June 22, 2013

What is Medical Billing Coding and its Main Responsibilities

Learn what is Medical Billing and Coding, What are Medical Billing main responsibility and benefits to the doctor as well as patients.

Medical Billing and Coding is an essential part of the modern healthcare system, responsible for transforming patient diagnosis and procedures into alphanumeric and numeric codes. The transformation of the procedures into codes requires some level of training to accurate and effectively document the patient procedures and diagnosis with proper Medical Coding, in order to claim payments from Health Insurance.

What is Medical Billing Coding and its Main Responsibilities

What is Medical Billing and Coding?

When patient go to the doctor, there is a lot that happens behind the scenes that will eventually lead to the doctor getting paid. If patient is paying directly without any insurance being involved, getting payment is a very easy for doctor. However, with the involvement of single or multiple insurance, like i most cases in United States, the payment process gets complicated for the doctor.

This is where understanding what is medical billing and coding comes in. Basically medical billing and coding is the process of submitting claims to insurance companies and then waiting for a response from these companies. If they don’t respond, the person who submitted the claim needs to contact the insurance company for a follow up. Which is usually done by a Medical Billing and Coding specialist, simply called Medical Biller.

Medical Billing and Coding main Responsibilities

Medical billing and coding as a study field is an essential field for those people who do not want to spend lots of time in school but want to earn a sizable amount of income. Medical coders ensure correct classification of patient diagnosis and procedures into codes that can be used by insurance companies for the billing purposes. The most important codes used in medical coding are CPT codes and ICD codes.

CPT Codes or Current procedural or Terminology is used for the recording of all the visits that a patient makes to a health facility up to brain surgery. International Classification of disease codes ICD on the other hand are used to identify the problems for which the patients were diagnosed. For insurance claim forms medical coders are usually required to use a combination of both CPT and ICD codes to make claims.

Ones a patient visits a medical facility, history is recorded classifying all the diagnosis and procedures performed. After all this is performed medical coders begin their operation by assigning numerical codes to each diagnosis and procedures and then use a relevant software to determine the amount of money a hospital or clinical ought to be reimbursed. As a medical coder one does not necessarily need to interact with patients as he or she only deals with the recorded procedures and diagnosis. This field requires people who are organized able to work through huge chunks of papers

Accuracy in the assigning of the numeric and alphanumeric codes is of utmost importance in this case. This is for the sole reason that thousands or millions of dollars can be involved with each transaction. It is also essential for medical coders to abide by the ethics rules as patient medical records are usually private. Failure to do is always sure to guarantee prosecution. It is also vital for medical coders to ensure that all the medical codes meet the insurance legal and federal regulations to ensure for accurate payments.

Whats is Medical Billing and Coding Specialist?

Now, when you understand that Medical Billing and Coding is the process of filing claims with insurance and following up with them. Some people find it a very good profession. They get Medical Billing Education and/or Medical Billing Certifications and then decide whether they should be self-employed and start a Medical Billing Home Business or search Medical Billing Jobs to work directly for a clinic or hospital, as a Medical Billing and Coding Specialist.

Becoming a Medical Billing and Coding Specialist alternatively called Medical Biller or Medical Coder, requires a firm grasp of the various medical terminologies and the relevant codes that ought to be assigned to them. In combination, a prospective medical coder ought to posses the highest levels of computer skills able to peruse through huge chunks of data. Communication skills are also important in this case.
  • Medical Insurance Claims Submission

    Claims are either submitted in paper form that are mailed or emailed through electronic forms or files that are sent to a clearinghouse over the internet. Medical Insurance Claims must be completed in compliance with insurance carrier’s guidelines.

    Different companies have different requirements, so a specialist needs to know what is billing and coding procedure for each company to avoid payment denials for incomplete or improper information.

    Along with personal information about the patient, claims also include up to six diagnostic codes that are relative to the most pertinent diagnosis that are being treated, and treatment codes that define what services the patient received. More than one date of service can be included on a single form.

  • Heath Insurance Payment Posting

    Payments were generally received in postal mail in the form of a cheque or pay orders. Now days, insurance carriers has started to generate automatic electronic transfer deposits into practice accounts.

    An explanation of benefits is sent under separate cover or can be viewed online, depending on what is medical billing and coding policy for the company. The explanation of benefits outlines what the cheque is specifically paying, including the patient’s name, date of service and service codes that have been paid.

