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Roger Steven

Developing Hospital Billing and Chargemaster Policies and Procedures - 0 views

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    Overview: Hospital chargemasters are complex and represent a key component for the revenue cycle of hospitals. Chargemasters are intertwined with coding for services, billing for services, charging for services and even involve the cost reporting process. A myriad of decisions must be made concerning how the chargemaster is organized, impacts on coding and billing, charge structuring, cost accounting, and other processes within the revenue cycle. Whenever decisions are made, policies and procedures should be developed, approved and implemented. A proper system of billing and chargemaster policies and procedures can help to maintain an appropriate compliance stance in a world where ambiguous guidance is often the norm. The development of charges and charge structuring within the chargemaster is a major issue often referred to as transparent pricing. While even the Medicare program maintains that hospitals should charge for everything, the way in which charges are set and amalgamated at the claim level can vary significantly between hospitals. A key issue for the chargemaster is differentiating separately charging from separately reporting. The way in which hospitals make decisions about the bundling of charges at the line-item level within the chargemaster leads to many decisions, all of which need justification through proper policies and procedures. Due consideration must be given to departmental concerns about revenue generation, cost reporting implications, coding implications and any associate challenges with billing and claims filing. Why should you Attend: See Typical Questions - Here are some reworded marketing questions: Why are the chargemaster and hospital billing targets of compliance audits? How should we prioritize statutory and contractual compliance for the chargemaster and billing process? Will chargemaster and associated billing policies and procedures give us protection relative to compliance? How should we develop a system of chargemaster po
Roger Steven

untitled - 0 views

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    Healthcare fraud and abuse: Healthcare fraud and abuse are different but related kinds of malpractice. They affect everyone concerned: the patient, the healthcare unit, the healthcare sector, and eventually, the economy. Healthcare fraud and abuse are serious malpractices that can have very grave consequences for the patient, the hospital and the healthcare sector. They can also cost taxpayers heavy amounts of money. Healthcare fraud: There is some distinction between healthcare fraud and healthcare abuse. Healthcare fraud is said to happen, according to medicare.gov, when Medicare gets billed for a service or supply the end user never gets. These fraudulent claims result in loss of billions of dollars of revenue to Medicare each year. Healthcare fraud could be said to happen when: False statements are submitted knowingly or facts are misrepresented with the purpose of obtaining a federal health care payment for claims for which the person is not entitled A person knowingly solicits, pays, or/and accepts a payment with the intention of inducing or rewarding referrals for services or items that any of the federal healthcare programs reimburse Eligibility is falsified Prohibited referrals are made for select, designated health services Healthcare abuse: Although related, healthcare fraud and abuse are not totally similar to each other in spirit. A healthcare abuse can be when physicians do not comply with or bypass established good medical practices or administer treatments that are not necessary. This is less serious than fraud in terms of intent, but carries the same consequences: loss of billions of dollars to the exchequer and potential damage the patient's health and the physician's and/or healthcare provider's reputation. Some examples of healthcare abuse These are some of the examples of healthcare abuse: When services that are not medically warranted are performed and charged for When services and/or supplies are charged in excess of their actual value
Roger Steven

Clinical Documentation Improvement - 0 views

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    Overview:   Review 6 points of high quality evidence based clinical documentation Review of 7 criteria that all entries in a patient record should include Impact of documentation on coding and claims Impact on audits and ability to defend an audit When an audit is initiated, the completeness of documentation becomes critical in the ability to support what you have reported. Let's take a look at areas in which weaknesses are often found.  Why should you Attend:  The granularity and accuracy of the ICD-10 code set is supported by quality clinical documentation. It is anticipated that payers will increasingly become less flexible in allowing non-specific codes. The use of unspecified codes will likely lead to rejected claims if it is possible to report the more definitive condition. In most cases, unspecified should not be reported unless there is clear evidence to support the inability to report the detailed option.  Is your E & M level supported in the documentation? If you have never experienced scrutiny of your billing patterns by payers and other entities, you may not be aware of weaknesses that lead to recovery of funds or other costly consequences. Your documentation will be key in supporting diagnoses, service codes and acuity of the patient. It is not just payers who engage in audits. Others include State medical boards, Qui Tam and possible reporting of questionable practices by patients. Do your billing patterns and documentation stand up under reporting scrutiny? This presentation will review areas in which you may not be as strong as you think!  Areas Covered in the Session: Significance of abnormal lab results Measurement of lesions, when taken and inclusion of margins Start & stop times & methodology for infusions & discrepancies in billing Diagnostic testing and medications should be supported in a diagnosis Depth of wounds and cause should be clear Severity of illness Diagnosis present on admission? Who Will Benefit: Coders Billers Rev
Roger Steven

