taken effect from January 1, 2013, has begun to impact orthopedic reimbursements in a big way. As a result, orthopedic practices may have inherited an ominous task of migrating to   a higher order in orthopedic surgical coding. Given the CPT Manual’s full list of revisions, deletions, and additions to have been effected for 2013, orthopedic practices would require to be conversant with the guidelines for the following coding sections:

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How best are medical practices prepared to address HIPAA breaches?

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Contrary to the notion that government’s move to digitize healthcare information would enable healthcare providers, doctors, and insurance companies comply more aptly with HIPAA’s guidelines for patients’ privacy and security, there has been an upsurge in HIPAA breaches with providers being reported for breaches of some kind or the other. Electronic Health Record (EHR) systems, which are made mandatory for providers seeking to attain ‘Meaningful Use’ status, have shown propensity to be manipulated either internally or by unscrupulous external elements. Either way, providers have been held accountable and penalized for breach of HIPAA’s mandate for ensuring patients’ information safety and security. With the cost data breaches being unbearable and providers or doctors’ credibility at stake, it is inevitable that HIPAA breaches are responded instantly with remedial measures, such as:

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Medicare Fraud Claims, A New Challenge Even For Honest US Physicians – is Competent Billing and Coding A Way Out?

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In 2010, Medicare improper payment amounted to $47.9 billion. Human and Health Services, in 2011, recovered $4.1 billion paid through reimbursements as a result of ‘fraudulent’ or ‘improper’ claims. You may be right if you think you won’t ever be among the fraudulent care practitioners who contributed to these figures because you are scrupulous.
But being scrupulous can’t prevent you from being suspected by federal authorities, thanks to the profusion of fraudulent cases – because bizarrely all some care providers have had to do to attract the scrutiny of federal authorities is over use a billing code, regardless of whether they did it for right or wrong reasons.

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What Implication Will Reimbursement Cuts For 2013 Have on Radiology Collections?

Andersen Keen's insight:
Radiology collections, which have been far from being impressive in the recent years, may further go down amidst a host of issues likely to surface throughout 2013. Significant of those issues is the reimbursement cuts, which is supposed to lead to a reduction of almost 19% in the collections of radiology practices. Further, a 25% cut in payments for imaging services has not gone down well with providers, who may eventually be discouraged to comply and continue with revised guidelines.
more...
Jacob Thomas's curator insight, April 8, 2013 8:27 AM

Radiology collections, which have been far from being impressive in the recent years, may further go down amidst a host of issues likely to surface throughout 2013. Significant of those issues is the reimbursement cuts, which is supposed to lead to a reduction of almost 19% in the collections of radiology practices. Further, a 25% cut in payments for imaging services has not gone down well with providers, who may eventually be discouraged to comply and continue with revised guidelines.

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Compliant Billing and Coding for your Podiatry Practice

Compliant Billing and Coding for your Podiatry Practice | Medical Billing Services | Scoop.it
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Podiatry is specific to the procedures for toe, ankle or foot treatments, so the medical billing and coding is a specialized process with detailed and specific codes. It also carries very precise guidelines and policies for the procedure to be billed. Your Podiatry practice cannot ignore the rapid changes and updates in the codes or will suffer from incomplete claims, decreased revenues and possible audits. It requires the transition to ICD-10 coding as well as the varied codes for a wide range of medical and surgical procedures. A compliant billing and coding Podiatry Practice must keep in mind –

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In- house biller for a Chiropractic practice in Washington Jobs in Seattle , Washington

In- house biller for a Chiropractic practice in Washington Jobs in Seattle , Washington | Medical Billing Services | Scoop.it

Find In- house biller for a Chiropractic practice in Washington jobs in Seattle , Washington , US. Apply In- house biller for a Chiropractic practice in Washington jobs at Medical billers and coder.

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Must possess previous experience in billing and reimbursement proceduresConversant with Chiropractic, Acupuncture, Physical Therapy & Massage Therapy billingRequires to be familiar with Chirotouch practice management softwareShould be able to review medical charts accurately and assign appropriate codesMust ensure all assigned codes meet insurance and insurance regulationsPossess significant billing experience to help reclaim funds and reduce rejections Follow-up until payments are received and resubmit denied claimsPossess significant billing experience to help reclaim funds and reduce rejections Required to research/analyze accounts to determine payment patternsMust be detail-oriented, organized and able to maintain a high degree of accuracy
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Medical Billing/Denials Jobs in Milwaukee, Wisconsin

View and apply for Medical Billing/Denials jobs in Milwaukee, Wisconsin at thingamajob.com.
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Medical Billing Companies: Efficient Billing Practice to Aid Physicians amidst Continual Coding Revisions, and Avert the Possibility of Denials

Medical Billing Companies: Efficient Billing Practice to Aid Physicians amidst Continual Coding Revisions, and Avert the Possibility of Denials | Medical Billing Services | Scoop.it
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Medical Billing Companies: Efficient Billing Practice to Aid Physicians amidst Continual Coding Revisions, and Avert the Possibility of Denials
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The Social Doctor: Being a Physician in the Age of Social Media

The Social Doctor:  Being a Physician in the Age of Social Media | Medical Billing Services | Scoop.it
How Clinics Can Leverage Social Media:  Being an Online Shaman For a long while it was felt that the medical profession was one way or another prisoner to the so-called Parkinson’s Law, proposed by the scholar of public administration Northcote Parkinson...

