Almost 30% revenue loss results from billing errors. These errors are the common cause for claim rejections by insurance companies, aka payers in the US. Medical billing is much beyond just documentation; it is the very means of revenue generation. Since the maximum percentage of a physician’s income is from the payers, the billing process should be devoid of the following common errors.

1. Incomplete Patient Information

When it comes to detecting the loopholes in a business, it is best to start with the basics. It is necessary to check for silly mistakes while entering the name, date of birth, gender of the patient in the claims as errors detected by the payers will result in rejection.

2. Lack of Patient Verification

Lack of thorough patient verification process reveals potential chances for revenue loss. A complete verification should include verifying how many policies the patient has, the insurance policy number and its coverage, the allowance limit of benefits, checking for authorization of procedures, etc.

3. Date of Service and Timely Filing

It is true that a thing as simple as mentioning the correct date of service is important is often missed and becomes the cause of denial of reimbursement. Not only that, the claims need to be filed within a specific period from the date of service if physicians want the payment. Missing that deadline results in delay in getting reimbursed and often loss of revenue.

4. Erroneous Diagnosis/Procedure Code

The payers have experts on their panel to verify the authenticity of claims and cross check the CPT or HCPCS, i.e. diagnosis codes with the treatment rendered. In an attempt to get more out of the payers the billing staff often codes unauthorized procedures along with wrong diagnosis. One should be careful while using the modifiers too.

5. Duplicity/Fraudulent Billing

One of the most common malpractices for trying to get maximum reimbursement is fraudulent billing, i.e. billing for unperformed procedures. At times upcoding too falls into this category. The billing staff should be well versed with the latest coding standards to avoid coding the old way. Downcoding too is tricky and can harm revenue.

6. Following up with Payers

Lack of following up with the insurance companies for rejections tops the list of the most common medical billing errors that cause monetary loss for medical practices. Blame it on staff shortage, increased workload, predominant administrative tasks over billing, lack of time for being on call for every rejected claim, following up can help the inflow of cash.

7. Ignoring the EOB

It is crucial to go through and understand the explanation of benefits (EOB) issued by the insurers. Apart from making the rectification, it is also essential for avoiding those mistakes in future billing.

All these errors delay the reimbursement unnecessarily besides risking tarnishing of your practice’s image in case of repetitive errors. Seek help from a billing partner if need be to handle these issues and avoid these pitfalls to keep the cash coming in.

High medical bills are among the numerous reasons why people file for bankruptcy. This is often the case in various cities in the US. The reason is very obvious; There's a high cost of health care services all over the US and beyond. Medicare is never cheap yet, it's still something you can't do without. It's necessary for the maintenance of life. Medical bills can actually become very high that you may even lose hope of paying them off. If you find yourself in such a situation, filling for a bankruptcy is the best option you can take. It can easily help you to resolve issues regarding the medical bills and also help you to begin anew.

There are several options you can take when you decide to file for bankruptcy. You need to begin with the common types of bankruptcy that can be of help.

Chapter 13 Bankruptcy is one of the best options to go for. It allows an easy repayment plan for individuals. You can always benefit a lot from this type when you go for it.

Chapter 7 Bankruptcy is also another better option to go for. It's actually the most popular when it comes to medical bills. It's simply a straight or liquidation bankruptcy. It deals with the liquidation of an insolvent company and the onward distribution of any remaining assets. You'll also benefit from that when you know the details.

Chapter 11 Bankruptcy is yet another unique option for most people. It allows an insolvent company to be reorganized. It also offers the repayment of debts and the creation of brand new corporate entity.

Any of these types of Bankruptcy will always be of help when you check them out. It's also important you know a lot about credit card debt consolidation if you want to receive more help for dealing with high medical bills. You're sure to gain a lot from that when you discover the processes involved.

To be on a safer side, it's important you seek for proper guidance in filing for bankruptcy due to high medical bills. You need to secure a profitable bankruptcy advice from a reliable outfit. There are several bankruptcy lawyers out there who can as well help you. If you're able to arm yourself with useful pieces of information regarding bankruptcy filing, you'll always have a smooth ride when you go for the right type.