    Insurance companies pay a standard rate for each service that is agreed upon in the contract signed by the practice. Amounts charged above the agreed upon rates are written off, meaning the practice cannot charge the patient for the balance. Insurance payments are applied to the patient’s account, as are payments received directly from the patient. Statements are sent by the billing and coding specialist to collect balances due from the patients.
However, there are few difference between Medical biller and Medical coder in terms of a job position. Larger hospitals and clinics often employ billers and coders separately due to the volume of work accumulated on a daily basis. Small establishments and individual doctors’ offices usually will have one person doing both tasks simultaneously.

Medical coders use classified Medical Billing Softwares to assign the relevant numeric and alphanumeric codes to the relevant procedures and diagnosis that patients undergo in healthcare facilities. One of this software is DGR which is used by insurance company to determine the amount of money they need to reimburse to healthcare facilities for service rendered to their clients.

Professional medical coders can earn as low $46,000 in a year and are usually employed by hospitals, physician groups or private medical insurance companies. According to Salary.com and HR Data statistics, a Medical Biller Salary in NY can go around $32,236 to $56,000 annually. However, it is not a rosy job as severe penalties can be incurred or fined due to incorrect coding.

Medical Billing Coding Advantages

Medical professionals may use different terms for the same illnesses, medical coding is thus used to enable the standardization of this medical procedures and diagnosis.

Medical Billing Coding creates uniformity for procedures and services for proper reimbursement and reporting.Reimbursement is made easy and faster by the use of the medical codes which insurance companies are able to read and interpret easily for reimbursement purposes.

Medical Billing Benefits for Patients

Without Medical Billing Specialist, medical practices would not receive payments from insurance companies for services rendered. Instead, they would be forced to charge patients directly, who would in turn be responsible for trying to get reimbursement from the insurance carrier.

In other words, Medical Billing Specialist helps physician and patient in a way that both doctor and patient could focus less on insurance reimbursement worries and more on the healthcare and well being of patient.

June 15, 2013

Best Psychiatry EMR/EHR Software Systems

Electronic medical records (EMR) and electronic health records (EHR) are both used for the safe storage of patient medical information. They may look the same but are completely different in terms of the information stored in them and the people who can have access to them.

Last month we have brought to you the reviews of best Psychology Billing Softwares for Mental Health Practices. This time, lets checkout Best Psychiatry EMR Software Systems in accordance with EMR Mandate 2014, Meaningful Use Program and latest Healthcare IT Standards in the United States.

Given the excellent EMR Benefits, one can easily conclude that using a Electronic Health Records or Electronic Medical Records System produces a very positive outcome in the long run. The performance of your workload as a health care provider will increase, as you can focus more on the the actual patient services.

Best Psychiatry EMR/EHR Software Systems

EMR’s are essentially used for the continuity of care and provide information for treating a patient from one provider to another. EMR’s make up legal record for patient treatment within a health care provider. EHR’s on the other hand are used to compile patient information overtime ones collected from various sources. One can be able to access EHRs records from anywhere unlike EMRs which tend to have restrictions on accessibility.

EHRs are also used to provide other information other than patient care such as billing research and quality management as well as public health reporting and research. EMRs records have strict access regulations depending on the kind of information recorded on them. Access of EMR can be denied if the information stored in it can cause further harm for anyone who wants to access it.

Best Psychiatry EMR/EHR Software Systems

Psychiatry Electronic Medical Records and Electronic Health Records software’s are specifically designed for psychiatrists to record specific Psychiatric content as well as specific workflow.

What is Psychiatric?

Psychiatry is the medical specialty devoted to the study and treatment of mental disorders, including various emotional, behavioral, cognitive and perceptual. The term was coined by German physician Johann Christian Reil in 1808. It literally means "the medical treatment of the mind". A physician specializing in psychiatry, is a psychiatrist.

What is Mental Health?

Mental disorders are now thought of as disorders of the brain circuitry is likely due to develop mental processes evolved a complex interaction of genetics and experience. In other words, the genetics of mental illness can be the genetics of brain development, the different results, depending on the possible biological and environ mental factors.

Mental illness refers to a wide range of mental health problems - problems that affect mood, thoughts and behavior. Some examples of mental disorders are depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviors.

Many people have mental health problems from time to time. However, a mental health problem becomes a mental illness where the signs and symptoms often cause stress and affect your ability to function. Mental illnesses can make you miserable and can cause problems in daily life, such as the workplace or in relationships. In most cases, symptoms of mental illness can be controlled with a combination of medication and counseling (psychotherapy).

