Medical Practice Management Blog

MBA Medical Business Associates stays on top of the constant changes in technology, law, & information that affects your medical practice & the healthcare industry. Check our medical practice management blog here for updates.
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How to Bill for Flu Shots

Flu season will be here before we know it and that means that there will be an increase of patients coming into the doctor to seek medical care. Being prepared for the billing that will come with the influx of patient visits will help you stay on top of paperwork and process medical claims faster. Situations from practice to practice can be different, so be sure to check the flu vaccine codes that range from 90654-90668 to see which code is most appropriate for the patient. Here are some of the basic facts to know about billing for flu vaccines.
Insurance Coverage and Copay’s

What’s the Difference Between Coinsurance and Copay?

There are plenty of people who mix up the terms coinsurance and copay. Another term to throw into the mix is deductible. While all three terms refer to the portion of the medical bill patients are responsible for paying out of pocket, there are some differences between them.
Innovation

How Are Medical Billing and Coding Different?

Medical billing and medical coding are two related fields. People who work in these fields are required to use similar skills but there are different methods used in each job. Many medical billers can be medical coders, and vice versa, simply because the skill sets will overlap.
Receptionist Greets Patient

5 Medical Billing Questions You Never Knew to Ask

Staying up-to-date with the inner workings and changes of medical billing is important. The medical industry is always advancing, so staying well informed is key to ensuring that your office will run smoothly with fewer denied claims.  Some information is more important than others, so here we’ve covered what medical billing questions you should ask.

What is Revenue Cycle Management?

Revenue Cycle Management (RCM) by definition refers to administrative and clinical functions that support capturing, managing, and collecting revenue from patient services. This process encapsulates the way in which revenue cycle processes flow and affect each other. In order for the cycle to perform in a predictable and sustainable manner, each process must be performed correctly. For this reason, preventing early problems in the cycle can go a long way to avoiding significant issues down the line, including those that would necessitate costly revenue recovery.

Terms Associated with RCM

Revenue Cycle Management features multiple terms specific to its functioning. The following can help you navigate RCM materials:

  • Charge Capture: At this stage, documented services are electronically or manually translated into billable fees.

  • Claim Submission: Using a universal claim form for payment, billable fees are submitted at this stage to the insurance company.

  • Coding: This includes the transformation of medical diagnosis descriptions and procedures into universal medical code numbers that can be processed by the insurance company.

  • Patient Collections: At this stage, patient balances are collected and payment arrangements made.

  • Pre-registration: Here, all registered information is collected, including eligibility, benefits, and authorizations, all prior to the patient arriving for procedures as an inpatient or outpatient.

  • Registration: At this stage, comprehensive data elements, required to establish a Medical Record Number, are collected. When correctly executed, this step satisfies regulatory, financial, and clinical requirements.

  • Remittance Processing: This term refers to posting or applying payments or adjustments to the assigned accounts, as well as rejects.

  • Third-Party Follow-Up: Here, billing specialists pursue collections from insurers after all initial claims have been filed.

  • Utilization Review: Finally, at this point in the process, the necessity, appropriateness, and efficiency of medical services and facilities, including regular reviews of admissions, length of stay, performed services, and referrals, are evaluated.

With these terms in mind, you’ll have a better understanding of the value of each step in the medical billing cycle.

 

Why Is Revenue Cycle Management Important?

Proper revenue cycle processes can prevent unnecessary loss of revenue through CMS-rejected claims, many of which will not be resubmitted if turned down. In order to make sure your office is implementing proper RCM practices, contact a medical billing company with a strong track record for maintaining exceptional procedures. At MBA Medical, we’re happy to answer any and all of your questions about billing procedures, training, communication, and workflow. We look forward to hearing from you – contact us today!

Guide: Accountable Care Organizations

Click here to download our Guide: "How Independent Practices Can Succeed in a Healthcare Industry Shaped by ACO Programs". If you would like more information you can Request a consultation.

Practice Management

  • Anesthesia Billing
  • Full-service medical billing
  • Patient account management
  • Encounter form design
  • Patient balance collections
  • Learn More

MBA In The News

Guide: Accountable Care Organizations

Click here to download our Guide: "How Independent Practices Can Succeed in a Healthcare Industry Shaped by ACO Programs". If you would like more information you can Request a consultation.

Practice Management

  • Anesthesia Billing
  • Full-service medical billing
  • Patient account management
  • Encounter form design
  • Patient balance collections
  • Learn More

MBA In The News

Contact

MBA Medical Billing Services, Inc.
P.O. Box 821350
Vancouver, WA 98682

866-622-2455 Toll-free
360-687-5221 Vancouver, WA

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