Medical Outsourcing on the Rise

Sunday, December 13, 2009

Medical Outsourcing on the Rise – More Time and Money Saved

Medical outsourcing is on the rise. This shouldn’t come as a surprise since it helps medical establishments save time and money. Outsourced medical processes include medical transcription, medical billing, medical coding, medical chart reviews, old AR collections, patient appointment scheduling and rescheduling, medical record review, medical case summaries, and so on.

Error-free and Secure

It is true that many Americans are opposed to the outsourcing trend – it causes a lot of jobs to be lost to countries such as India, Mexico, and China, where service charges are lower. Adverse implications of “job shipping” have been felt by Americans working in the manufacturing sphere. However, the many benefits cannot be overlooked. Outsourcing frees up more time for medical professionals to dedicate to their patients, back office work can be done by experts thereby minimizing possible errors, money does not have to be wasted on in-house training, data privacy (HIPAA compliance), secure file transfer, accuracy, regular reports, customer accuracy, and so on.

Medical outsourcing can be done for a variety of branches of medicine including cardiology, dentistry, emergency room, obstetrics and gynecology, internal medicine, anesthesiology, oncology, sports medicine, and so on.

Improved Workflow and Patient Care

Outsourcing to a country such as India for example, is popular, because of benefits such as a superior talent pool, good government healthcare policies, cost-savings, and superior grade infrastructure. It is a good thing that medical outsourcing is on the rise since more and more medical concerns can improve their workflow and patient care.

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posted by Outsource Strategies International @ 7:23 PM Go to Medical Outsourcing on the Rise



The Importance of Medical Coding /Billing

Tuesday, February 19, 2008

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).

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posted by Outsource Strategies International @ 7:24 PM Go to The Importance of Medical Coding /Billing



Benefits and Features of Medical Billing Software

Tuesday, February 12, 2008

Medical billing and coding processes having become a mandatory part of the regular medical insurance claim process, irrespective of whether it is from private / government insurance company, Medicare/Medicaid etc. Due to the ever rising need for health care triggered by the increase in the percentage of the aging population, one can be assured that medical billing and coding is going to be an active profession. Today,there are many types and brands of medical billing software that have developed and used in the market.


But, what are the benefits of having electronic medical billing software? Well, the foremost reason of course is because the software will speed up the actual work and greatly improve our work efficiency. The medical billing software can have some or all of the following features and assist us to do the following;


  • Generate faster and better medical claims

  • Lesser errors in billing

  • Can generate variety of reports at one time

  • Customizable reporting

  • Windows based environment

  • Easy access to patient data

  • Short learning curve

  • Clearinghouse service solutions

  • Can handle all commercial carriers plus Medicare, Medicaid, Blue Cross/Blue ShieldPatient/Resource scheduling

  • Multi-provider scheduling views

  • Electronic billing

  • Electronic insurance eligibility checks

  • Patient letters

  • Patient/Insurance billing

  • Automatic remittance

  • Advanced accounts receivables management

  • EMR integration

  • HL7 compliant

  • NPI number ready

  • Tracking of patient demographics, visits /diagnoses

  • Tracking billing information and insurance payments.

  • Appointment scheduling/managing.

  • Reports Gathering

  • Locating a Medical Biller

Among the major benefits of having a medical billing software include improve patient security, achieving of 100% HIPAA compliance, improved collections, faster payment entry, improved front desk and back office efficiency and more.

Outsource Strategies International (OSI) is a US based medical transcription company that offers professional services in medical billing, medical coding and medical transcription services to clients in the US and globally.

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posted by Outsource Strategies International @ 10:45 PM Go to Benefits and Features of Medical Billing Software