The best psychiatric EHRs/EMR software should have the following features:
  • GAF Chart
  • Ability to highlight the degree of severity of psycho social factors
  • Medication Management
  • Physical Exam
  • Medical health intake
A top Psychiatric EMR/EHR software should contain the following templates:
  1. Depression
  2. Emotional Disorder
  3. Delusional Disorder
  4. Anxiety
  5. Antipsychotics Med
  6. Personality Disorder
  7. Schizophrenia
  8. Suicide
  9. Vertigo

Top Psychiatry EMR/EHR Softwares

The following are some of The best Psychiatric EMR and EHRs software that psychiatrists can use:
  1. A+ Delphi Psychotherapy Software

    A+ Delphi Psychotherapy Billing Software is affordable EMR software specifically designed for mental and behavioral health. It is perfect for small practices as it can store lots of information and provides easy access. The software is often installed on premise and is perfect for billing.

  2. Valant Psychiatric Electronic Record

    Valant Psychiatric is an EMR billing and scheduling system that is designed essentially for psychiatrists. The software can also be used for psychologists as well as therapist or other mental health related professionals. This is web based Psychiatric software that is certified and highly affordable.

  3. Epitomax EHR/PM by PsyTech Solution

    Epitomax Psychiatry EMR is a web-based EMR software by PsyTech Solution, best for both midsized and large mental health providers, it can be used by behavioral health providers. Epitomax unlike other psychiatric software’s comes with additional advanced features like prescribing patient portals and custom templates.

  4. Compiling Psych Advantage

    Compiling Psych Advantage is the only fully customizable Electronic Health Record and practice management solution designed for all mental health issues. This software includes all the essential templates as well as integrated e-Prescribing scheduling and many more.

  5. Med iTouch Electronic Health Record

    Med iTouch Psychiatry EHR is an affordable web based software solution that is suitable for all Psychiatric solutions regardless of size. It is fully customizable software that comes with high levels of ease of use as well as sleek system functionality.

  6. CAM by Celerity

    CAM is affordable Psychiatric software by Celerity that is web based and perfect for Electronic Medical Records. It comes with deep roots in practice management and mental and mental health. It is essentially useful for a psychiatrist who is providing psychiatric advice as well as substance abuse care.
The National Health Information Network sets up a set of standards and policies of which all Electronic Health Records and Electronic Medical record software are always required to adhere to. It also sets up policies on transmitting electronic health information.

June 8, 2013

Echocardiogram CPT Codes Changes 2013

EchoCardiogram is a painless procedure that cardiologists usually perform by the use of ultrasound procedures to produce a clear image of the inside of a patient’s heart. Echocardiogram CPTs changes are a part of new Cardiology CPT Codes 2013.

Echocardiogram procedure is highly essential in instances where accurate examination is needed of the inside of the heart. Echocardiography diagnostic tests use high-frequency sound waves (ultrasound) to view the inside and outside of the heart, the pericardial sac that surrounds the heart, and the major blood vessels adjacent to the heart. The sound waves travel through the body and bounce off the tissues inside. The echoes from these waves are translated into an image on the display screen and stored as a permanent record. Echocardiography performed with a device that does not provide a permanent image may not be reported as an echocardiogram.

It is a test that is usually carried out to check the exact functioning of the heart by essentially looking at the chambers, valves and the main arteries. This test is not for seeing coronary arteries as they are extremely small.

Echocardiogram CPT Codes Changes 2013

Echocardiogram CPT Changes 2013

The CPT codes for Echocardiogram have essentially changed as from the beginning of the year with new being in use for the sole purpose of accurate billing of the insurance companies.

Below is a summery of adjusted CPT codes for Echocardiogram are aimed at ensuring accurate reimbursement of all the Echocardiogram procedures that a patient undergoes at any medical facility:
  1. CPT 93306: Echocardiography transthoracic real time with image documentation (2D) includes M-mode recording when performed, complete with spectral Doppler Echocardiography, and with color flow Doppler Echocardiography.

  2. CPT 93307: Echocardiography transthoracic real time with image documentation (2D), includes M-mode recording when performed, complete with spectral Doppler Echocardiography

  3. CPT 93320: Doppler Echocardiography, pulsed wave and or continuous wave with spectral display (list separately in addition to codes for Echocardiography imaging) complete

  4. CPT 93321: Doppler Echocardiography, pulsed wave and or continuo’s wave with spectral display (list separately in addition to codes for Echocardiographic imaging); follow up or limited study

  5. CPT 93325: Doppler Echocardiography color flow velocity mapping (list separately in addition to codes for Echocardiography)

  6. CPT 93303: Transthoracic Echocardiographic for congenital cardiac anomalies

  7. CPT 93350: Echocardiography transthoracic real time with image documentation (2D), includes M-mode recording when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise or pharmacologically induced stress, with interpretation and report

