The Importance of Medical Coding /Billing
Why medical coding has become so important today? Well, for the simple reason that one must be able to recognize/identify and then appropriately bill every single medical service that has been offered. Let me give a similar and more familiar example for the layman. Whenever we get into a supermarket there are so many different sections in there that we walk into. From grocery to books to dresses, all we need to do is just pick up things and put them into our shopping cart. With so many different items and rates how is the billing managed? We soon realize that it is the barcode stickers on each item that store the entire story of the different item inside the supermarket and all the cashier needs to do is just scan each item. As he scans the rates / and all the other required details of all those product that we picked up is automatically incorporated calculated by the computer as our final bill is generated.
It is very similar with medical coding and billing. Before the bill is prepared it is first necessary to identify the service that is given. With so many different medical specialties, procedures, and medications how are we to identify and determine the rate that has to be charged? That is why it has to undergo the medical coding process which is now a universal standard that has been developed and is being perfected. Every single process may it be a laboratory test, consultation with a specialist or a surgery has been given a category with rates/charges that have been assigned. Today most part or the total amount of the medical bills is paid by either the private/government insurance companies including Medicare and Medicaid. These companies always want to make sure that the billing is perfectly done and that the right codes are assigned and billed. Any discrepancies found usually result in denial of the claim. The basic types of codes are,
- Diagnostic codes
- Procedural codes
- Pharmaceutical codes
- Topographical codes
Highly affordable outsourcing solutions in medical coding / billing and medical transcription are now offered by the Oklahoma based outsourcing leader and medical transcription company, OSI (Outsource Strategies International).
Labels: importance of medical coding, medical billing, Medical Coding, medical transcription, medical transcription company, need for medical coding
HIMSS Annual Conference
The Annual HIMSS (Health Information and Management Systems Society) Conference and Exhibition is recognized as one of the world's largest and most respected healthcare IT exhibitions. Founded in 1961 with offices in Chicago, Washington D.C., Brussels, and other locations across the United States and Europe, HIMSS represents more than 20,000 individual members and over 300 corporate members that collectively represent organizations employing millions of people. Over 900 companies will exhibit at the conference.
This year's HIMSS O8 Annual Conference and Exhibition will be held from February 24-28 at Orlando, Orange County Convention Center.
As Collin Brack, the Manager, Software Systems Programming The University of Texas Medical Branch has to say, " The Annual Conference has a wealth of information, from the nuts and bolts of electronic medical records to emerging trends in healthcare IT, topics that are important for healthcare professionals all the way up to the CIO level."
Here is the conference brochure http://www.himssconference.org/docs/HIMSS08Brochure.pdf
Registration Details are at http://www.himssconference.org/registration/Policies.aspx
Outsource Strategies International (OSI) is a Oklahoma based medical transcription company that offers professional domestic and offshore outsourcing solutions in medical coding, medical billing and medical transcription to clients in the US and globally.
Labels: Healthcare Conference Orlando, HIMSS Conference 2008, medical transcription company, Orlando Conference
US Health Care Is Poised to Get Better
One thing is for sure! Healthcare in this country is going to get better in the future than it is today. Even though there is a difference of opinion between the people in the US, as to whether there should be a Universal Health Care system in place or not. For the past few years this has been a core issue and has been a hot topic of discussion and debate. It will also influence voters to determine as to who is going to be the next American President.
There are some who believe that the term Universal Health Care itself has to be analyzed and defined well before using it. Anyway, what are the main factors that have to be looked into when we discuss our current healthcare system? Well, clearly they are,
- Should every citizen have access to health care?
- Control of medical expenses
- Health care quality
Here are a few links I came across that discuss on whether to have a Universal healthcare system its pros and cons:
- http://www.pnhp.org/
- http://www.u2kcampaign.org/
- http://www.uhcan.org/
- http://www.peak.org/~ramselj/onepayer.html (supporting Universal Health)
Take a look at the Barack Obama Health plan if you havent yet, at, http://www.barackobama.com/issues/healthcare/
And here is the link to the Health Choice Plan from Hillary Clinton's website, http://www.hillaryclinton.com/feature/healthcareplan/
OSI (Outsource Strategies International) is an Oklahoma based medical transcription company that offers outsourcing services in medical coding, medical billing and medical transcription to clients across the country and globally.