Pain Management Billing

Monday, February 11, 2008

Pain management or pain medicine is about getting relief from physical pain. There are two basic types of pain, acute and chronic. The patients for acute pain often have a reversible cause while chronic pain is more difficult and takes longer to be diagnosed and reverse. What are the different treatments given for pain and how are these drugs billed? Pain management practitioners come from all fields of medicine. The pain fellowship trained physicians can be anesthesiologists, neurologists, physiatrists or psychiatrists. Treatments include, prescriptions like,
  • Analgesics
  • Narcotics
  • NSAIDs
  • Pain modifiers
  • Tricyclic antidepressants
  • Anticonvulsants
  • Steroids
  • Trigger point injections
  • Neurolytic blocks
  • Spine stimulators
  • Intrathecal drug delivery system implant
  • Interventional procedures,
  • Physical therapy
  • Physical exercise
  • Application of ice/heat
  • Psychological measures
  • Biofeedback
  • Cognitive Therapy
What are the properties that a pain management billing company must have? Well they include, good coding experience, and being able to support the long term and short term aspects of the patient's pain management system. Most billing for chronic pain cases will involve claims for pain relief drugs. Some points to remember include, that the Medicare coverage vary according to State. Pain management reimbursement policies are carrier-specific and practices should review local medical review policy for each type of procedure.

For total outsourcing solutions in medical coding / billing and medical transcription, call the US based medical transcription company OSI (Outsource Strategies International).

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posted by Outsource Strategies International @ 10:38 PM Go to Pain Management Billing



Medical Billing / Coding and SADMERC

Sunday, February 10, 2008

Medical billing always requires adherence to proper coding and other procedures so that the insurance medical claim process is simplified. So what is SADMERC? Well, it refers to The Statistical Analysis Durable Medical Equipment Regional Carrier. It is a national entity that provides services under contract to the CMS (Centers for Medicare & Medicaid Services). It's Reports and Analysis Unit provides data analysis support to the Durable Medical Equipment (DME) and Program Safeguard Contractors (PSCs).

Thus, SADMERC is a liaison between medical suppliers, manufacturers, and the Centers for Medicare & Medicaid Services to determine which Level II HCPCS codes work best for Medicare-reimbursed DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies). CMS instructs the different manufacturers/suppliers to contact the SADMERC HCPCS units to get the proper codes and prices for items. SADMERC also performs a variety of national pricing functions for DMEPOS services besides assisting CMS with the DMEPOS Fee Schedules and analysis of DMEPOS fees/ issues.

How long does it take for the verification of a code? SADMERC indicates that a decision may be made 90 days after receipt of the supporting documentation and initiation of the review process. Users of a product contact the SADMERC to find out if a particular product is coded. Now can a SADMERC Coding Verification Review decision be appealed? Yes of course!

The SADMERC toll free helpline is (877) 735-1326, and works 9 AM to 4 PM (EST). Refer a more detailed FAQ at,http://gmassocinc.com/7-faq.htm

HCPCS Coding Verification Applications can be accessed HERE!

For effective outsourcing of medical coding, medical billing and medical transcription, do contact the US based medical transcription company, Outsource Strategies International (OSI).

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posted by Outsource Strategies International @ 9:12 PM Go to Medical Billing / Coding and SADMERC



ABC Medical Coding

Thursday, February 07, 2008

What are ABC Codes? ABC Codes are five-digit Health Insurance Portability and Accountability Act (HIPAA) compliant alpha codes (e.g., AAAAA) used by licensed and non-licensed healthcare practitioners on standard healthcare claim forms (e.g., CMS 1500 Form) to describe services, remedies and/or supply items provided and/or used during patient visits.Developed by a private New Mexico company called "Alternative Link" and FIHC (The Foundation for Integrative Healthcare) the ABC codes support and fill gaps in the CPT (Current Procedural Terminology) codes. The ABC codes contain both a short description and an expanded definition of the service, remedy and/or supply item. Here is the homepage of the site http://www.alternativelink.com/ali/home/default.asp

Our medical coding system had been mainly for the allopathic stream and today there are many alternative healthcare professionals who are not able to make claim from insurance companies. ABC codes fill gaps in healthcare coding and the National Health Information Network (NHIN) that older medical code sets do not cover by describing care provided by all healthcare practitioners. Thus, ABC codes can help bring non-physicians into the insurance-industry mainstream.

ABC Coding Solutions has announced ZipClaims.com, a new online claim filing system, designed to empower over 2 million healthcare practitioners to transmit standard medical billing. This includes other alternative medicines also besides the regular allopathic system of medicine. Here is the full news article, http://biz.yahoo.com/bw/080206/20080206005121.html?.v=1

ABC codes can also be used in conjunction with two-digit, alpha-numeric practitioner identifiers that identifier the specialty of the service. ABC codes are also supported by state legislative references regarding scope of practice and training requirements on a code, state and practitioner-specific basis.