There are several options you can take when you decide to file for bankruptcy. You need to begin with the common types of bankruptcy that can be of help. Chapter 13 Bankruptcy is one of the best options to go for. It allows an easy repayment plan for individuals. You can always benefit a lot from this type when you go for it.

Medical malpractice is one of the most commonly recognized forms of malpractice. It refers to the breach of duty by the medical professionals (such as doctors, nurses, technicians, therapists, or hospitals) in providing a decent standard of care to the client and, in the process, cause damage, injury or loss to the client . In such cases of medical malpractice, the client has the right to sue the medical professional. But this is not possible for just any layman. He or she has to rely on an attorney or lawyer who is an expert in medical malpractice.

The client approaches a medical malpractice attorney reputed for his or her outstanding performance in the standard of care, competence and, most of all, an appropriate education. He or she is the one who has specialized in the type of case for which the client wants to sue the medical professional. For instance, if the case is pertaining to a damage caused due to the negligence of the doctor while performing a hip replacement surgery, the client takes the help of a specialist attorney in hip replacement cases. The attorney with his expert knowledge will study the case, estimate the compensation due to his client and tell if the case is worth being filed.

The law in medical malpractice checks for the reasonable standard of health care as provided by the medical practitioner. This standard of care is based on the services provided by similar professionals specializing in the filed of medicine in the same geographical location.

The attorney evaluates the medical professional under scrutiny on this standard of care. The medical malpractice attorney also takes into consideration the fact that some of the procedures involved in medical sciences are prone to unavoidable risks.

The attorney remains just to his or her client, maintaining ethical standards. As far as the attorney's fee is concerned, the client will pay a percentage of his or her settlement amount. If otherwise, the client gets exempted from making payment.

Aside from their routine duties, healthcare providers have to maintain notes for the record-keeping process and meet the HIPPA-compliance standards. Typically, small providers have an experienced in-house transcriptionist to take care of the recorded materials. In this article, we are going to take a look at the uses of medical transcription and why it's important to maintain accurate medical transcriptions. Read on.

Accuracy

Accurate medical records are quite important for primary care providers, physicians, and doctors. Since doctors need to treat patients on a daily basis, they need to maintain reliable medical records to get a better idea of ​​a patient's condition. This helps them choose the best treatment plan.

Collaboration

Even at small clinics, you may find more than one professional who takes care of medical records. For proper care, it's important to share important data of a patient with different specialists. This is even more important if a case is special and requires the assistance of more than one specialist. This is where the importance of a medical transcription comes. Different professionals need the medical records of a patient to ensure clear and concise communication.

Communication across the Facility

Doctors and specialists don't work with the patient directly. It's the nurses and other support staff who is responsible for taking care of a patient and giving them the required medicine. With the help of medical transcriptions, all of them will have access to the required information.

HIPAA Compliance

HIPPA stands for the Health Insurance Portability and Accountability Act, which revolutionized the medical record-keeping and its compliance across the US. These records make sure that proper care is given to each patient. Also, medical transcriptions are important in case of a lawsuit.

Insurance Purposes

For consistency, medical records are very important. Medical staff protects healthcare providers in case of legal battles and lawsuits. For every healthcare facility, it's important to maintain accurate and consistent medical records for proper operations.

Actually, medical records provide the basis so that the insurance provider could be billed. In other words, a medical facility can't get paid unless it provides accurate records.

Importance of Accuracy

Regardless of the size or complexity of a medical facility, we can't say that there is no importance of medical transcriptions. Even if you use the services of an in-house transcriptionist, you have to achieve 100% accuracy. If you don't, you may suffer from serious problems. In the worst case scenario, your medical licenses can be held.

If you want to maintain accurate and reliable records, make sure your team is trained and skilled. Even a small mistake may create dire consequences for your organization, which means you need to choose your medical transcriptions with great care.

Long story short, it's important for every medical facility to hire an expert transcriptionist to handle the medical records. As a matter of fact, medical records including medical transcriptions are much more important than the financial accounts of a medical facility. Inaccuracy in the medical transcriptions may cause the closure of a medical facility.