ICD-10 and Other Factors Affecting Your Cash Flow - 0 views

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    Overview: As the healthcare industry moves toward a value based reimbursement model rather than fee for service, it is crucial that the provider and ancillary staff understand how ineffective reporting can lead to dollars lost. We will review the 3 critical areas that require skilled management. Understand that patients are more educated about their healthcare and are increasingly responsible for more out of pocket costs. High dollar deductibles may result in self pay realities and bad debt increases. Learn areas that increase your chances for an audit. Are you ready for the challenge? Why should you Attend: Revenue is dependent upon proficiency in multiple areas. In today's environment, it is risky to maintain the status quo and increasingly important to obtain and maintain skilled business staff. The granularity of the ICD-10 code set requires understanding of the official coding conventions and guidelines, the ability to apply those guidelines, and the ability to recognize when reporting may lead to revenue delay, reduction or loss. Additionally, other factors affect your revenue stream. This includes patients with high deductible plans, collection of much more than a small co-pay, and staff understanding of regulations that govern telephone collection activity. Don't leave money on the table or invite an audit into your practice. Audits are often the result of weak billing and coding skills. This program will review several areas that will cost you money if poorly handled. Areas Covered in the Session: Required specificity in coding Documentation necessary for ICD-10 reporting Why coders must frequently query for clarification How ambiguous diagnosis reporting affects you r bottom line Internal collections versus outsourcing. What should you consider Staff effective in handling problem claims? Developing appeals? Who Will Benefit: Coders Billers Revenue cycle Physicians Mid-level providers Nurses Claims follow-up Managers Managers Speaker Profil
instapayhealth

Transforming the Medical Field Top ICD 10 Coding Services You Should Know About - Healt... - 0 views

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    Exciting news! Instapay Healthcare Services is now offering highly affordable ICD-10 Coding Services in the US. We understand the importance of accurate coding in healthcare, and our team of experts is here to ensure that your coding needs are met efficiently and effectively. With our cost-effective solutions, you can streamline your coding processes without breaking the bank. Trust Instapay Healthcare Services for reliable and affordable ICD-10 Coding Services. Contact us today to learn more! Fax:- 9179607960
instapayhealth

Unlocking the Value of Ophthalmology Billing Services: Streamlining Medical Billing for... - 0 views

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    Are you an ophthalmologist looking to streamline your billing process and focus more on patient care? Look no further! Instapay Healthcare Services offers specialized ophthalmology billing services tailored to your practice's unique needs. Our team of experts understands the complexities of eye care billing, from accurate coding to timely claim submissions. With Instapay, you can optimize your revenue cycle management and minimize billing errors, all while saving time and resources. Don't let billing challenges hold your practice back. Trust Instapay Healthcare Services to handle your ophthalmology billing needs with precision and affordability. Fax:- 9179607960
Roger Steven

The Roles And Responsibilities of a HIPAA Privacy & Security Officer - 0 views

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    Overview: Discussions, presentation, and webinars regarding HIPAA regulations are usually addressed from the perspective of what the regulations entail, the necessity of compliance with the regulations, and the consequences of willful neglect or non-compliance. This presentation addresses HIPAA regulations from a different perspective - from a personal perspective - from the perspective of the person in charge of moving an organization or facility toward full compliance with HIPAA. The by-product of this presentation will be both an understanding of, and a detailed job description for, a position mandated in the regulations - the HIPAA Security/Privacy Officer. Why should you attend: The HIPAA regulations are numerous, complicated, often vague, and affect every person working in a healthcare facility. Compliance with HIPAA will require a unique individual to lead the charge - an individual whose education, background, experience, and demonstrated skill sets offer the opportunity for that person to succeed in achieving the goals of that position. This is a new position to most healthcare facilities. So understanding who this person should be, what is required of the person with this job title, and with whom this person will interface is vital to every healthcare organization with the goal of achieving full compliance with HIPAA. Areas Covered in the Session: Position goals Position requirements (education, experience, skill sets, etc.) Position responsibilities Stay abreast of regulations Initiate compliance with HIPAA (according to regulations) Ensure continuous progress toward full compliance Develop appropriate security/privacy policies & procedures Oversee and deliver appropriate training programs to all employees Track compliance with HIPAA regulations at the facility & individual levels Track access to PHI Investigate and resolve HIPAA violations Apply sanctions to HIPAA violators Manage any information security personnel Prepare a department budget Hold Bu
instapayhealth