ABC codes consist of five-character, alphabetic strings that identify services, remedies, and/or supplies. Codes are followed by two-character code modifiers which identify the practitioner type who delivered the care. Here is a detailed explanation of the code, http://www.abccodes.com/ali/abc_codes/code_struct.asp

Outsource Strategies International (OSI) is a US based medical transcription company that offers outsourcing solutions in medical coding, medical billing and medical transcription services.

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posted by Outsource Strategies International @ 6:47 PM Go to ABC Medical Coding



The Different Parts of Medicare Health Insurance

Thursday, January 31, 2008

Medicare, in the US is a social insurance program provided by the federal government to provide health insurance coverage to the following group of people.

  • Elderly workers and their dependents,
  • Individuals who become totally and permanently disabled
  • End stage renal disease (ESRD) patients.
Thus Medicare is a critically important source of health insurance for over 44 million Americans. Those on Medicare also have the additional choices associated with the Medicare prescription drug benefit.

So what are the different basic parts of Medicare? These are the four basic parts.

Medicare Part A is about Hospital Insurance and helps cover your inpatient care in hospitals. It can also help to cover skilled nursing facility, hospice, and home health care under certain conditions.

Medicare Part B is concerned with Medical Insurance and helps cover medically-necessary services like doctors' services and outpatient care. It also helps cover some preventive services to help maintain your health and to keep certain illnesses from getting worse.

Medicare Part C (Medicare Advantage Plans) is another way to get your Medicare benefits. It combines Part A, Part B, and, sometimes, Part D coverage. Medicare Advantage Plans are managed by private insurance companies approved by Medicare. These plans must cover medically-necessary services. However, plans can charge different co-payments, co-insurance, or deductibles for these services.

Medicare Part D (Medicare Prescription Drug Coverage) helps cover prescription drugs. This coverage may help lower one's prescription drug costs and help protect against higher costs in the future.

Detailed information from official Medicare site is at http://www.cms.hhs.gov/home/medicare.asp

If you already have Medicare go to http://www.medicare.gov/

To keep up with the latest changes in America's health insurance coverage system, go to the link, http://usgovinfo.about.com/od/medicarehealthinsurance/Medicare_and_Health_Insurance.htm


Outsource Strategies International (OSI ) is a US based medical transcription company that offers professional outsourcing solutions in medical billing, medical coding and medical transcription to clients in the US, Canada the UK and Australia.

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posted by Outsource Strategies International @ 6:59 PM Go to The Different Parts of Medicare Health Insurance



The Origin of Medical Coding

Wednesday, January 30, 2008

What is medical coding and who are medical coders? Well, everyone does know about the importance of medical data while providing quality healthcare service. The professional medical coders is one of the main person involved in the capturing of this critical and accurate medical data that needs to be delivered it in time.

During medical coding all verbal descriptions of diseases, injuries, and procedures are converted into numeric or alphanumeric designations. How did the medical coding originate? It was originally performed to classify mortality (cause of death) data on death certificates besides being used to classify morbidity and procedural data. Such type of coding is very useful especially as it helps us today to get easy access to medical records by diagnoses and procedures so that in can be used in,
  • Hospitals/clinics etc
  • Research work
  • Education
The federal government introduced The Medicare Prospective Payment System (PPS) in October, 1983, for better management of medical care. Each patient was classified into a DRG (Diagnosis Related Group) depending on the information from the Medical Record that appears on the bill. Under PPS, hospitals are paid a pre-determined rate for each Medicare admission. Since then there has been a great deal more emphasis placed on medical coding.

At present assigning of medical codes is the backbone for reimbursement of claims for Medicare patients. Codes are given for diagnoses, services, and procedures provided. Thus healthcare providers today have to comply with different medical coding guidelines.

OSI (Outsource Strategies International) is a US based medical transcription company that offers outsourced services in medical coding, billing and medical transcription services to clients globally and also across USA.

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posted by Outsource Strategies International @ 6:53 PM Go to The Origin of Medical Coding



General Surgery Medical Coding Conference

Tuesday, January 22, 2008

The General Surgery Coding and Reimbursement Conference held by The Coding Institute will be held at San Antonio, Texas from March 16-18, 2008. Pre-conference workshop will be held on the first day Sunday the 16th of March followed by two days of conference. Here is a list of topics that will be presented at the conference / pre-conference workshop.

