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3. Other than a certification, will I have a resources to teach me HOW TO START?
Visit www.MedicalBillingFoundation.com for more info
Wednesday, April 8, 2009
Tuesday, April 7, 2009
Medical Billing Goofs - medical billing news
In a previous installment of medical billing goofs, we discussed what happens when you bill the wrong item to a carrier and how you can be charged with fraud, but what happens when you send a bill to the wrong carrier. What follows is a genuine story. It's kind of funny when you read it, but the truth is, it's far from funny. This is some serious stuff.
A medical billing company, we'll call them XYZ company, was sending out a claim for a patient, we'll call him John Smith, to Medicare Region A, which is in the New York area of the United States. Now in actuality, the name of the patient was a common name so there could have very well been many people with that name.
Anyway, the bill makes its way to Medicare Region A and the response from Region A is that they are not going to pay the claim because the patient that the company was billing was dead. Well, to make a long story short, the medical billing company gets on a conference call with Medicare Region A and the patient. On the one end, the patient is screaming at the carrier, "How can I be dead? I'm right here". The carrier simply responds that according to their records, the patient is dead.
Well, this back and forth goes on for quite a while with quite a few phone calls. Finally, Medicare Region A decides that they're going to go over the patient's records with the patient and the medical billing agency. So they begin the questions starting with name, address, etc. Well, when the patient gives the carrier his street address and state, the carrier responds with the following. "Sir, Texas is not in our region". Well, it turns out that the patient had the same street address as another patient in New York. Everything was exactly the same except for the state, which nobody bothered to check. So what happened was that the patient had his claim sent to Medicare Region A when it should have gone to Medicare Region C.
Everybody had a real good laugh about this, but the problem still wasn't solved. Now the claim had to be forwarded to Medicare Region C. The problem was that the medical billing agency was not licensed to bill Medicare Region C. They only had a package to bill Medicare Region A. So now they had to see if they could get Medicare Region A to forward the claim to Medicare Region C. Well, they could, but there was a charge for this. Well, the medical billing agency said no way. So what did they do?
They got a hold of another medical billing agency that did bill Medicare Region C and arranged to do a swap. They'd bill one of their patients for them, thus incurring the cost, if they'd bill Medicare Region C for them. The company agreed and sent the claim. The problem was finally solved.
You can't make this stuff up.
Michael Russell
A medical billing company, we'll call them XYZ company, was sending out a claim for a patient, we'll call him John Smith, to Medicare Region A, which is in the New York area of the United States. Now in actuality, the name of the patient was a common name so there could have very well been many people with that name.
Anyway, the bill makes its way to Medicare Region A and the response from Region A is that they are not going to pay the claim because the patient that the company was billing was dead. Well, to make a long story short, the medical billing company gets on a conference call with Medicare Region A and the patient. On the one end, the patient is screaming at the carrier, "How can I be dead? I'm right here". The carrier simply responds that according to their records, the patient is dead.
Well, this back and forth goes on for quite a while with quite a few phone calls. Finally, Medicare Region A decides that they're going to go over the patient's records with the patient and the medical billing agency. So they begin the questions starting with name, address, etc. Well, when the patient gives the carrier his street address and state, the carrier responds with the following. "Sir, Texas is not in our region". Well, it turns out that the patient had the same street address as another patient in New York. Everything was exactly the same except for the state, which nobody bothered to check. So what happened was that the patient had his claim sent to Medicare Region A when it should have gone to Medicare Region C.
Everybody had a real good laugh about this, but the problem still wasn't solved. Now the claim had to be forwarded to Medicare Region C. The problem was that the medical billing agency was not licensed to bill Medicare Region C. They only had a package to bill Medicare Region A. So now they had to see if they could get Medicare Region A to forward the claim to Medicare Region C. Well, they could, but there was a charge for this. Well, the medical billing agency said no way. So what did they do?
They got a hold of another medical billing agency that did bill Medicare Region C and arranged to do a swap. They'd bill one of their patients for them, thus incurring the cost, if they'd bill Medicare Region C for them. The company agreed and sent the claim. The problem was finally solved.
You can't make this stuff up.
Michael Russell
Sunday, April 5, 2009
Small business tax nightmares
Small business owners across America are cheering the imminent demise of the estate tax, but Congress is poised to approve a little-known tax procedure that soon may give them headaches all over again, according to Bruce Bartlett, senior fellow at the National Center for Policy Analysis (NCPA).
The procedure is known as carryover basis. Why the nightmare? Bartlett explains, "Under carryover basis, the value of assets is no longer stepped-up at death. Instead, heirs inherit the original basis of the assets. So if a small business owner leaves at death stock worth $120 that he bought for $10, the survivor must pay tax on the full $110 appreciation, not the original price of $10 as current tax law provides."
Application of carryover basis also can be difficult. Since assets have historically been stepped-up at death, small business owners may not have kept complete records. And even when records exist, it is difficult to establish original basis when dividends, interest or other returns to capital have been reinvested over time. Then there's always depreciation and renovation for plant and equipment.
