Healthcare Professionals – Looking For Free CEUs?

The Center for Medicare & Medicaid Services just released this weeks MLN Connects Provider News and there is a LOT of information to check out whether you are a participating or non-participating provider, medical coder/ biller or staff member working with Medicare and Medicaid patients. The MLN has a new streamlined look and the site now offers easier ways to navigate and search for the content you need.

mln-banner

These publications provide you with the rules and regulations you need to know on program and policy details, updates, upcoming educational events along with claim, pricer and code information for all specialties.You can check out past issues here and if you’d like to receive weekly emails to remind you of new issues there is a link allowing you to sign up.

In this months issue, a new Medicare Basics: Parts A and B Claims Overview Video is included and whether you are new or familiar with Medicare, it’s a quick brush-up everyone should watch.

The MLN Learning Management and Product Ordering System (LM/POS) gives you free access to a number of web-based training (WBT) courses, documents and podcasts you can view or read at any time. CMS also provides continuing education credit (CEUs) for most courses although you should check with your association to verify if they will accept the credit(s) for the course.

Take advantage of these excellent resources and if you are looking for assistance with your coding, billing or any other practice management issue, feel free to give me a call or send an email.

Heidi Kollmorgen, CCS-P

AHIMA Approved ICD-10 Trainer

hdmedical@live.com

(440) 785-3894

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Ready To Increase Your Practice Revenue?

** Does your AR report show numerous accounts over 60 days remaining unpaid?

** Is your staff overwhelmed and not able to keep up with reviewing outstanding claims?

** Do you need assistance with reviewing and appealing carrier denials and rejections?

With the holidays around the corner everyone is starting to relax and get excited to plan parties or take some time off. Keeping up the pace to keep working seems to become a challenge, especially when it comes to the dreaded task of following up on unpaid insurance claims.

If you aren’t outsourcing your billing, your billing and coding staff must be given time away from the phones and front desk so they have uninterrupted time to work that AR report. Each unpaid claim over thirty days old should be reviewed with the status noted or steps to correct and resubmit handled immediately.

Checking status online can be a time saver and should be taken advantage of although making actual calls is inevitable. Realize that this can take anywhere from 3 minutes to an hour or more – for EACH one.

 How can you determine the time needed to catch up that backlog?

  • Run your AR report and get a count of each claim over 30 days old
  • Multiply that number by 5 minutes for each one

This gives you an idea of the number of hours needed to check status although you also need to allow additional time to make corrections, pull documents, query the provider for questions – it isn’t always a quick fix.

You will also need to keep in mind that each day will allow some of the claims to fall off the report when a payment is received however, chances are high that more unpaid claims will be added to the report.

ar-report-ex

We are seeing insurance carriers use any reason to delay or reject a claim and when you aren’t allowing the necessary time and resources to follow up and track unpaid claims you risk rejections for timely filing.

 Are there other options – I can’t shut down my office!

Outsourcing your billing, even for a short-term project like cleaning up a backlog of claims is quickly becoming a recognized solution. What are some of the pros and cons?

PROS

100% Focus on Coding & Billing – Being outside of the office avoids any chance to be pulled away from the actual intended job

Reduced Overhead – No taxes, deductions, bonuses, PTO, retirement, healthcare etc.

No Sick Days – Unexpected time off delays the billing process, especially when other urgent matters need to be caught up when staff returns

Training & Education – Not only the cost for the actual sessions and materials but additional staff time away from the office

Tax Benefits – Billing Service fees are a deductible business expense

CONS

The feeling of losing control – Avoid this by planning and keeping scheduled meetings through Skype, Webex or other online tools

Staff resistance to change – A billing service should express their goal to become part of the team – not “take over”

Transferring Documents – Scanning to a shared, encrypted file allows you to keep original paperwork and avoids postal costs

Contract Issues – Both sides should be clear about expectations and responsibilities

Practice Management System Change – Your billing service should be able to virtually work on your existing system which allows a seamless transition

 If you change nothing, nothing will ever change!

My experience with multiple practice management systems allows me to remotely access your existing system so there are no issues with buying new software or transfer of data. I can easily review your reports to identify trends and areas needing improvement which results in optimizing the reimbursement your practice is entitled to.

HD Medical Solutions has worked with solo and group practices for 20+ years on short or long term projects. As an AHIMA Approved ICD-10-CM Trainer as well as a certified coder (CCS-P) my staff and I are ready to assist you with all practice management tasks including credentialing, AR review, ICD-10 / CPT / HCPCs coding, insurance and patient billing as well as EMR implementation or oversight.

Contact me today and we can develop a solid plan which meets your expectations and goals. I look forward to working with you and your practice!