Pre Conference Workshop Topic/Presenter

Dissecting the Op Note: Essentials Every Coding Professional Needs to Know
Presenter: Kathleen A Mueller, RN, CPC, CCS-P, CMSCS

Day 1 Topics/Presenter

Strain-Free Hernia Repair Coding
Presenter: John Bishop, PA-C, MS, CPC

Gall of the Wild: Get the Most from Cholecystectomy Coding
Presenter: Jan Rasmussen, CPC, CCP, ACS-OB, ACS-GI

Bariatric Coding: Don't Let Weight Loss Surgery Turn into Revenue Loss
Presenter: Terri Brame, CPC-GENSG, CPC-H

Avoid the Confusion: Master Tubes & Ostomies Coding For Accurate Reimbursement Every Time!
Presenter: Terri Brame, CPC-GENSG, CPC-H

8 Steps to Better E/M Coding Pay-UP for Surgery Practices
Presenter: Kim Garner Huey, CPC, CCS-P, CHCC

Billing & Coding Tactics for General Surgery in an ASC

Identify Every Element To Ace Your Colectomy Claims
Presenter: Kim Garner Huey, CPC, CCS-P, CHCC

Day 2 Topics/Presenter

Heal Payment Leaks with Air-Tight Wound Repair Coding
Presenter: Terri Brame, CPC-GENSG, CPC-H

Successfully Maneuver Through Coding and Billing for Breast Excisions, Incisions, and Biopsies
Presenter: Nanette Orme, CPC

Defect-Free Coding For Skin Lesion Excisions
Presenter: Nanette Orme, CPC

Fee Schedule Fundamentals: Using the Medicare Physician Fee Schedule Database
Presenter: Marcella Bucknam, CPC, CCS-P, CPC-H, CCS, CPC-P, CPC-OBGYN, CPC-CARDIO

More details are available at http://www.codingconferences.com/gen_surgery08a.htm Registration and rate details are at http://www.codingconferences.com/gen_surgery08r.htm

Outsource Strategies International (OSI) is an Oklahoma based company that offers affordable outsourcing solutions in medical transcription, medical billing and medical coding.

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posted by Outsource Strategies International @ 6:01 PM Go to General Surgery Medical Coding Conference



HIPAA and Medical Billing Software

Monday, January 21, 2008

Every medical practice, whether from a small clinic or a major hospital has to comply with The Health Insurance Portability and Accountability Act of 1996 (HIPAA) its privacy, security and transactional regulations. Most medical billing software made available today is HIPAA compliant, as it is the only standard method for claiming one's insurance. What are the features that are seen in such software?
  • We can send claim to all payers and receivers
  • Increase in data accuracy
  • No delay in claim due to paper work
  • Reduced rejections
  • Integrates with accounts receivable
  • Increases collection
  • Reduces waiting period for receivables
  • Ideal for clinics and hospitals
  • HL7 interface
  • Free/paid Updation
  • Technical support
Thus we see that HIPAA standards have redefined the way we handle the coding, security, insurance reimbursement and the patient's information and care. When choosing a billing software care must be taken to see that free revisions of the software is provided free by the vendor so that the program does not become obsolete especially because frequent changes take place every year with better technology. Transfer of all patient information has also to be done in a very strict and highly secure manner.

When was the HIPAA regulation implemented? Well even though it did take effect in February 2003, only by April 2005 did it actually become mandatory. HIPAA has very clear definitions against unauthorized retrieval and storage of patient's electronic data, and about provision for emergency access to data.

Outsource Strategies International (OSI) is a US based outsourcing services provider company that offers affordable services in medical transcription, medical coding and medical billing.

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posted by Outsource Strategies International @ 8:51 PM Go to HIPAA and Medical Billing Software



Health Level 7 and Medical Coding

Sunday, January 20, 2008

What is Health Level 7 or HL7? Well, in the health care sector we know standards are very important. The American National standards Institute (ANSI) has accredited many Standards Developing Organizations and HL7 is one of such international community of healthcare subject experts and IT scientists who create standards for the exchange, management and integration of the EHR (Electronic Health Record). This is a not-for-profit volunteer organization that promotes the increased use of standard within and between the health organizations. As a result of such implementation everyone gets benefited and it increases the effectiveness of the total health care.