Revolutionize Your Healthcare Finances: The Power of Medical Billing and Coding Service... - 0 views

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    Instapay Healthcare Services offers specialized neurology billing services that ensure maximum reimbursement and streamlined revenue cycles. With our state-of-the-art technology and industry expertise, we simplify your billing processes, allowing you to focus on patient care. Contact us today for a consultation! Fax:- 9179607960
Roger Steven

The Roles And Responsibilities of a HIPAA Privacy & Security Officer - 0 views

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    Overview: Discussions, presentation, and webinars regarding HIPAA regulations are usually addressed from the perspective of what the regulations entail, the necessity of compliance with the regulations, and the consequences of willful neglect or non-compliance. This presentation addresses HIPAA regulations from a different perspective - from a personal perspective - from the perspective of the person in charge of moving an organization or facility toward full compliance with HIPAA. The by-product of this presentation will be both an understanding of, and a detailed job description for, a position mandated in the regulations - the HIPAA Security/Privacy Officer. Why should you attend: The HIPAA regulations are numerous, complicated, often vague, and affect every person working in a healthcare facility. Compliance with HIPAA will require a unique individual to lead the charge - an individual whose education, background, experience, and demonstrated skill sets offer the opportunity for that person to succeed in achieving the goals of that position. This is a new position to most healthcare facilities. So understanding who this person should be, what is required of the person with this job title, and with whom this person will interface is vital to every healthcare organization with the goal of achieving full compliance with HIPAA. Areas Covered in the Session: Position goals Position requirements (education, experience, skill sets, etc.) Position responsibilities Stay abreast of regulations Initiate compliance with HIPAA (according to regulations) Ensure continuous progress toward full compliance Develop appropriate security/privacy policies & procedures Oversee and deliver appropriate training programs to all employees Track compliance with HIPAA regulations at the facility & individual levels Track access to PHI Investigate and resolve HIPAA violations Apply sanctions to HIPAA violators Manage any information security personnel Prepare a department
instapayhealth

Healthcare Revenue Cycle Management Services: Streamlining Financial Success in Medical... - 0 views

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    Explore how Instapay Healthcare Services can optimize your revenue cycle with expert medical billing, CPC certified professional coders, healthcare provider credentialing services, and more. Learn why choosing Instapay is a strategic decision for comprehensive healthcare revenue cycle management.
instapayhealth

Unlocking Success: Mastering Obstetrics and Gynaecology Billing - Your Essential Guide ... - 0 views

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    Looking for trustworthy Obstetrics and Gynecology billing services? Look no further than Instapay healthcare Services. Our dedicated team provides accurate and efficient billing solutions tailored for OBGYN practices. Trust us to handle your billing needs, so you can concentrate on providing top-notch care. Call us today to learn more! Fax:- 9179607960
Roger Steven