The term 'locking the stable after the horse has bolted' certainly applies to medical malpractice suits. Suing a medical practitioner for malpractice can, by definition, only happen after actual damage has been inflicted. Legally speaking, medical malpractice is a rather vast concept. However, the baseline definition includes areas such as wrongfully administered medical treatment, damages arising from a doctor's incompetence, and the resulting loss in terms of wellbeing and finance for the patient.

Derived from the Latin term 'mala praxis', medical malpractice is a legal area that holds the treating doctor responsible for deviating from accepted norms of medical practice by failure to ensure proper treatment parameters. A patient, while under treatment, is more or less a helpless spectator to the process and has no real control over it. Loss of health and finance resulting from incompetence or maliciously administered wrong treatment therefore puts a high degree of accountability on the treating physician. Medical malpractice lawyers specialize in zeroing in on this accountability factor and claiming damages for affected patients.

Malpractice claims depend on the nature of the event in question. Plain negligence on the part of the treating physician, though a serious matter, would probably not be dealt with as harshly in a court of law as wrongful treatment (via administration of medicine, surgery or other therapeutic measures). Problems arising out of a physician's incompetence or ignorance would entail a civil suit, while deliberate malice, if proven, would result in criminal charges against the doctor – and significantly greater restitution in damages for the patient. A good malpractice lawyer will evaluate a client's claim and attempt to secure the highest amount in damages from the offending medical practitioner.

It’s not news nowadays that healthcare providers are heavily outsourcing their medical billing services to professional companies to look after their medical billing and collections. A number of physicians, hospitals, nursing homes, urgent care centres, laboratories, DME companies, and other entities associated with the healthcare industry have realized the need for professional handling to regain focus on revenue recovery mainly through the reduction in operational costs.

There lies another challenge ahead – to find out the proper medical billing service, which can provide you with the solution you are looking at your budget. It is extremely important to research rigorously by self-defined parameters for selecting the desired service. However, some common factors that can be broadly considered essential for most healthcare providers can be discussed:

Points to Ponder

Some basic points that cannot be overlooked in your search for the desired medical billing assistance will include the following:

• Accurate and efficient service: Go for the medical billing services that can take the onus of all your billing collections – accurate, complete, and timely payment from the third party payers and patients through latest technology to attain maximum efficiency in the system.

• Excellent references: Revenue is the key focus and you need more business for that and for more business you need more references. Look for medical billing services that have enough experience and reputation to provide you excellent referrals from physicians.

• Expert coding: Coding is one of the most important aspects of medical billing in this time of EMR and EHR technology. Sought medical billing services that can provide you with the required expertise in ICD-10 coding. Due to an absence of certified and experienced coders in their in-house team, most of the practices suffer from common coding issues like:

o Unbundling: Unbundling involves listing of different billing codes for charging for services falling under one billing code. This results in bill getting inflated because the items that should have been billed as a package rate get billed separately.

o Balance billing: This coding error arises when the balance bill sent to the patient after the insurance company’s price negotiation with the care provider and all of the hospital’s charges are supposed to be covered under the patient’s policy.

o Duplicate Billing: Another common billing error, which involves multiple bills getting generated for the same procedures or services.

• Dedicated account management: Always prefer a service that provides you, experts, to dedicatedly look after your collections without any extra charge. The account managers should always be within your communication range to provide assistance during an emergency.

• Flexible services: Sometimes you might need a single service like prior authorization. Choose a medical billing service that can offer you standalone services as and when required and not charge for a whole package for RCM or other packages. It should also be flexible enough to work in both the electronic and manual platforms as per the requirement.

• Special edge: A great and a good medical billing service can be distinguished by the virtue of that ‘something special’ it offers. A great medical billing service can maintain a seamless healthcare management through cutting-edge services for the patients, providing your practice with the professional guidance it needs to complete a comprehensive end-to-end revenue cycle management. An experienced and reliable company can do the trick for you by achieving the seamless overall transitions from your time and cash stripped condition to making your practice revenue-healthy, up, and running.