Labels: health care system, Hillary healthcare plan, medical billing, medical transcription company, Obama healthcare plan, Universal health care, US healthcare
Certified Medical Coding Professionals Get Better Salary
The AAPC (American Association of Professional Coders) had conducted a survey (for the year 2007) questioning 5155 professional coders and the results clearly revealed the fact that certified coders earn an average of 17 percent more than theirnon-certified counterparts.
The survey revealed the range of salary today for the 3 different categories of coding professionals;
- Noncertified coders earn (on average) $25K-$30K
- Certified coders earn $30K-$35K
- Specialty certified coders earn $35K-$40K
- 41 percent of coding positions are closed to non-certified coders
- Specialty coders get the most pay.
- Only one percent of non-certified coders took home over $85,000.
- Coding professionals from urban locations earned more than suburban or rural locations.
- More years of experience means more earnings
- Graduate coders earn more than non graduate coders
For details on different certifications for professional coders go to,http://www.aapc.com/certification/index.aspx
Outsource Strategies International (OSI) is a US based medical transcription company that offers professional outsourcing services in medical coding, medical billing and medical transcription for all the medical specialties.
Labels: 2007 coding survey, AAPC survey 2007, coding professional survey, medical billing, Medical Coding, medical coding certification, medical transcription company
Level II HCPCS Medical Coding
There are two levels of HCPCS codes. While the Level I is numeric and consist of the American Medical Association's Current Procedural Terminology (CPT), the Level II codes are alphanumeric, and includes all the non-physician services such as ambulance services, prosthetic devices etc. The CPT codes basically identify medical services and procedures furnished by physicians and other health care professionals.
Level II HCPCS coding are representing the different items, supplies, non-physician services that are not covered by the CPT-4 codes. It is a standardized system that classifies similar products that are medical in nature into clear categories and thus simplifies the insurance claim process. Each alphanumeric HCPCS code has a descriptive terminology that identifies a category of items. Thus various suppliers use HCPCS level II codes to identify items on claim forms that are being billed to the health insurer. It ensures uniform reporting on claims forms of medical items or services. The codes identify categories of similar items or services rather than specific products.
Do you wish to buy the latest level II manual? The 2008 HCPCS Level II Manual can be bought at,http://www.hcmarketplace.com/prod-5287.html
Requests for HCPCS coding advice can be sent using the HCPCS coding advice form available at,http://www.ahacentraloffice.org/ahacentraloffice/images/Request_HCPCS_Coding_Advice.pdf
Outsource Strategies International (OSI) is an Oklahoma based medical transcription company that offers professional yet affordable outsourcing solutions in medical coding, medical billing and medical transcription services.
Labels: HCPCS, HCPCS coding, Level II HCPCS coding, medical billing, Medical Coding, medical transcription company, The Healthcare Common Procedure Coding System
Medical Billing by Non Physician Practitioners (NPP)
Who are the Non-Physician Practitioners and can they also bill the patients? Well by non physicians we are referring to the,
- Physician Assistants (PA)
- Nurse Practitioners (NP)
- Direct method - Here the PA or NP is provided a unique number and services are billed under the non-physician practitioner's name itself.
- Incident-to billing method - Here service is provided under a physician's supervision and billing is in the Physician's name.
- An integral, although incidental part of the physician's professional service.
- Commonly rendered without charge or included in the physician's bill.
- Of a type commonly furnished in physicians' office or clinics.
- Furnished by the Physician or by auxiliary personnel under the physician's direct supervision.
Under the 'Direct Billing' method, while PAs are permitted to bill independently, NPs are not permitted to bill on their own.
Outsource Strategies International (OSI) is a US based medical transcription company that offers professional yet affordable services in medical billing, medical coding and medical transcription services to clients globally
Labels: medical billing, Medical Billing by Non Physician Practitioners (NPP), medical transcription company, NP billing, NPP, PA billing
Medicaid Medical Billing
Medicaid is the United States health program for individuals and families with low incomes and resources. Who funds Medicaid? Well, it is jointly funded by the states and federal government, and is managed by the States. Medicaid is basically for low-income individuals that include,
- Children,
- Pregnant women
- Parents of eligible children
- Seniors
- People with disabilities
Medical Billing of Medicaid and Medicare are very different processes. The main difference between these two programs is that while Medicare is entirely funded at the federal level, Medicaid is not solely funded at the federal level. It is more of a needs-based social protection program than a social insurance program.