Heidi Bio Pic

 

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Interested in the NEW codes for ICD-10?

Well, October 1, 2014 has come and gone and most of us have successfully made the transition from ICD-9 to ICD-10.  Sure, there have been bumps along the way and new challenges seem to pop up every now and then but we did it.

Just like any other situation involving coding and billing for healthcare providers, constant changes to rules and regulations are still happening and they always will.  No matter what we do to verify coverage or precertify services, there’s always that last line in small print explaining that your efforts are not a guarantee of payment.

I’m sure many of you understand the feeling I get when a denial or rejection comes in and I have a copy of my proof.  Even if it doesn’t always work, I’m relieved I have something to support my appeal. It’s the little things that count, right?

bottleneck

If you take pride in your job and always want to do your best, you would agree that continuing your education is critical to staying successful. There are so many free resources to take advantage of and one that I have followed for the last couple of years is ICD10monitor.  I go to their site at least a few times a week to catch up on news, case studies, bulletins or to find out about new resources they may have added.

Talk Ten Tuesdays is a weekly, live podcast where providers and industry experts can share their experiences with ICD-10. Registration is free and you always come away learning something new or at the very least, gain a better understanding of something related to ICD-10.

On Friday, March 11 they will have a Special Edition Broadcast to hear about the outcome of the federal ICD-10 Coordination and Maintenance Committee meeting held at Centers for Medicare and Medicaid Services (CMS) headquarters.  This meeting is being held to discuss proposed changes to ICD-10 for both procedure and diagnosis codes.

If you are able to listen in, even if it’s playing in the background while you work, hearing about the process and what new changes are being proposed would certainly be helpful to know.  So many times I hear people complain or question why things are the way they are so here is your chance to find out!

You can register here for the special edition, Code Explosion: New Codes, New Issues and I hope you will take a bit of time to check out their website also.

Happy coding and billing everyone!

 

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How to Guarantee Clean Claims With ICD-10

IMPROVE YOUR DOCUMENTATION AND READ THE ICD-10 GUIDELINES.  That really is the key to surviving the transition from ICD-9 to ICD-10.  This process does not involve learning a new way to actually code – you follow the same steps as you would with ICD-9.  First, look up the diagnosis alphabetically and then verify the code in the tabular section.  The difference is in the new and/or expanded ICD-10 guidelines along with the notes each section provides.

Reading and understanding the guidelines will help you understand what is needed in your documentation so the correct code(s) can be assigned to your claims.  The Alabama Association of Health Information Management offers detailed ICD-9 and ICD-10 Chapter Guideline Comparisons and if you are looking for specialty specific tip sheets, Steve Sisko (@ShimCode) has over sixty downloads including a “Create Your Own Template”.

Many ICD-10 codes include a note stating “Use additional…” or the new “Excludes 1 and Excludes 2” notes.  This is the part of the coding process where many providers (or their coding staff) will have issues – what details do you have documented in the note?  For example, if you frequently used the ICD-9 code 729.5 – Pain in Limb you need to include specifics such as right/left upper/lower arm/leg.  When those details aren’t documented, you can be sure problems will begin to creep up.

ICD10 CDI EX

If you are using an EMR and claims are generated and submitted automatically, you or your billing staff will begin to notice more clearinghouse rejections for “Invalid ICD-10 code (or combination)”.  Many of the online ICD-9 to ICD-10 code converters or EMR programs I have seen only lead you to the right family of codes.  Any additional notes, guidelines or codes required in addition to the main code you chose are not factored in, and many programs do not have the capability of alerting you of these critical details.

There are a number of ICD-10 codes which require an additional code to identify alcohol abuse and dependence, exposure to environmental tobacco smoke and/or history of tobacco use or dependence for example. If you aren’t familiar with the actual book and have not read the guidelines, you won’t know to include this when you finalize your EMR entry or write a code on the bottom of your superbill.

Most facilities and hospitals require physicians to fully document every detail and if they don’t, the HIM department coders will query you when information is missing.  If you do not have a certified coder in your office, your staff may not know when to question you and may unintentionally assign the wrong code.  This only leads to denied claims and a gradual decrease in cash flow to your practice. Add this to the usual list of issues related to denials and rejections and you can see why experts have suggested keeping a three month cash reserve on hand for ICD-10.

bottleneckI often suggest comparing one of your Admission notes from the hospital to a New Patient progress note.  Or a hospital Operative Report (your own or another surgeons) to the entry you have when procedures are performed in the office.  Do you provide the same detailed information for your office patient notes?