Errors, both electronic and human can nag your practice from getting the desired result. Signing a really able medical billing service will provide you with the shield from those errors saving you unnecessary loss of time and money!

So many questions need not faze you because we are here to guide you on how to choose the best medical insurance plan based on your needs. What points should you consider while buying a medical insurance plan so that your plan comes in handy when it is most required? Let us take a look at the 7 short-listed key points which we think is the secret in choosing the best medical insurance plan for you.

# 1 – Decide on the type of plan

When buying a medical insurance plan, decide what type of coverage is required – individual or family floater. While individual insurance plan covers only you, a family floater policy is an umbrella policy that covers your family members in the same plan. An individual policy is ideal for you if you are a young adult and do not have dependent parents. At a lower premium, you can buy an individual insurance plan. A family man, on the other hand, cannot afford to insure only himself. His family, namely his spouse, children and even parents depend on him to foot their medical expenses. As such, he should invest in a family floater plan that will provide coverage to his dependent family under a single plan.

#2 – Adequate coverage amount

The next big decision is finalizing on the amount of coverage that should be availed. Currently, the cost of any treatment is high and with an ever rising trend of medical costs, these costs are expected to increase manifolds over the years. So, it is prudent to buy a plan with an optimal coverage amount which will be sufficient to take care of the medical costs as and when they accrue. However, the biggest impediment towards availing a higher coverage is the subsequent premium which becomes unaffordable for the common man. So what is the solution? Top-up plans available in the market is the answer to your question. These plans help in increasing the coverage at a low premium. So buy a regular medical insurance plan and supplement it with a top-up plan and you can enjoy a high coverage at lower costs

#3 – Consider the benefits or coverage provided

Every medical insurance plan comes with its own list of benefits also known as coverage. Most medical plans are hospitalization benefit plans. They cover expenses covered at the time of any hospitalization of the insured individual. While some of the points are universally available in all plans, others are included in some plans and excluded in others. The list of common benefits include hospitalization expenses which include room rent, ICU room rent, doctors visit fees, procedure charges, pre and post hospitalization charges, day care procedures and so on.

The other coverage options which are included at the discretion of the company include organ donor expenses, maternity and new born coverage, Ayush treatments, Ayurvedic and Homeopathic treatment expenses, etc. So, before buying a plan, consider the list of coverages that the plan provides or does not provide and see whether the coverages not provided relate to your life or not. For instance, you may not be keen on Ayush treatments and its exclusion may not have any bearing on your decision.

#4 – Pre-existing diseases clause

If you are completely healthy at the time of purchasing the plan, consider it a blessing. But you may be affected with certain illnesses like diabetes, hypertension, etc. at the time of buying the plan which are called pre-existing illnesses. Every insurer excludes the pre-existing illnesses from the plan’s scope of cover for a certain period called the Waiting Period. If you suffer from such illnesses, go with a plan with the shortest waiting period to include your condition at the earliest.

#5 – Claim process

Cashless or reimbursement – there are two ways in which the insurer may settle your claim. Under the cashless facility, if you seek treatment in a network hospital, the insurer directly settles the medical bills with the hospital without you having to get involved. Under a reimbursement claim mode, you will first have to foot the bills and later get those bills reimbursed from the insurer. The reimbursement method of claim settlement may prove a curse because the costs involved may not be affordable and also the process involved is quite cumbersome.

#6 – List of Network Hospitals

Rather a sub-point of the above point, a network hospital is one which has a tie-up with the insurer to provide you with cashless facility of bill settlement. Every insurer has a list of such hospitals with which it is tied up and considering the list is important because you must know which hospital to rush to in case of an emergency or whether the local hospital is among the list of network hospitals and would honor your policy and offer cashless services.

#7 – Discounts and bonuses

Who doesn’t love a good discount or that extra benefit which comes at no extra cost? Most medical insurance plan has the concept of No Claim Bonus wherein extra benefit is provided to the customer if there has been no claim in the previous years. This bonus is given in two forms – either it involves a reduction of the subsequent year’s premium or an increase in the coverage amount at the same rate of premium. While a discount in premium sounds tempting, an increase in the coverage is a better option in the long run when the medical costs are expected to increase.