  8. CPT 93015: Cardiovascular stress using maximal or sub maximal treadmill/bicycle exercise. Continuous electrocardiographic monitoring or pharmacological test

  9. CPT 93304: Transthoracic Echocardiography for congenital cardiac anomalies; follow or unlimited study

  10. CPT 93308: Echocardiography, transthoracic, real time with image documentation (2D) with or without M-mode recording; follow up or limited study`

  11. CPT 93312: Echocardiography transesophageal, real time with image documentation (2D) with or without M-mode recording including probe placement, image acquisition interpretation and report

  12. CPT 93314: Echocardiography transesophageal, real time with image documentation (2D) with or without M-mode recording including probe placement, image acquisition interpretation and report

  13. CPT 93320: Doppler Echocardiography, pulsed wave and/or continuous wave with spectral display (List separately in addition to codes for Echocardiographic imaging)

  14. CPT 93321: Doppler Echocardiography, pulse wave and/or continuous wave with spectral display (list separately in addition to codes for Echocardiography imaging); follow up or limited study (list separately in addition to codes for Echocardiographic imaging)

  15. CPT 933025: Doppler Echocardiography color flow velocity mapping (list separately in addition to codes for Echocardiography)
Some of the CPT Echocardiography codes look similar but greatly differ in terms of the payment structure they come with.

June 2, 2013

Mental Health Billing and Psychiatry CPT Code Changes

For Mental Health care billing codes, there have been major changes in Psychiatry CPT Coding in 2013, thereby considerably changing the billing and documentation for all insurances.

The Psychiatry CPT Code Changes have brought huge distinction between initial evaluation of medical services done by a physician 90792 and evaluation done by a non Physician 90791.
Mental Health Billing and Psychiatry CPT Code Changes
Psychotherapy codes have been simplified and expanded to include time with both the patient and/or family member. In 2013 there will only be three timed codes to be used in psychotherapy (90832-30minutes; 90834-45minutes; 90837-60minutes).

Mental Health Psychiatry CPT Changes

According to Mental Health Billing and Psychiatry CPT Code changes, whenever psychotherapy is done in the same encounter as an E/M service there will be timed add-on codes for the psychotherapy that will be used by psychotherapist to indicate both services were provided; the codes to be used in this case will be (90833-30minutes, 90836-45minutes, and 90838-60minutes).

The only CPT codes that are not changing are:
  • 90845 Psychoanalysis
  • 90846 Family Therapy-Patient not present
  • 90847 Family Therapy-Patient Present
  • 90849 Multi-Family Group Treatment
  • 90853 Group Therapy
The time for each psychotherapy will be described as being time spent with the patient or family member in contrast to the previous psychotherapy code times which only denoted time spent face to face with a patient.

Psychiatry add-on CPT Code

There is an add-on code that will cater for scenarios where a patient encounter is made more complex by the involvement of other people other than the patient (90785). This add on code will be used with initial evaluation codes (90791 and 90792).

This code is expected to be used more often with children. There is an interactive manual that clearly stipulates what constitutes an interactive complexity. This code should be followed with a documentation to clearly indicate the complexity at hand.

Psychiatric CPT changes for 2013

90839 is another code that has been added in the Psychiatric CPT changes for 2013. This code will essentially be used whenever an encounter goes beyond the maximum 60 minutes.

The add-on code for each additional code in this case will be 30 minutes. This code was developed upon a request by the National Association of social workers. Psychiatrists will use this code when administering high level evaluation management. There is a manual guideline that clearly stipulates how this code should be used and when it will be used

Psychotherapy Medication CPT Codes

Code 90862 has all but been faced out and psychiatrists in this case will be required to use appropriate evaluation and management code whenever they perform pharmacological management of the patients.

A new add-on code has +90863 been added in the CPT psychiatric that will solely be used for medication management whenever a psychotherapy is done by a psychotherapist.

Some of the changes that are to be seen in the CPT Psychiatry include:
  1. Removal of evaluation and management (E&M) plus psychotherapy codes from the psychiatry section (90805, 90807).
  2. Deletion of pharmacologic management (providers to use appropriate E&M code).
  3. Psychotherapy and E&M services are distinguished from each other (time spent on E&M services is not counted towards psychotherapeutic services, and separate codes can be used in combination with one another).
  4. Inclusion of add on codes for psychiatry, which are services performed in addition to a primary service or procedure (and never as a stand-alone service).
  5. Addition of code 90785 for interactive complexity.
  6. New code for psychotherapy for a patient in crisis.
These CPT changes clearly stipulate that insurers including Medicare and Mediacaid cannot use codes that have been deleted by AMA. They can only make pricing and coverage decisions within the remaining and modified codes.