Medical Billing & Coding

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Medical Billing: How to Troubleshoot Issues with the 5010 Platform

As a medical billing professional, the transition to ICD-10 means working with and sometimes troubleshooting the 5010 platform. Experts have already identified problems associated with the 5010 transition [more…]

Medical Billing: Causes of Claim Denial under the 5010 Platform

As a medical billing professional, you may find yourself faced with claim denial under the 5010 platform. Every step that delays the claim also delays the payment. Possible causes of rejections or denials [more…]

How to Facilitate the Transition to ICD-10 for Medical Billing in Your Office

The transition in medical billing to ICD-10 WILL happen and it is essential you understand how to facilitate this in your own office. As you move toward ICD-10, remember that claim transactions are the [more…]

How to Prep Office Staff to Transition to ICD-10 for Medical Billing

As a medical billing professional, you will need to prepare your staff for the transition to ICD-10 that is coming. After the back end is ready to roll for ICD-10 [more…]

10 Medical Billing and Coding Mistakes to Be Wary of

Medical coders are obligated to do everything within their power not to make errors, but everybody makes mistakes. Ethical violations are serious, and by virtue of your coder position, you have access [more…]

Understanding Medical Billing and Coding Compliance

In the healthcare world, rules are referred to as compliance. Compliance simply means following the rules for billing and coding as well as patient confidentiality as established by the United States Office [more…]

Getting on the Path to Medical Billing and Coding Certification

The two primary certification organizations for medical coding are the American Academy of Professional Coders (AAPC) and the American Health Information Management Association [more…]

Walking in the Steps of a Medical Biller or Coder

The job of a medical biller or coder is to transform a patient visit into revenue. In order for this to happen smoothly, you must follow several steps. [more…]

Medical Billing and Coding Teamwork: Working with Payers

The revenue cycle of medical billing and coding requires teamwork in order to work efficiently. You may find yourself as the go-between for patients and their insurance companies. The patient [more…]

Accounts Receivable: The Medical Biller's Secret Ethical Weapon

When patients have trouble meeting their financial responsibilities or physicians fail to document, as the medical biller you may be asked to let payments slide or to go ahead and code an encounter that [more…]

10 Medical and Billing Acronyms You Should Know

The world of medical billing and coding is like one big bowl of alphabet soup. Just about any term that comes up in your daily dealings has a corresponding acronym. Every office becomes familiar with the [more…]

Billing Each Payer Correctly in Medical Billing and Coding

Most payers accept electronic claims, although some still require paper claims. It’s your responsibility to know which method will be accepted. This information is contained in the payer contract, but [more…]

Being Both Medical Biller and Coder

Although you often hear people refer to billing and coding in the same breath — they’re really two different jobs. After the coder has assigned the correct codes, the biller transforms the codes into a [more…]

Working As a Medical Biller and Coder in a Physician’s Office

Several different kinds of physician offices employ their own coders and billers. If you’ve seen someone buried under stacks of medical files as you take care of your copay in the doctor’s office, chances [more…]

Working As a Medical Biller and Coder in a Hospital

Working in a hospital may be busy and exciting, but it’s not always as dramatic as Grey's Anatomy, especially in the “back of house,” where billers and coders do their stuff. That said, working in a hospital [more…]

Working Off-Site As a Medical Biller and Coder

Working remotely — it’s a good gig if you can get it! Some offices allow medical coders to work remotely. If you work off‐site as a coder, you access the systems that contain the necessary documentation [more…]

Freelancing or Temping as a Medical Biller and Coder

A well‐seasoned medical coder may carve out a reputation that enables him to work on his own in a freelance or consultant capacity. As a freelancer, you may be hired by companies for particular projects [more…]

Advice for New Medical Coders

Working independently — whether you’re working off‐site, as a freelancer, as a consultant, or as a temp — isn’t a good idea for a novice coder. The liability for errors is too much of a risk to both you [more…]

What Medical Billers and Coders Need to Know About the CMS

The Centers for Medicare & Medicaid Services (CMS) is the home of two government healthcare programs: Medicare and Medicaid. Originally, Medicare was intended to provide healthcare to the elderly at the [more…]

What Medical Billers and Coders Need to Know About the OIG

The Office of Inspector General (OIG) was established in 1976 to oversee programs administered through HHS. Much of the OIG’s efforts focus on identifying waste, fraud, and abuse in Medicare, Medicaid, [more…]

What Medical Billers and Coders Need to Know About Individual Payers

When you hear the term individual payers, you may assume it refers to individuals, but it doesn’t. Individual payers are actually the insurance companies that provide group and individual coverage plans [more…]

Electronics Systems Used by Medical Billers and Coders

You need to distinguish between two types of electronic ­systems — Electronic Medical Records (EMR) and Electronic Health Record (EHR). An EMR is just a digital version of a paper chart. It is not accessible [more…]

What Medical Billers and Coders Should Know About HIPAA's Confidentiality Rules

The Health Insurance Portability and Accountability Act (HIPAA), passed by Congress in 1996, set a national standard for protecting health data and protecting the patient’s rights. HIPAA does more than [more…]

Endoscopic Procedures Medical Billers and Coders Encounter

Many surgical procedures that you code are performed through the use of scopes. This type of procedure is generally referred to as minimally invasive surgery [more…]

Open Surgical Procedures Medical Billers and Coders Encounter

Open surgery refers to traditional surgical procedures, which involve an ­incision made by a surgeon. Obvious differences exist between endoscopic and open surgical procedures from a coding position. The [more…]

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