HL7 is more about clinical and administrative data. The term "level seven" refers to the highest level of the International Standardization Organization (ISO) communications model for Open Systems Interconnection (OSI) - the application level. Historically there was no proper integration / communication between a health care management information system and the electronic medical records. Using the process of coding of medical records for claiming, to government and commercial insurers, it is mandatory that all information must be referenced or copied into from a physician authored document.

Today's XML documents that are compliant with Health Level Seven's (HL7) clinical document architecture (CDA) do provide the missing link between healthcare information management (HIM) and the electronic medical record (EMR) domains, improving the processes of medical coding and abstracting, and provides for great accuracy during the insurance claims process enabling quick reimbursement.

More details on HL7 is at http://www.hl7.org/about/hl7about.htm

For affordable outsourcing solutions in medical coding, medical billing and medical transcription call the Oklahoma based OSI (Outsource Strategies International).

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posted by Outsource Strategies International @ 8:16 PM Go to Health Level 7 and Medical Coding



Avoiding Problems in Medical Billing

Wednesday, December 26, 2007

What are the problems that can happen with medical billing? As the medical and health care expenses are rising by the day, it is very essential to plan ahead for unexpected health care bills. If the clients are not careful they may end up paying huge medical bills out of their pockets. The very purpose of taking medical insurance is to avoid such burden of unexpected medical expenses which can be devastating and may totally upset all personal / family plans.

Some of the common problems that you may encounter during the healthcare / medical billing are,
  • Overdue payments
  • Denied claims
  • Not good communication within the provider group
  • Errors in claims
  • Inaccurate coding
Medical bills have to be paid either by the patient, or by a third party payers, which is could be a private insurance company, a private managed care company, or a government insurance program such as Medicare. Whenever a claim is denied by the insurance company the billing company must find out the exact reason why it happened. The claim should be thoroughly checked to determine if any coding or other error has occurred.

Quite often, a portion of the care (co-payment or deductible) is to be paid by the patient, and the remaining amount gets billed to the insurance or managed care company. If the patients cannot pay the amount at one stretch, he or she can request for credit so that payment can be done over a period of time. Is interest charged for this extended credit? Well, it depends on the individual state credit laws.

A statement called the explanation of benefits (EOB) is received from the insurance company from where the payment is received and it has all details of the payment. All received payments must be endorsed with a rubber stamp. The physician or health care provider must be contacted and doubts clarified if there is any doubt about the diagnosis or service performed.

For highly professional medical billing/coding outsourcing services do contact the US based medical transcription company OSI (Outsource Strategies International).

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posted by Outsource Strategies International @ 11:19 PM Go to Avoiding Problems in Medical Billing



National Medical Biller's Day

Tuesday, December 25, 2007

AMBA (American Medical Biller's Association) has declared March 27, 2008 as the Medical Biller's day. AMBA has the goal to provide medical biller's association members with resources to enhance knowledge and skills, to develop new ideas and technology collectively, increase and realize true industry growth and leadership. See details at,http://www.webcom.com/medical/AMBA.htm

AMBA's Online Compliance and HIPAA Seminar can be taken at http://www.ambanet.net/compliance.htm

This medical billing association offers a totally unique concept and approach in networking, sharing of information and in building an association led by professional medical billers from across the US. Its National Advisory Board provides input, ideas and advice to AMBA leadership for the betterment of the association and the medical billing profession. AMBA also offers the Certified Medical Reimbursement Specialists (CMRS) an exam which is a voluntary, national credential for the medical billing profession.

Contact Outsource Strategies International (OSI) a US based medical transcription company that offers professional outsourcing services in medical billing, medical coding and medical transcription.

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posted by Outsource Strategies International @ 11:40 PM Go to National Medical Biller's Day



Medical Classification is Medical Coding

Sunday, December 23, 2007

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
What is the use of these medical codes? They are used to track diseases and quite useful for health insurance companies, government hospitals, worker's compensation carriers etc. Some of the other applications of these medical coding/ classification systems include,
  • Reimbursements
  • Statistical analysis
  • Epidemic surveillance
  • Knowledge based decision support
Here are the different types of medical classifications
  • 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
Outsource Strategies International (OSI) is a US based medical transcription company that is offering professional medical billing, medical coding and medical transcription services.