Insurers also offer other discounts like a family discount of 5%-10% if more than one member is covered under the plan or a discount of 10% – 20% if two years’ premium is paid together. So while buying a plan, look out for these discounts as they will lower your premium and also increase the coverage.

The above tips are the mantra to avail the best medical insurance plan both for yourself and your family so that you have a secured future.

Let me introduce you to Cari; a teacher, loving wife, and mother of two young children whom was recently diagnosed with crohn’s disease and prescribed infusions. Cari, assumed her insurance policy covered these treatments until she received a bill for close to $20,000, and that was for ONE treatment. She would have to continue these treatments every five weeks!!!!! After not much success, Cari reached out to me in panic, and we managed to get her bill down to $411 with some of the following tips:

1. Get into your Zen: The last thing Cari needed was an ulcer. With a few deep breathes and a plan of action in place, she was ready to tackle this “billing monster.”

2. Get a copy of the itemized bill and medical records: We were able to uncover some billing mistakes, but get a “clearer picture” of what was being done and if there were any options. In Cari’s place, it looked like her insurance rejected part of the bill because the infusion center was not covered by her insurance.

3. Talk to the right person: Some facilities have patient advocates or social workers that can help find other options for payment. Cari was able to verify what we discovered through an advocate at the facility. In addition, the advocate pointed out some additional insurance options that Cari was qualified for, but not taking advantage, so we immediately filled out all the paperwork with the help of the facility and got her on the correct plan within 2 months.

4. Talk to your prescribing doctor: Maybe there is an alternative medication or cheaper treatment? In Cari’s case, she had an adverse reaction to alternative treatments, so that was not an option. In some cases, the prescribing doctor may have free samples (usually about 2 months worth) that he/she can provide you with until a financial solution is figured out. Cari’s case was a little more difficult since she was in need of a biologic which tends to be a little more complicated therapy since there are many factors involved including an infusion site.

5. Find out what financial assistance programs are out there: There are plenty of “patience assistance programs” and/or “financial need programs” that are available for all situations. Familiarize yourself with these programs and get qualified as soon as possible. Some websites that may be helpful include: NeedyMeds, together Rx Access, or a State Pharmaceutical Assistance Program.

6. Go straight to the manufacturer: Many larger manufactures have an “Access Services Manager” or someone equivalent that can help guide you through the process of qualifying for some of these access and affordability programs. Cari found Kim, an access services manager for the Remicade she needed by going to the Janssen Pharmaceuticals, Inc. website and calling the 888 number provided. For those that are not as savvy, the prescribing doctor can help provide you with the correct number by contacting the representative they deal with from that pharmaceutical company.

7. Be pleasant and prepared: Before initiating any calls, take a deep breathe and be sure you write down the following information so you can provide it in a cohesive way when the representative asks, which will make the call pleasant and quick:

• Your name and contact information
• The pharmaceutical prescription
• The desired location if needed
• Insurance information (if you have insurance)
• Your income level (a copy of your W-2 can provide this information)

Some programs may require additional information, and you may not get the correct person on the phone the first time. Be patient and be persistent. If your blood starts to boil, hang up and call again when you are calm, or have a loved one call with you.

8. Take notes: Get the person’s name and contact information if possible. Document the date and time of the call, and summarize what was said, including any additional instructions given to you as well as when the person may call you back. In Cari’s case, we were asked to call back to get an update on what Kim was able to find out regarding her situation. In conclusion, Kim was able to locate a site that was accepting her insurance and determine that this site was accepting new patients. Kim also enrolled Cari in an additional free service to remind her of her infusion dates.

9. Breathe and get started: Now that everything is verified, Cari is able to get her infusions and NOT go into medical debt. In addition, she knows to ask for an itemized bill and a copy of her medical records after each infusion, so she can keep track of her bills and be sure there are no mistakes. If there is a discrepancy, she has her access service manager, Kim to help her work it out and avoid an ulcer.

Today, Cari is an empowered patient with no medical debt and an infusion center that is convenient to her house that is covered by her insurance.

