Prerna Gupta's Article in Business

340 Standards of ethical Medical coding: Part 2
Coding is one of the core functions of healthcare providers and, due to the complex regulatory requirements impinging upon the health information coding process; the coding professionals are frequently faced with ethical challenges. There are stringent medical guidelines in place for the entire gamut of coding practices which include issues such as the privacy of patient healthcare data, accuracy, and regulation compliances.
Posted on Nov-02-2011

414 Medicare learning network Updates Medicare Claim Submission Guidelines
Center of Medicare and Medicaid services has released fact sheet on Medicare claim submission guidelines. The fact sheet offers billers, coders and physicians up-to-date guidance on how to file Medicare Claims. Following are some important points mentioned in the fact sheet
Posted on Nov-01-2011

290 Salary survey 2011 for coders
Salary survey for coders is out for year 2011. The survey is carried out amongst 12,000 respondents; the survey clearly shows an upward trend in average salaries for coders. The survey has also brought out some key trends in coders hiring, region wise average salaries and various career paths coders are opting for.
Posted on Nov-01-2011

507 Physicians see value in handling Claim Denials in a Better Way
Appealing denied claims is one of the important steps in enhancing the revenue of physicians and this fact is supported by a report by the U.S Government Accountability office (GAO). The report released on March 16, 2011 states that – “coverage denials occurred for a variety of reasons, frequently for billing errors
Posted on Oct-31-2011

310 Tax Exemptions for Physicians in Underserved Areas
The tax exemptions for physicians serving in underserved areas are no longer limited to a few states and have expanded to the whole nation, according to the IRS. The Affordable Care Act makes provision for professionals who received student loan relief under state programs that reward those who work in underserved communities may qualify for refunds on their federal income tax for the year 2009 and annual tax cuts after the year 2009.
Posted on Oct-31-2011

324 Gearing Up for Inpatient Medical Coding and Reimbursement Challenges
The prevalence of such demanding challenges is reason enough to push physicians beyond their Medical Billing Management capabilities, which invariably results in compromised medical efficiency. Therefore, physicians – faced with insurmountable challenges of inpatient medical billing management – have either to set up a dedicated team in-house or look elsewhere for competent outsourced solutions.
Posted on Oct-28-2011

287 Towards Cleaner Claim Submission and Realization
Despite vigilant system of medical claim submission practiced by physicians, the recent statistics released by the American Medical Association (AMA), has reported an increase in medical billing inaccuracies by 2% over the last year’s results.
Posted on Oct-24-2011

255 The Relevance of Using Perfect Modifiers in Medical Claims
The overlapping nature of certain medical procedures is such that it is impossible to report them with CPT codes alone. Although CPT coding has grown to be comprehensive enough to cover breakthrough procedures over the years, yet, physicians are not spared from submitting separate procedural forms for medical procedures requiring explanation that overshoot the CPT boundary.
Posted on Oct-20-2011

340 Deciphering Medicare Fee Schedules
A proactive affinity to Medicare Fee Schedule alerts physicians to the efficacy of attending to Medicare beneficiaries, and also plans their revenue prospects in advance. As Medicare Fee Schedule – which decides on the reimbursement to be allowed to Medicare providers for different services,
Posted on Oct-19-2011

339 Alleviating the Time Factor in Evaluating Revenue Generation from Medical Claims
“While physicians would not mind investing in revenue optimizing systems, asking them to invest their invaluable time in something which is non-core to their medical efficiency could ultimately have an adverse impact on their efficiency for medical care.
Posted on Oct-18-2011

266 Towards Minimizing Legal Errors In Handling Medical Records
Despite such indicators from time to time, the incidence of legal errors has only been destined to move upwards. Physicians, whose core-concern being medical efficiency through best medical practices, cannot be expected of too much in this regard.
Posted on Oct-17-2011

303 Implementing an Ideal EMR System for Your Practice
“Judging from the evidences of successful EMR implementation, customization has been the pivotal element, and will hold good for future also. Taking cue from such references, practices can benefit immensely, and successfully mitigate the probability of misadventure” More than the mandatory obligation of digitalizing/computerizing/electronically recording healthcare data,
Posted on Oct-17-2011