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posted by Outsource Strategies International @ 10:45 PM Go to Medical Classification is Medical Coding



Medical Billing and the PPO Plan

Friday, December 21, 2007

Medical billing is the process of collecting fees for medical services. A medical bill is also called as a claim that has to be collected from the insurance company. There are different types of insurance plans. What is the PPO plan? PPO stands for Preferred Provider Organizations and is today one of the most preferred kind of health care plan. More than 50% of the Americans have chosen to go for the PPO plan. Its popularity is because PPO is a system where doctors and hospitals, have made an agreement with the insurance companies to offer discounted fees to the company's members.

Main advantages of PPO plans include,
  • Not mandatory to maintain a Primary Care physician
  • Can directly see a specialist without referral
  • Freedom to choose own doctor / hospital
The main advantage of going for a PPO plan is that while here you can choose a health service provider from outside the provider list, in a HMO (Health maintenance organizations) the insurance company does not pay for out-of-network services. However one must remember that more freedom will means more expensive medical bills.

There are many types of PPO plans and actual benefits will depend on different factors like,
  • Monthly premium amount
  • The amount of coinsurance obliged to pay
  • Whether treatment from the network/ outside
  • Annual deductible amount
For availing professional outsourcing solutions in medical coding, medical billing and medical transcription do contact Outsource Strategies International (OSI) a US based medical transcription company.

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posted by Outsource Strategies International @ 8:15 PM Go to Medical Billing and the PPO Plan



Medical Coding / Billing: General Duties and Jobs

Tuesday, December 18, 2007

What are the duties that professional medical coding or medical billing professionals do? Following are some of the duties that may have to be handled by them.

  • Insurance benefits presentation to patients / clients
  • Administrative work / bookkeeping
  • Completion of claim forms
  • Medical billing procedure handling
  • Signature verification
  • Data entry
  • Supervision work
  • Adhering to the insurance carrier's policies and procedures
  • Software based medical data/charts analysis
  • Interaction with healthcare providers
  • Billing work of insurance companies
  • Documentation using the right medical terms
  • Scheduling appointments
What are the different jobs and designations that medical coders / billers can get? Depending on the type of work specialization and the employer, these are some of the different job titles the qualified medical coders/ billers work may work under.
  • Billing Specialist
  • Patient Account Representative
  • Electronic Claims Processor
  • Billing Coordinator
  • Coding Specialist
  • Health Information technician
  • Claims Analyst
  • Reimbursement Specialist
  • Claims Assistant
  • Professional Medical Collector
  • Claims Processor
  • Claims Reviewer
Outsource Strategies International (OSI) is a US based outsourcing company that offers professional yet quick and cost effective solutions in medical billing, medical coding and medical transcription.

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posted by Outsource Strategies International @ 9:11 PM Go to Medical Coding / Billing: General Duties and Jobs



Medical Coding / Billing and H.C.P.C.S

Medical coding/ billing is today one of the 10 fastest-growing allied health occupations. Medical coding and billing professionals are responsible for submitting the proper documents to the various insurance companies and federal agencies for reimbursement of the medical expenses. Medical coders use special codes to specifically identify outpatient and also inpatient procedures / services and this is very useful for billing of both private as well as public insurance companies.

HCPCS stands for Healthcare Common Procedure Coding System. It is a set of health care procedure codes based on the American Medical Association's Current Procedural Terminology (CPT). See the official website of HCPCS at http://www.cms.hhs.gov/MedHCPCSGenInfo

Established in the year 1978, HCPCS provides a standardized coding system for describing the specific items and services provided in the delivery of health care. This type of coding ensures that insurance claims are processed properly and is needed by Medicare, Medicaid, and other health insurance programs.

HCPCS codes exist in two levels.

  • Level I is numerical and consists of the American Medical Association's Current Procedural Terminology (CPT)
  • Level II codes are alphanumeric and meant for non-physician health services.