Claims Follow Up, Appeals and Self Pay Collections - 0 views

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    Overview: Many medical entities are increasingly struggling to manage revenue effectively. Self pay is on the rise due to high deductibles. Bad debt is increasing. What is your plan to manage these areas? Staff trained in denial management? Variances? Are they handling these areas in a timely manner? Payers have time limits in which dollars can be salvaged. Missing those strategic times mean dollars lost. Don't leave money on the table. We will discuss multiple avenues in which strong training and timely action can equal $$$. Why should you Attend: Don't lose hard earned revenue. Learn tips to strategic follow up, when and how to manage the appeal process. Is the claim appealable? Partial payments and why? Today's industry of high dollar deductibles create the necessity to expend additional efforts on self-pay accounts. There is a significant difference in collecting small co-pays and managing large balances. Bad debt creep? What is your plan for managing these areas? Areas Covered in the Session: Hire the right staff - Then engage in ongoing education Variances and denial management Billing compliance Coding for specificity, co-existing conditions and correct modifiers Supporting medical necessity CCI edits and unbundling Productivity Claims follow up Payer processing edits Additional development requests Handling problem claims and appeals Who Will Benefit: Coders Billers Revenue cycle Physicians, mid-level providers Nurses Claims follow-up Managers Speaker Profile Dorothy D. Steed is an Independent Healthcare Consultant and Educator in Atlanta. She was a Medicare specialist for a large hospital system and a physician coding audit supervisor for another hospital system, with 38 years of experience in healthcare. Additionally, she is an instructor at a state technical college in Atlanta, provides auditing & training in both facility and physician services, and has been a speaker at several healthcare conferences. Ms. Steed has written articles for
instapayhealth

Unlocking Efficiency: Gastroenterology Billing Services - 0 views

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    Struggling with the complexities of gastroenterology billing? Look no further! Instapay Healthcare Services is here to streamline your billing processes and maximize your practice's revenue. Our comprehensive solutions, tailored specifically for gastroenterology practices, ensure accuracy, compliance, and efficiency every step of the way. Don't let billing headaches hold your practice back. Join the countless gastroenterology practices that have already unlocked efficiency with Instapay Healthcare Services. Contact us today to learn more and take your practice to the next level! Fax:- 9179607960
instapayhealth

The Untold Benefits of Outsourced Medical Coding Audit Services - 0 views

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    Instapay Healthcare Services offers reliable and accurate medical coding audit services and efficient medical billing solutions. With our expertise, your healthcare practice can stay compliant and streamline administrative processes. Contact us to learn more about our services and how we can assist you in delivering quality patient care. Fax:- 9179607960
instapayhealth

Unlocking Revenue: The Definitive Guide to Medical Coding Audit Services by Instapay He... - 0 views

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    Dive into the world of medical coding audit services and discover how to maximize revenue, ensure compliance, and streamline billing processes! Our comprehensive guide covers everything from the audit process to common challenges, with insights from industry leader Instapay Healthcare Services. Don't miss out - optimize your billing today! Fax:- 9179607960
instapayhealth

The Importance of ICD Coding Services in Medical Billing: Why Instapay Healthcare Servi... - 0 views

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    Did you know that precise ICD coding is the backbone of efficient medical billing? It ensures faster reimbursements, reduced claim denials, and keeps your practice compliant with federal regulations. At Instapay Healthcare Services, we lead the industry with our expert ICD coding services!
instapayhealth

Medical Coding Audit Services | healthcare coding and consulting services - 0 views

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    Medical coding audit services are essential for businesses in the healthcare industry. These services ensure accurate and compliant coding practices, minimizing errors and potential financial risks. With a team of experienced auditors, these services thoroughly examine medical records, billing data, and coding procedures. They identify discrepancies, coding inaccuracies, and potential fraud, ensuring adherence to industry standards and guidelines.
instapayhealth

Unlocking Revenue Success: Mastering Neurology Billing Services with Instapay's Expertise! - 0 views

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    Instapay Healthcare Services offers top-notch neurology medical billing services. Our expert team ensures accurate coding, quick reimbursements, and higher revenue for your clinic. Say goodbye to billing headaches and focus on what matters most - providing exceptional care to your patients. Partner with us today! Fax:- 9179607960
instapayhealth

Medical Coding Services: Streamlining Healthcare Documentation - 0 views

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    Discover the importance of Medical coding services, ICD-10 coding Services, and HCC coding services in healthcare. Learn how accurate coding ensures seamless documentation. Fax:- 9179607960
instapayhealth

The Importance of Critical Care Medicine Billing Services: Why Instapay Healthcare Serv... - 0 views

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    At Instapay Healthcare Services, we understand the complexities and precision required in critical care medicine billing. Our expert team ensures accuracy, maximizes reimbursements, and streamlines your billing processes so you can focus on what truly matters-delivering exceptional patient care.
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