252 Group Appointments A new niche for Primary Care Practice
Group appointment, also referred to as shared medical appointment, includes multiple patients seen as a group for follow-up or routine care. According to the AAFP, Group Appointments were utilized by around 6% of family physicians to provide some amount of patient care in 2005, and that number has gone up to 13% in 2010.
Posted on Oct-14-2011

243 Hospitalists registered a pay increase in 2010
The year 2010 has registered a hike in the median compensation for Hospitalists. The Hospitalists in adult medicine saw their compensation increase 2.6% to $220,619 from $215,000 while the Pediatric Hospitalists’ pay rose by 7.2% to $171,617. The report, which is based on MGMA survey information, takes into account data from 4,633 hospitalists in 412 groups and 726 academic hospitalists in 68 academic medicine practices.
Posted on Oct-13-2011

249 Medicaid claims audits slated for January
The Medicaid recovery Audit program is due to get implemented nationwide in January, carrying on in a similar vein as Medicare RAC program, as announced by CMS on 14th September, 2011. The states will enter into a contract with the Medicaid RACs, which will review the past claims that have already been paid and scrutinize them for fraud, waste and abuse.
Posted on Oct-12-2011

283 Revenue Cycle Management – prescription for optimum medical claim realization
“Despite such volatile environment, physicians have to find means to realize their each and every dollar owed them as their very sustenance and growth hinges on efficient reimbursement of medical bills”. Unlike other professional services that realize their professional fees instantly
Posted on Oct-10-2011

286 Under-Coding: Financial Repercussions and Solutions
Under-coding can be defined as the procedure of medical coding where the codes do not reflect the full extent of the treatment provided to a patient. This can usually happen due to many reasons but the most common are errors or misreading of codes or because of the misconception that the chances of insurers paying would increase because of under-coding.
Posted on Oct-07-2011

395 Appealing Denied Insurance Claims: An Overview
The process of appealing a denied insurance claim is complicated but can be effective if done correctly since there are numerous reasons for claims to be denied by an insurance company.
Posted on Oct-05-2011

434 Are You Prepared to Deal with Patient Information Breach?
‘The readily available sources for implementing security-rich technology platforms should not only make your search easier but also ensure Patient Privacy Compliance by sage-guarding critical information against undesirable proliferation, and sharing information only at the behest of patients’
Posted on Oct-04-2011

623 Combating Healthcare Fraud and Abuse – a challenging task for providers
The inherent nature of Health Insurance is such that it is highly susceptible to fraud and abuse by unscrupulous healthcare providers and beneficiaries. While there have been regular reforms – medical billing and coding compliances such as EHR System,
Posted on Oct-03-2011

321 Small Practices: Adapting to the Challenges of Healthcare Reforms for Better Revenue
The major challenges faced by physicians who run a small practice or clinics that have less than four or five physicians are expanding exponentially. Many physicians find themselves worrying and spending time on administrative processes and interacting with payers rather than spending some quality time with their patients.
Posted on Sep-29-2011

268 CPT Category II code updates by AMA
The American Medical Association (AMA) has released an update of CPT Category II code list, which will first appear in CPT 2012, with an implementation date of 1st Jan, 2011. The CPT Category II codes are supplemental tracking codes that can be used for performance measurement.
Posted on Sep-28-2011

250 Standards of ethical Medical coding: Part 1
Coding is one of the core functions of healthcare providers and, due to the complex regulatory requirements impinging upon the health information coding process, coding professionals are frequently faced with ethical challenges.
Posted on Sep-28-2011

237 Increasing Demand for Certified Coders in Healthcare
The year 2010 has set a premium on the coding professionals, registering a rise in their average salaries. And as expected, the salaries for certified medical coders are higher as compared to the non certified ones.
Posted on Sep-27-2011

296 Superbill Analysis – an imperial stamp of authentication
“Consequently, physicians’ medical bills get an imperial stamp of authenticity, and nullify the chances of undesirable delay, denial, resubmission, and audits from highly stringent medical insurance companies”, Notwithstanding physicians’ integrity in preparing honest Superbills, comprehensive analysis has become imperative before these can be submitted to payers for reimbursement because of the highly dynamic nature of US healthcare industry.
Posted on Sep-26-2011