It is very essential for medical coders to keep in touch with the latest codes and changes. This is possible by the use of HCPCS books that contain the complete lists of HCPCS Level II codes with descriptions and guide the medical coder through current modifiers, code changes, additions and deletions.

Outsource Strategies International (OSI) is a US based medical transcription company that offers outsourced services in medical coding, medical billing and medical transcription for clients in the US and worldwide.

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posted by Outsource Strategies International @ 7:45 PM Go to Medical Coding / Billing and H.C.P.C.S



Common Medical Billing Problems

Monday, December 17, 2007

Whenever there are problems during a medical bill claim it becomes quite embarrassing leading to stress for the client and others. Hence it is best to avoid mistakes right from the beginning itself. Medical billing and collection errors do occur due to oversight or even incompetence. Some of the common mistakes that cause problems in the medical billing process are listed below.
  • Bills are confusing and difficult to understand
  • Not consistent billing cycle
  • Double billing/ overcharges
  • Charges for services not given
  • Time constraints
  • Credit card payment problems
  • Not well filed insurance
  • Disputed outstanding bills
  • Problem with billing network
  • Medical billing software problems
  • Denial of care to prepaid insurance coverage
  • Taking out very old bills
  • Denial of care to children of parents with outstanding balances
  • Improper collection practice
  • Wrong place, person, address
  • Balance owed overlooked
  • Failure in credit payment
Outsource Strategies International (OSI) is a US based medical transcription company that offers professional services in medical billing, medical coding and medical transcription.

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posted by Outsource Strategies International @ 9:42 PM Go to Common Medical Billing Problems



Medical Coding: Live Audio Conference on 2008 Updates

The American Academy of Professional Coders (AACP) is now offering audio conferences with various topics throughout the year. Professional coders can get coding education from a qualified presenter while obtaining CEUs (continuing education units) online. During each session one can listen and also interact with the presenters. Each session is worth 1.5 CEUs.

Upcoming schedules:

  • December 18th 2007 (Radiology Coding)
  • December 19th 2007 (Opthalmology Coding)Update

December 18, 2007 (2008 Update Radiology Specialty Conference)

What will the update cover?

  • Can get the skinny on new codes and the latest on the federal government's OIG work plan, fee schedule issues, and instructions on new modifiers for 2008 all targeted to the important 2008 coding and compliance issues of radiology.
  • Highlights on the 2008 CPT® and 2008 ICD-9-CM changes.
  • For CPT® 2008, there are 242 new codes, 298 revised codes, and 364 deleted codes. These code changes must be implemented by January 1


CPT

Understand the latest CPT code and modifier updates that are specific to radiology with instructions for successfully implementing them into your practice. Learn how these changes will affect your organization, and how you can prepare effectively.

HCPCS Level II

Successfully implement the Medicare rules for new and revised HCPCS Level II codes. BONUS: We also cover ICD-9-CM

Find out how the ICD-9-CM changes (effective Oct. 1, 2007) will alter the way you code and how it affects your reimbursement.

Details on the Ophthalmology conference scheduled for December 19th can be seen at http://www.aapc.com/onlinestore/item-details.aspx?pid=5140&id=141

Conference registration forms can be accessed at http://www.aapc.com/documents/Workshop_Audio%20Reg.pdf

AACP Membership details are at http://www.aapc.com/membership/index.aspx


Outsource Strategies International (OSI) is a US based medical transcription company offering professional solutions for medical billing, medical coding and medical transcription outsourcing.

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posted by Outsource Strategies International @ 6:58 PM Go to Medical Coding: Live Audio Conference on 2008 Updates



Outsourcing Medical Work

Thursday, December 13, 2007

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.

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posted by Outsource Strategies International @ 6:36 PM Go to Outsourcing Medical Work



Medical Billing Career

Wednesday, December 12, 2007

Medical billing is the process of submitting claims to insurance companies and following up to receive the payment for various speciality health services rendered by a health care provider. Medical billing is in itself a specialty area of work and professional medical billers are real experts at claim reimbursements.

Now if you are thinking of becoming a medical billing person, the foremost thing to do is to try and know a bit about the profession, the required skills and abilities and also determine which medical speciality area is preferable to you. It is also essential to know about medical transcription and the medical billing software.