Conferees established carryover basis in the Tax Reform Act of 1976. Within six months, the outcry was so loud, Congress basically told people to ignore the law. And finally in 1978, Congress delayed implementation of carryover to its effective date-as though it never existed.
"The carryover basis provision Congress appears ready to endorse may not be the way to go. If it's enacted, I predict a repeat of the 1976 revolt with almost immediate pressure for its repeal," Bartlett said.
Bruce Bartlett's columns are distributed nationally by Creators Syndicate.
The procedure is known as carryover basis. Why the nightmare? Bartlett explains, "Under carryover basis, the value of assets is no longer stepped-up at death. Instead, heirs inherit the original basis of the assets. So if a small business owner leaves at death stock worth $120 that he bought for $10, the survivor must pay tax on the full $110 appreciation, not the original price of $10 as current tax law provides."
Application of carryover basis also can be difficult. Since assets have historically been stepped-up at death, small business owners may not have kept complete records. And even when records exist, it is difficult to establish original basis when dividends, interest or other returns to capital have been reinvested over time. Then there's always depreciation and renovation for plant and equipment.
Conferees established carryover basis in the Tax Reform Act of 1976. Within six months, the outcry was so loud, Congress basically told people to ignore the law. And finally in 1978, Congress delayed implementation of carryover to its effective date-as though it never existed.
"The carryover basis provision Congress appears ready to endorse may not be the way to go. If it's enacted, I predict a repeat of the 1976 revolt with almost immediate pressure for its repeal," Bartlett said.
Bruce Bartlett's columns are distributed nationally by Creators Syndicate.
Thursday, April 2, 2009
When in doubt, GET OUT!
Walking (or in some cases...running) away from a client is the best possible thing for you and for your business.
HUGE red flag is a client's inability or "challenge" in paying.
If a client either post-dates checks to pay you in segments OR only pays via credit card, be aware.
This happened to me.
I worked with a large clinic that was mostly a PIP and WC practice and I collected thousands and thousands for them. But, they never seemed to have the available funds to pay me.
They often post-dated checks to pay, but there was never any money in the account, etc. It was a nightmare!
I was at a huge loss when I finally decided that something was just not quite right with this company.
But, it was the best thing that I could have done!
Visit www.MedicalBillingFoundation.com for more info and daily blogs.
HUGE red flag is a client's inability or "challenge" in paying.
If a client either post-dates checks to pay you in segments OR only pays via credit card, be aware.
This happened to me.
I worked with a large clinic that was mostly a PIP and WC practice and I collected thousands and thousands for them. But, they never seemed to have the available funds to pay me.
They often post-dated checks to pay, but there was never any money in the account, etc. It was a nightmare!
I was at a huge loss when I finally decided that something was just not quite right with this company.
But, it was the best thing that I could have done!
Visit www.MedicalBillingFoundation.com for more info and daily blogs.
Monday, November 5, 2007
Promise BIG - Deliver BIGGER!
As a medical biller, on thing that can QUICKLY become a nightmare is if you OVER promise and UNDER deliver.
You will be resigned QUICKLY.
Promise ONLY what you ARE ABLE to deliver. Then, go over and above from there.
Your service is safe from becoming a regret, or ultimately a nightmare!
You will be resigned QUICKLY.
Promise ONLY what you ARE ABLE to deliver. Then, go over and above from there.
Your service is safe from becoming a regret, or ultimately a nightmare!
Tuesday, October 9, 2007
Medical Billing Invoicing and YOU
One thing that can turn into a nightmare and make you look REALLY bad?
Your very own INACCURATE invoice.
Don't make mistakes on your own bills.
HUGE RED FLAG.
If you are making errors in your own invoices, what mistakes are you making on behalf of your clients and their billing?
When in doubt SOURCE IT OUT!
Your very own INACCURATE invoice.
Don't make mistakes on your own bills.
HUGE RED FLAG.
If you are making errors in your own invoices, what mistakes are you making on behalf of your clients and their billing?
When in doubt SOURCE IT OUT!
Monday, September 24, 2007
Medical Billing Hurdles, 101
Earning a Provider's trust is THE MOST challenging hurdle to overcome, NO matter WHAT miracles your medical billing service makes happen.
Ask yourself WHAT tools you have (or should have) in your bag of tricks?
1. Do you offer a "share-able" software platform so that the Provider is granted a window into your billing world?
2. How long HAVE you been in business VS. What experience do you bring to the industry?
3. Why SHOULD a provider "hand over" their receivables, aka PAYcheck??
These are all very real / very valid challenges!
Share what you do.
Share what you say.
Share how you overcome such hurdles.
How do you prevent the loss of an account due to these challenges, therefore PREVENTING nightmares?
Ask yourself WHAT tools you have (or should have) in your bag of tricks?
1. Do you offer a "share-able" software platform so that the Provider is granted a window into your billing world?
2. How long HAVE you been in business VS. What experience do you bring to the industry?
3. Why SHOULD a provider "hand over" their receivables, aka PAYcheck??
These are all very real / very valid challenges!
Share what you do.
Share what you say.
Share how you overcome such hurdles.
How do you prevent the loss of an account due to these challenges, therefore PREVENTING nightmares?
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