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Tag Archives: Patient

Pediatric Patient History – Who Can Take It?

Contrary to popular belief, it is safe practice to allow any office member to take the review of systems and the family social history. These two evaluation and management history elements can actually be taken by absolutely anyone. It is ok in medical billing for a parent or a secretary to take down this information as long as the information is reviewed and signed off on by the acting pediatrician.

The only part of an evaluation and management visit that the physician or nurse practitioner must complete for medical billing purposes is the history of present illness or the reason for the visit.

By allowing your administrative staff to complete some of the patient documentation, a practice can save time and money as it frees up the pediatricians and nurse practitioners to have more time for the actual servicing of the patients.

Another great way to save your practice time and money is to outsource your medical billing. Your medical billing partner will make sure your pediatric practice gets the maximum return and if you’re not using a medical billing company, you could be losing almost 30% of your medical billing revenue by simply not knowing how to get the maximum reimbursements that your practice is allowed for services rendered and general errors that occur when practices file their own claims.

Look into expanding the duties of your administrative staff and consider outsourcing your medical billing – the winners will be your patients and your practice!

The post Pediatric Patient History – Who Can Take It? appeared first on Outsource Management Group, LLC..

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Best Practices in Radiology Patient Billing

 Maximizing the patient experience is no longer limited to the achievement of clinical success. It is a critical component of the new, broader partnership between provider and patient – one that now encompasses conversations regarding not only service quality and cost, but also places a greater focus on practice billing processes in line with the higher demands inherent to the new patient consumerism trend.  

 


Radiology Billing and Coding Blog

Showing Patient Payments in CMS 1500 form


Most of the practices would collect copayments from the patient at the time service. Although it’s not a violation for participating providers to accept payment prior to rendering services, there are specific guidelines to follow, especially when reporting these payments.

Additionally, some providers who accept assignment have a concern that Medicare issues partial checks to beneficiaries. Such checks are generally issued because of a patient paid amount in item 29 of the CMS-1500 (02/12) claim form.

Here are a few guidelines to follow;

Medicare Part B recommends not to collect copay amounts prior to a claim being submitted to Medicare since it is difficult to predict when deductible/coinsurance amounts will be applicable (and over-collection is considered program abuse). So, it is recommended that providers not to do so until Medicare Part B payment is received.

If you believe you can accurately predict the coinsurance amount and wish to collect it before Medicare Part B payment is received, note the amount collected for coinsurance on your claim form. It is recommended that providers do not collect the deductible prior to receiving payment from Medicare Part B because, as noted above, over-collection is considered program abuse. In addition, this practice can cause a portion of the provider’s check to be issued to beneficiaries on assigned claims. 

Do not collect money from the patient for the preventive services for which copayment and coinsurance are waived. Please refer Preventive Services covered by Medicare.

Do not show any amounts collected from patients if the service is never covered by Medicare Part B or you believe, in a particular case, the service will be denied payment. Where patient paid amounts are shown for services that are denied payment, a portion of the provider’s check may go to the beneficiary.

There is no need to show a patient paid amount in item 29 of form CMS-1500 (or electronic equivalent) when assignment is not accepted.

Reference: https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c26.pdf


Coding Ahead

Infographic: Six Ways to Promote Patient Safety

Healthcare Associated Infections

Healthcare Associated InfectionsMinimize the Risk of Healthcare-Associated Infections

Healthcare-associated infections (HAI) are a significant concern for both patients and healthcare providers.

HAIs compromise patients’ treatment plans and recoveries — particularly for those who are post-op, have chronic health conditions, or compromised immune systems. HAIs, like C. diff and MRSA, are often difficult and costly to treat.

The Centers for Disease Control and Prevention (CDC) recently completed their National and State Healthcare-Associated Infections Progress Report. Here are their findings as well as six ways patients can minimize their risk of contracting HAIs.

Key Findings

One of the CDC’s goals is to implement policies and procedures that will stop the spread of HAIs. In doing so, there will be better patient outcomes and the burden on healthcare providers and facilities will be minimized.

For example, in 2011, there were approximately 722,000 HAIs in U.S. acute care hospitals, or the equivalent of 1 in 25 patients. About 75,000 patients who contracted an HAI died during their hospital stay.

The most recent report pooled 2014 national and state-level data from acute care hospitals. They evaluated the following types of infections:

  • central line-associated bloodstream infections (CLABSI),
  • catheter-associated urinary tract infections (CAUTI),
  • surgical site infections (SSI),
  • hospital-onset Clostridium difficile infections (C. difficile), and
  • hospital-onset methicillin-resistant Staphylococcus aureus (MRSA) bacteremia (bloodstream infections)

On a national level, there was a decrease in the majority of infection types. Between 2008 and 2014, the rates decreased by:

  • 50 percent for CLABSI
  • 17 percent for abdominal hysterectomy SSI
  • 2 percent for colon surgery SSI

Between 2011 and 2014, there was an 8 percent decrease in C. diff infections and a 13 percent decrease in MRSA infections.

Minimize Risks

Research has shown that healthcare facilities can minimize the occurrence of HAIs by strictly following appropriate best practices and guidelines. It’s been demonstrated that an estimated 70 percent reduction in infection rates is possible.

Additionally, patients should follow these six steps to protect against HAIs:

  1. Speak up. Ask your doctor or care providers how they are protecting you from infection.
  2. Keep hands clean. Make sure all healthcare workers cleans their hands before touching you.
  3. Get smart about antibiotics. Ask your doctor if testing will be done to confirm that the correct antibiotic is prescribed.
  4. Know the signs and symptoms of infection. Infections present differently – know the signs and symptoms of the most common ones.
  5. Watch out for deadly diarrhea. Report any ongoing episodes of diarrhea to your physician.
  6. Protect yourself. Avoid complications by opting to receive vaccinations for potentially life-threatening infections.

To see each state’s infection rates, check out the full CDC report. The CDC also released a handy infographic about preventing the spread of HAIs. You can find that below.

How did your state rate? What steps do you take to prevent HAIs? Please tell me in the comments below!

Healthcare-Associated Infections HAI

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This post Infographic: Six Ways to Promote Patient Safety was written by Manny Oliverez and first appeared on Capture Billing. Capture Billing is a medical billing company helping medical practices get their insurance claims paid faster, easier and with less stress allowing doctors to focus on their patients.

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