All billing work can be outsourced to professional medical billers who will coordinate between the patient and the health providers/ doctors anytime during the claims process. Transcription work is usually outsourced to some third party who will be from a different location. It is the billing software that links the actual billing and the electronic documents and transcripts that are transcribed from audio recordings by the medical transcriptionist. All health service aspects have specific medical codes. The medical billing personnel must be familiar and also an expert in record keeping. He must also familiarize himself with the various medical codes besides being at ease with various other healthcare standards and certifications.

Medical billing professional can take the CMRS (Certified Medical Reimbursement Specialists) exam which is a voluntary, national credential for the medical billing profession. The CMRS designation is awarded by the Certifying Board of the American Medical Billing Association.For more details go to the AMBA (American Medical Billing Association ) website at, http://www.ambanet.net/AMBA.htm

Outsource Strategies International (OSI) is a US based medical transcription company that offers professional yet affordable services in medical billing, medical transcription and medical coding.

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posted by Outsource Strategies International @ 10:21 PM Go to Medical Billing Career



Medical Transcription and Drug Reference

Medicines and drugs are an integral part of mainstream western allopathic medicines that are consumed around the world. A medical transcription professional who daily transcribes the physician's or any specialist doctor's dictations may come across prescription of drugs both old and new. A medical transcriptionist has to be aware of the latest drugs introduced in the concerned market and this can be done with the following pharmacology (drug) reference books which should always be a part of his library.
  • Physician's Desk Reference (PDR)
  • American Drug Index (ADI)
  • Saunders Pharmaceutical Word Book
  • Understanding Pharmacology
Whenever a transcriptionist comes across a new drug name he must know how to search for it and become familiar with the drugs, their indications and dosages. Being up to date can save a lot of search time. Remember, good productivity in transcription is a critical factor as payment is usually made on a per line basis.

While a drug's trade name or brand name is selected for its appeal to prescribing physicians, the generic drug can have several trade names, each copyrighted by different manufacturers. While transcribing drug names these are some of the main factors that should be kept in mind by the transcriptionist.
  • Generic names are always in lower case
  • Trade names start in capitals and can have internal caps as well
  • PDR (Physicians' Desk Reference) is for prescribed drugs
  • Separate publication for non prescribed drugs
  • Drugs can sound similar but be totally different in spelling and usage
  • Do not capitalize words like tablet / capsule / solution / cream etc.
Outsource Strategies International (OSI) is a US based medical transcription company that offers professional yet affordable outsourcing services in medical transcription, medical coding and medical billing.

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posted by Outsource Strategies International @ 8:51 PM Go to Medical Transcription and Drug Reference



Medical Outsourcing Services

Tuesday, December 11, 2007

In the US outsourcing is a popular term and so is globalization. After the popular term BPO (business process outsourcing) it is medical transcription, medical billing and other types of medical outsourcing that are the major outsourcing areas. Outsourcing of non core areas of a business is very beneficial and allows one more time to focus on the more important and core aspects of the business.

Medical outsourcing services offshoring to Asian countries like India has become very convenient for the medical practitioners and professionals. Not only are they free from a lot of hassles but also can save time and money.

What are the assured advantages with medical outsourcing?
  • Reduction in cost
  • No cutting of services to current clients
  • More time for essential work
  • Professional/accurate service
  • Low turnaround time
  • Saving precious time
  • Reliable work on time
Medical transcription is a process to translate into digital text the voce dictated patient histories and medical treatment records they receive from medical firms requiring good listening skills.

Developing countries like India, and then Philippines have the advantage of having a large pool of English speaking graduates who can deliver consistent service with high accuracy levels. Besides medical transcription, some of the other services are billing, claims processing, and coding, as well as remote medical and medical help desk services and amount to two hundred billion dollars a year globally.

Further the advantageous time difference and low wages in these countries make the services very attractive to the average American. Many companies even establish a company branch in the chosen Asian country to get good qualified and inexpensive workers.

A more recent development of medical outsourcing is seen in the area of drug testing where major pharmaceutical companies chose to test their drugs in India because of the availability of enough educated doctors and patient volunteers.

Outsource Strategies International (OSI) is a US based medical transcription outsourcing service provider offering cost effective services in medical transcription, medical billing and medical coding.

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posted by Outsource Strategies International @ 10:32 PM Go to Medical Outsourcing Services




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