If you do – Kudos!  Your practice should not experience too many additional issues although you should still become familiar with the ICD-10 Official Guidelines.  If you feel there is room for improvement, you and your staff should set aside time NOW and check out the CMS.gov Provider Resources page.  There are many links to help everyone involved in the coding and billing process as well as links on how you can improve your documentation.

The best advice I can give is to track your claims religiously from this point on.  If you submit electronic Medicare claims and they aren’t rejected initially at the clearinghouse level, expect that remittance advice within 2 weeks and verify every detail.

Also, don’t let weeks or months go by without tracking your Accounts Receivable report.  If you start to notice the higher numbers creeping towards the 31-60 and 61-90 columns, changes are needed IMMEDIATELY.  Those outstanding claims need to be worked before they end up as denied for timely filing.

There are many consultants, billing services and other professionals who have prepared for ICD-10 and are also experienced in improving and/or managing the revenue cycle of a medical practice. It may be worth it to consider taking advantage of their experience and expertise so you can continue focusing on providing quality care to your patients.

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We need #ICD10!!

URGENT MESSAGE RECEIVED FROM AHIMA!

I’d like to share the following information for everyone who knows #ICD10Matters. Ms. Margarita Valdez is asking for everyone’s help in reaching out and spreading important #ICD10Facts.

This is a reminder that tomorrow, February 11th the Energy & Commerce subcommittee on Health will hold a hearing on ICD-10 implementation at 10:15am ET. Now is the time to voice your support for the new code sets with key legislators in Congress. Please call your legislators today! It’s urgent that Congress hears from you before the hearing.

You can follow these 4 easy steps:
1) Call Dr. Michael Burgess at (202) 225-7772
2) State that you support ICD-10 implementation in 2015.
3) Use the talking points below:

ICD10Fact
4) When you are done, call the other congressional leaders and Tweet also using hashtags #ICD10Matters and #SubHealth.

Legislator District / Phone Number
Chairman/Rep. Joe Pitts PA-16   (202) 225-2411
Rep. Morgan Griffith VA-9   (202) 225-3861
Rep./Dr. Andy Harris MD-1   (202) 225-5311
Chairman/Rep. Fred Upton MI-6   (202) 225-3761
Ranking Member/Rep. Frank Pallone NJ-6   (202) 225-4671

Find more Twitter handles here

Hope to see you at the hearing tomorrow!

~Heidi

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Will this study help Medical Billers and Coders get claims paid?

Medical billers and coders spend quite a bit of their day posting charges and payments or calling insurance companies to check status.  Does anyone actually know how long it takes to get the claim paid?  We all have an idea from seminars and consultants or articles we may have read from time to time, but what is that time really based on?

If you would like to be listed as a Research Contributer, this work study is simple.  Just pick a random claim and use this form to track each minute spent on the various processes involved  – all the way to a zero balance.  It may take six months or longer, but I’ll keep everyone who signs up to help informed of the progress along the way.

Work Study on Claims FilingIf you are interested, I must know  you are participating and you should choose a claim with a date of service ranging from June 1 – June 15 of 2014. This way I can keep track and know when all final submissions have been received.

Add your email here or send me a private message if you would like a copy of the .pdf.  Thanks for considering this project and please feel free to share with other billers and coders so we get as much data as possible!

~Heidi

hdmedical@outlook.com

 

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Need ICD-9 help for your RHIT?

If you are preparing for your RHIT and only studied ICD-10, you are sure to be panicked right now but you shouldn’t be.  AHIMA and many others are ready to help you and HD Medical is one of them.

Follow our blog and under our Services section, you will find a link where questions can be posted.  We will do our best to help you find the answers and give you the extra support you need.teamTake this as a rare opportunity to prove your amazing ability to overcome obstacles.  Future HIM employers seeking coders will be impressed with any new grads earning the RHIT credential in 2014!

~Heidi

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EMR & HIPAA – A Guest Blog Post

Why Do People Find ICD-10 So Amusing?

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Where do you stand on a possible ICD-10 delay?

AHIMA held a virtual rally on Twitter today to raise awareness about another impending delay on ICD-10.  Excellent points and questions were shared by all who participated – kudos for showing your support to vote against H.R. 4302!

My hope is the progress made with ICD-10 is not jeopardized with a delay. What do you think?  Would you be happy if we finally put ICD-9-CM to rest?

RIP 401.9

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A proud moment to share!

I Passed.jpg

Even with the uncertainty of these last few days, I reviewed, studied and took the AHIMA assessment.  After several grueling hours and support from so many – I passed!

I believe in ICD-10 and the enormous benefits, research potential and opportunity for advancement for our healthcare system.

~Heidi

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