Medicaid payments assist nearly 60 percent of all nursing home residents and about 37 percent of all childbirths in the United States. The biggest chunk of the federal money that is spent on the HIV positive people is provided by the Medicaid program. Poor people who are HIV positive must progress to AIDS before they become eligible. Over 50% of the people living with AIDS are estimated to receive Medicaid payments.
During the 1990s, many states created the Medicaid Managed Care programs. Under this scheme Medicaid recipients are enrolled in a private health plan, which receives a fixed monthly premium from the state. Early and Periodic Screening, Diagnostic and Treatment (EPSDT) is a mandatory Medicaid program for children that aims to focus on prevention on early diagnosis and treatment of medical conditions. In some states Medicaid is subcontracted to private health insurance companies, while other states pay directly to the health providers. The poor children and parents are usually enrolled in managed care, while the aged and disabled eligibility groups go for the "fee for service" Medicaid.
Outsource Strategies International (OSI) is a US based medical transcription company that offers highly professional yet affordable outsourced services in medical coding, medical billing and medical transcription.
Labels: Medicaid, Medicaid billing, Medicaid managed care, medical billing, medical transcription company
National Correct Coding Initiative (NCCI)
The CMS (Centers for Medicare and Medicaid Services) has developed the National Correct Coding Initiative (NCCI) with the objective of promoting National correct coding methodologies and also to control improper coding that leads to wrong payments in Part B claims.
What are the CMS policies developed from? They include,
- Coding conventions from CPT manual,
- National and local policies / edits
- Coding guidelines developed by national societies
- Analysis of standard medical and surgical practices
- Review of current coding practices.
National Correct Coding Initiative
Correct Coding Solutions LLC
P.O. Box 907Carmel, IN 46082-0907
The NCCI Edits Manual may also be obtained by purchasing the manual, or sections of the manual, from the National Technical Information Service (NTIS) website, or by contacting NTIS at 1-800-363-2068 or 703-605-6060.
Click here to see the NCCI faq.
Outsource Strategies International (OSI) is an outsourcing services provider from Oklahoma, and offers outsourcing solutions in medical coding, medical billing and medical transcription services.
Labels: CMS, medical billing, Medical Coding, medical transcription company, National Correct Coding Initiative, NCCI
Dental Coding Conference 2008 in Las Vegas
The Coding Institute will conduct the Dental Reimbursement & Practice Management Conference fromFebruary 24 to the 26th, 2008, at Las Vegas. The conference is ideal for all dentists, practice managers,dental assistants, owners, dental hygienists, financial coordinators, practice management consultants, or anyone involved in dental reimbursement & practice management.The pre-conference workshop is on Sunday the 24th February and the topic/presenter for that day's workshop is,
Lead Your Dental Office to Success: A Step-by-Step ACTION Plan
Presenter: Joanne Tanner, MBA, Larry Lacy, MBA and Rebecca Lacy, MBA
The topics/presenters for the first day of the conference (February 25th)
Scheduling Strategies That Work
Presenter: Joanne Tanner, MBA
Benchmarking Bonanza: How Do You Compare?