The manufacturers, distributors, sellers, renters and service people involved in the durable medical equipment industry are part of a very lucrative business that is consistently in demand. Nonetheless, the exposure to risks is as exceptional as the line of work.

In the event a related product is deemed faulty those that supplied it may be liable for associated property damages, bodily injury or death …

Insurance for the Durable Medical Equipment Manufacturer

Risk exposure for each piece of equipment that is manufactured is determined in relation to its type and usage. Specific types of equipment need to be fashioned in very sterile circumstances.

Some equipment is designed to sustain life, and some are used in the hospital's operating room.

Insurance companies place the varying durable medical equipment into three separate groups:

– For diagnosing
– For therapy
– For monitoring purposes

Insurance for Durable Medical Equipment Dealers

Dealers involve themselves in either the selling or renting aspects of products like:

– Wheelchairs
– Oxygen apparatus
– Respiratory machinery
– Therapy devices
– Orthopedic equipment

Clearly, the renting of the equipment is much more problematic than selling. This is due to the following reality:

– Renting equipment leads to less preventative care and attention to manufacturer's instructions

– Renting equipment can lead to lawsuits due to breakage or malfunction and their subsequent negative effects on already physically weak patients.

Bond News for the Durable Medical Equipment Provider

Dealers of Durable Medical supplies are subject to Federal bond requirements. In order to get Medicare reimbursements, durable medical equipment providers, as well as those that deal in prosthetics and orthotics and supplies must acquire a $ 50,000 bond.

Of particular note is the country-wide competitive bidding that will take place between July 16, 2019 and September 18, 2019. Any dealer that has the appropriate bond can take part in the bidding, after which, three-year contracts will be granted to those deemed worthy.

As of now, there are one-hundred-thirty competitive areas in the United States. Each competitive bond area necessitates 1 bid bond. This applies to a provider that bids on all sixteen of the different products presented as well. If there are several bidders for the same bond area product, there is still eligibility. For instance, if there are five or more bidders for the same product, at least five contracts will be presented. If there are fewer than five bidders, at least two contracts will be presented.

An experienced independent agency can help with the acquisition of this and other commercial bonds.

Though many industries can claim a level of difficulty in the challenges they see on a day-to-day basis, it would be safe in assuming that navigating the medical field is about as tough as it gets. So, too, do the difficulties of the job fall on the equipment medical professionals use, whether it’s wear and tear on the surface or an electrical wire harness on the inside.

Staying on the subject of the electrical wire harness, it’s important to understand what it is and what it does. Wire harnesses keep electrical systems organized. By bundling wires and cables together, those that work closest with these items can keep their wiring systems organized. Organization leads to efficiency, both in form and function, and the right solution can make a big difference when medical professionals are in need of dependable equipment.

Though they can be found just about anywhere, here are three major uses for an electrical wire harness in the medical field:

Taking Patient Vital Signs – There was a time when vital signs were taken by hand, leading to pertinent information such as blood pressure and pulse rates taking longer to be read. Over the years, mobile machinery has been developed that allows the same vital signs to be taken all at once, thereby providing basic readings quicker.

X-Ray Technology – X-ray machines are used everyday, which means that the amount of use they go through puts parts (interior and exterior) under tremendous amounts of stress. Medical facilities depend on this technology to help them in all facets of treatment, such as determining bone breaks and internal bleeding.

Anything with A Power Button – This seems a bit like cheating, but the truth is that everything in the medical field that is able to power on depends on electrical wire harnesses to actually work. The efficient transfer of an electronic signal is something that we take for granted. With as automated as modern medicine is, and is becoming, manufacturers will be scrambling to keep up with the demand.

An electrical wire harness is a simple answer to helping keep electrical systems organized and running smoothly. Experts in the medical field depend on the quality of their machinery to deliver state-of-the-art treatment to patients every single day. As such, when medical industry leaders decide to contract the manufacturing of their equipment, they must work with a company that has years of experience. The prospective manufacturer must also have all of the industry-standard certifications and licensing as stipulated by the medical field and all governing bodies pertaining to wire harness manufacturing & electronics assembly.