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Insurance Underpayments, the Issue That is Plaguing Orthopedic Billing the Most

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Insurance underpayments continues to be a major concern for medical practices across the United States; more so for orthopedic surgeons, who, despite serving in a more critical specialty, find it hard to fully recover their medical cost. Because most of the orthopedic procedures happen to be highly expensive, even a marginal percentage of insurance underpayments might turn out to be a major drain on practitioners’ revenue, which could severely spoil clinical and operational efficiency. With orthopedic surgeons’ insurance underpayments touching an all-time high of 10 percent and potentiality to reach 20 percent, it may be time that orthopedic surgeons relooked at their medical billing practices and process, and aggressively track and resolve their underpayments. It is encouraging that significant portion of these underpayments (as high as 7 to 10 percent) can easily be made good with a refined and robust orthopedic-specific medical billing.

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ICD-10 Training, ICD-10 Online Training, Medical Billing Training, ICD 10 Codes, ICD-10 Implementation

MBC offering 52 weeks of ICD 10 Training online, ICD-10 Implementation training and medical billing training in all specialty across US.

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Senate revives vetoed medical care pricing bill - KTAR.com

Senate revives vetoed medical care pricing bill - KTAR.com | Medical Billing Services | Scoop.it
Senate revives vetoed medical care pricing bill
KTAR.com
Senate Bill 1115 by Republican Sen. Nancy Barto would have required health care providers to post prices for common medical procedures.
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Doctors Are Human Too - This Is Where Computers Fail · AMBC · Storify

A heartwarming note that speaks right from the heart of a doctor. Indeed, in this age of technology, computers cannot express emotions beyond the script and codes. The son may have lost a parent, but the loss was not in vain.
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Negotiating Your Reimbursement Rates during this Phase of Payer Consolidation & Health Insurer Monopoly Power

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Physicians’ choice of health plans and contracts seem to be getting fewer and fewer with each passing moment as U.S. health insurance sector, particularly the private sector, witnesses unprecedented payer consolidation, acquisitions, and mergers amongst private health insurance carriers. Besides contradicting the hope that such consolidation, acquisitions, and mergers would bring down the cost premiums for patients, it has virtually helped a few players to wield monopoly over the entire commercial health insurance landscape. The situation has grown so unchecked 70 percent of 385 metropolitan areas in the U.S. do not have competitive conditions, and as much as 40 percent of these areas have a single health insurer controlling the majority share of the commercial health insurance market. As a result, physicians have virtually lost the bargaining leverage that they would have enforced had there been a perfect competitive market for commercial plans.

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What Do Stage 2 Meaningful Use Guidelines Have in Store for Radiologists?

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Stage 2 meaningful use guidelines are finally out, and radiologists may heave a sigh of relief since most of the ambiguity that existed in Stage 1 about their eligibility and the ways to approach the qualification criterion seem to have been made amply clear by CMS and the Office of the National Coordinator (ONC). The American College of Radiology (ACR) needs word praise for its relentless effort in getting most of the necessary changes made to radiology guidelines before the Stage 2 meaningful compliance regime comes into force.  While it is not before 2014 that radiologists should complying with newly laid out guidelines, it may still require some crucial adjustments in processes and technology to be fully ready for compliance and qualification under State 2 of meaningful use criterion.

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Would Dwindling Medicare and Medicaid Payment Rates Turn Providers to Private Insurance Beneficiaries?

Would Dwindling Medicare and Medicaid Payment Rates Turn Providers to Private Insurance Beneficiaries? | Medical Billing Services | Scoop.it
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It is an irony that Medicare and Medicaid, which reimburse more than the half of the nation’s total health insurance, have come in for heavy flak by physicians, who claim to have lost considerable revenues that they could otherwise have rightfully earned had they avoided seeing Medicare and Medicaid beneficiaries and favored patients with private health insurance policies. The problem seems to originate from the sustainable growth rate (SGR) formula that has been proved unscientific against exponential growth in public health care beneficiaries and medical cost associated.

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In Search of Resources to Counter Radiology Billing and Compliance Challenges

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Much like medical billing challenges faced by other practitioners, radiologists too will have challenges unique to their own profession. The general perception of billing being more complex than ever before and progressive fall in reimbursements seems to hold good to Radiology Billing as well. As a result, radiologists may see their revenues dropping considerably, which in turn could have disastrous impact on clinical and operational efficiency. With possible threat to sustain diagnostic and radiologic quality amidst a host of clinical and Radiology medical billing challenges, radiologists will have to identify and address the key factors that may carry potentially greatest threats to their revenues, profitability, and more importantly the patient care.
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