Presenter: Janet Hagerman, RDH, BS
Proven Tactics To Boost Treatment Acceptance
Presenter: Ginny Hegarty
Focus on Financing - and How It Can Fuel Your Practice's Profits
Presenter: Ginny Hegarty
Power Up Your Hygiene Production
Presenter: Debbie Seidel-Bittke
Survey Says! How Smart Dental Practices Know What Their Patients Want
Presenter: Debbie Seidel-Bittke
Bring on the Baby Boomers! Secrets for Attracting the Newest Seniors
Presenter: Dick Chwalek
Day 2 topics/presenters (February 26th)
A-Z of CDT
Presenter: Maryann T. Dillon, CAE
5 Top Insurance Mistakes And How To Avoid Them
Presenter: Maryann T. Dillon, CAE
Show Me The Metrics! Watch These Numbers & Win
Presenter: Janet Hagerman, RDH, BS
The topic for the post conference workshop that begins in the afternoon of day 2 is
Future Shock: Plan for These Trends and Profit
Presenter: Dick Chwalek and Jackie Wheeler
See more details at http://www.codingconferences.com/dental08a.htm
For conference registration details go to http://www.codingconferences.com/dental08r.htm
Outsource Strategies International (OSI) is a US based company that offers affordable yet highly professional services in medical coding, medical billing and medical transcription.
Labels: coding company, medical billing, Medical Coding, Medical coding conference, medical coding conference 2008, medical transcription company
Details Required for Medical Billing
In the earlier days medical billing was done on paper. Today this process is being replaced by computers and it has become possible to effectively manage large amounts of insurance claims. Who handles the medical billing process? It may be handled either directly by the doctor or by his staff or by a third party professional medical billing company. Medical billing could also be a team work process and may involve the following people.
- Office manager
- Nurse
- Receptionist
- Medical assistant
- Insurance clerk
- Medical coders
- Name, address, telephone number, and ID number of provider
- Name of insurance company / groupID number of insurance holder
- Patient's name, date of birth/address/phone no
- Insured person's name, date of birth/address/phone
- Relationship between patient and insured person
- Details of provider name, address, telephone number, and ID number
- Details of other health insurances
- Patient's medical history /condition
- Details whether the medical condition is related to accident etc
OSI (Outsource Strategies International) is a US based medical transcription company that offers medical transcription, medical billing and medical coding services outsourcing either domestically or from the Philippines and India.
Labels: AMA, medical billing, medical transcription company, National Medical Coding
Medical Billing Rules
Medical billing procedures are governed by certain laws. Those who work in this field and directly involved in collecting the medical fees have especially got to be aware of these basic rules and regulations. What is the main purpose of medical billing? Well it is just to make sure that the service provider receives fair payment for services provided and also that payment is received in time. What are main laws that govern medical billing? They include,
- Fair debt Collection Act
- The Health Insurance Portability and Accountability Act
- The Privacy Rule
The Health Insurance Portability and Accountability Act of 1996 which is better known as the HIPAA was enacted by the U.S. Congress in 1996. HIPAA has two titles.
Title I of HIPAA regulates the availability and breadth of group and individual health insurance plans. It amends both the Employee Retirement Income Security Act and the Public Health Service Act. This act also prohibits any group health plan from creating eligibility rules or deciding of insurance premiums for individuals in the plan based on health status, medical history, genetic information, or disability.
The second title of HIPAA contains a portion that increases the efficiency of data exchange for healthcare financial transactions and protects the privacy of electronic data transmission and the confidentiality of patient records. If the HIPPA rules are violated, penalties can be imposed. Title II of HIPAA defines numerous offenses relating to health care and sets civil and criminal penalties for them. It also creates several programs to control fraud and abuse within the health care system.
The privacy rule regulates the use and disclosure of Protected Health Information (PHI). PHI is any information about health status, provision of health care, or payment for health care that can be linked to an individual. Any person who believes that the Privacy Rule is not being upheld can file a complaint with the Department of Health and Human Services Office for Civil Rights (OCR).
Outsource Strategies International (OSI) is a US based medical transcription company that offers highly professional outsourced services in medical coding, medical billing and medical transcription.
Labels: HIPAA, medical billing, Medical Coding, medical transcription company, Privacy rule
Medical Classification is Medical Coding
What is medical classification and what is medical coding? Well, both the terms refer to the process of transforming details of medical diagnostic processes and diagnosis into medical code numbers that are universal. From where are the details about the patient's disease and his medical history taken? Some of the sources include,
- Doctor's notes
- Biochemistry/Lab reports
- Radiology reports
- Reimbursements
- Statistical analysis
- Epidemic surveillance
- Knowledge based decision support
- Reference Classifications
- International Statistical Classification of Diseases and Related Health
- International Classification of Functioning, Disability, and Health
- International Classification of Health Interventions
- International Classification of Primary Care
- International Classification of External Causes of Injury
- Anatomical Therapeutic Chemical Classification System
- Technical aids for persons with disabilities: Classification and terminology
- International Classification of Diseases for Oncology, Third Edition
- ICD-10 for Mental and Behavioural Disorder
- Application of International Classification of Diseases to Dentistry and Stomatology
- Application of the International Classification of Diseases to Neurology
- International Classification of Functioning, Disability and Health for Children and Youth Procedure Coding System
- Diagnostic and Statistical Manual of Mental Disorders
- Systematized Nomenclature of Medicine
- TNM Classification of Malignant Tumours
- Unified Medical Language System
- Mendelian inheritance in Man
- Current Procedural Terminology
- Health Care Procedure Coding System
- North American Nursing Diagnosis Associates
- Logical Observation Identifiers Names and Codes
- International Classification of Headache Disorders 2nd Edition
Labels: medical classification, Medical Coding, medical transcription, medical transcription company
The CPT Medical Coding Set
CPT or Current Procedural Terminology is a code set with the trademark of the AMA (American Medical Association). It is maintained by the CPT editorial Panel. The current version of CPT is 2007. What does the CPT describe? It accurately describes,
- Medical services
- Surgical services
- Diagnostic services
All the information regarding the different services are communicated in a very uniform way healthcare providers, among doctors, physicians, patients, coders, Accreditation organization, insurance companies etc.
The three categories of CPT codes:
- Category I CPT Code(s)
- Category II CPT Code(s) - Performance Measurement
- Category III CPT Code(s) - Emerging Technology
CPT is currently identified by the Centers for Medicare and Medicaid Services (CMS) as Level 1 of the (HCPCS) Health Care Procedure Coding System.
The upcoming CPT Editorial Panel meeting is scheduled for Feb. 7-10, 2008 at the
Rancho Las Palmas Resort & Spa, Rancho Mirage, CA.
General public registration for the meeting can be done at
http://www.ama-assn.org/ama/noindex/category/16960.html
There is a free search engine that gives users of CPT the opportunity to perform CPT code searches and also obtain information about Medicare's relative value payment amount associated with these codes. To use the services go to https://catalog.ama-assn.org/Catalog/cpt/cpt_search.jsp
Outsource Strategies International (OSI) is a US based medical transcription company that offers professional services in medical billing, medical coding and medical transcription.
Labels: CPT codes, medical billing, Medical Coding, medical transcription company
Outsourcing Medical Work
Outsourcing is the process where a third party (who may be located domestically or in a offshore country) is used to perform a company's in-house work. Outsourcing has many benefits and may involve many different types of activities.
Medical outsourcing of health sector back office processes like transcription, coding, and billing is growing by the day. Medical outsourcing work groups in offshore Asian countries like India and the Philippines are constantly trained to be conversant in US guidelines and standards and services like medical transcription is delivered on a daily or even a few hours turnaround basis.
In recent years medical outsourcing has taken a different path where people are seen taking flights out of the US to get surgeries done. Expensive heart or spine surgeries from cheaper countries mean savings in tens of thousands of dollars. Look at this 2006 Time magazine article titled "Outsourcing Your Heart" at http://www.time.com/time/magazine/article/0,9171,1196429,00.html
One of the main reasons for the high cost of medical expenses in the US has been due to the lack of competition. Countries like India are planning and focusing on their medical tourism industry where patients from around the world will come for getting high quality health services at competitive rates. As India is a developing country development growth in this type of surgery outsourcing has to develop gradually. But when it comes to processes like medical transcription or medical billing India and the Philippines have already become the world's favorite destinations.
Outsource Strategies International (OSI) is a US based medical transcription company that offers total outsourcing solutions in all specialities of medical transcription, medical billing, and medical coding.
Labels: medical billing, medical outsourcing, medical transcription, medical transcription company
Medical Transcription Training
What are the different learning options available today for the MT profession aspirants? Well there are two clear choices available. They are,
- Learn from an offline academic center
- Join an online MT school
- Online training is cheaper
- Flexibility in taking the course possible
- Can study from home
What is it that is taught in an MT school? They include being familiar with all medical terminology, the study of the medical root word along with its different suffixes and prefixes. A study of the human anatomy and physiology is very essential and so is knowledge about the various diseases, and the different systems of the body like the digestive, nervous, lymphatic, endocrine, and genitourinary systems.
Other major study areas include, pharmacology, different medical abbreviations, awareness about the different diagnostic tests and procedures used in the medical profession. Special emphasis is also given to the preparation and layout of various medical reports and documents using the right terms that will be handled during transcription.
Needless to say it would be ideal to join a course that can assure a job opening after successful completion of the Medical transcription course and becoming a certified professional.. The title of Certified Medical Transcriptionist (CMT) can be got by passing a certification examination conducted solely by the Association for Healthcare Documentation Integrity (AHDI), formerly the American Association for Medical Transcription (AAMT).
Call Outsource Strategies International (OSI) a US based medical transcription company offering professional services in outsourced and domestic medical billing, coding, and total medical transcription solution.
Labels: AAMT, certified medical transcriptionist, CMT, medical transcription company, MT industry
The Medical Transcription Industry and Organisations
Medical transcription has been evolving since the 1960s. With the mushrooming of companies at all levels there has always been a constant demand for the professional medical transcriptionist. In the US it is only from March 7, 2006, that the MT occupation became an eligible U.S. Department of Labor Apprenticeship.
The Association for Healthcare Documentation Integrity (AHDI) which was formerly the American Association for Medical Transcription (AAMT) was established in 1978 to obtain recognition for their contributions toward patient safety and more accurate medical records. The AHDI is an organization to join for validation and protection as an MT. The association offers many resources that are of use to those in the MT industry and it takes pride in following the latest and modern trends. Services include giving of advice, networking, and job opportunities to those who joins the organization. Advances in digital technology have made it possible for many medical transcriptionists to even work from the privacy of their homes.
One other organization that promotes the MT industry is the Medical Transcription Industry Association (MTIA) which is a non-profit trade association that represents the companies, vendors, and health professionals. Working alongside AHDI, the association has greatly helped to improve the medical transcription industry and maintain health records world wide. MTIA services include,
- Access to thousands of vendor suppliers through a transcription service finder
- Sponsoring events and conferences annually
- Networking through its website.
- Providing cutting edge technology know-how to MTs
Outsource Strategies International (OSI) is a US based medical transcription company that offers professional medical transcription outsourcing services in all the specialty areas. Other related services offered include affordable medical billing and advanced medical coding.
Labels: AAMT, AHDI, medical transcription company, medical transcription organizations, MT industry, MTIA
The Growing Need for Medical Transcription Outsourcing
Why it is that medical transcription outsourcing has become a big business today? Well it is just because one thing leads to other. In the earlier days medical secretaries just had to type out the reports dictated by the doctor after the rush time. Now it is different. For one so much more documentation is required and that too in such less time that a secretary will have time for nothing else. It has become mandatory for hospitals to keep digital records of all the patient details. Why?
Because every time a medical bill is being made there is the possibility that some insurance company is actually paying the bill. So unless we have perfect documentation of the disease the process of diagnosis medicines etc how can the billing be done? And with so much of growth in the volume of health care clients and hospitals /specialties, either a full time transcription team has to be arranged within the hospital premise or the transcription work has to be outsourced. Work is being sent to offshore locations for purely economic and turnaround time reasons. Thus today we have the fully evolved transcription outsourcing industry.
According the United States department of Labor, the world wide demand for medical transcription is set to reach 20 billion dollars. So if looking out for a career in Medical transcription now is a good time. What are basic requirements to become a good medical transcription professional? It is actually quite simple. One must have,
- A good knowledge of basic to advanced medical terminologies.
- Good verbal communication and memory skills.
- Ability to be accurate with numbers
- Skill in office equipment/computer.
- Good listening skills
- Good verbal and written comprehension.
- Ability to maintain records
- Above-average typing skills.
- Good grammar/punctuation skill
- Proficiency in certain or multiple medical specialties
Labels: medical outsourcing, medical transcription company, Medical Transcription Company. Medical transcription Services, MT Outsourcing

