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Re: Medicaid Managed Care
From: Liz Forum Facilitator
Date: 3/3/99
Time: 3:30:23 PM
Remote Name: 205.188.193.164
Comments
Greetings 76512.433 -
Sounds like you have a problem! But I don't think the fact that the billing service is out of state has anything to do with it.
Your plan of action seems appropriate. 1. When was the last codes were reviewed, both ICD and CPT change annually. Plus, some MCOs use codes that are particular to them. If the service is not billing the proper code they could be down coding the service. 2. Who have you tasked with the review of denials and payments? I hope it is an outside agency or someone in house, not the service you are using to process your claims. You need an impartial judgement.
You asked a question about the how the aging process works. Are you referring to patient accounts receivable or carrier?
Below is how we handle accounts receivable:
1. For Carriers, When claims are generated a copy is placed into a tickler file. At 30, and 60 days we follow-up. If there is no payment after 60 days, and no record of the claim at the carrier, we resubmit-but we clearly note on the claim "Resubmitting Claim" so they don't think it is a duplicate bill.
2. For Patients, We bill monthly. At 30 days we send a reminder. At 60 days we threaten to add a statement fee of $25 per statement. (Be careful. States have different laws about how much you can charge as a late fee percentage, but there is no limit on the Statement fee.) At 60 days we also offer payment arrangements. At 90 days we charge the $25 and again offer payment arrangements. At 120 days we charge $25 and send a series of 3 letters, each getting more firm, the last threatening collections if the account is not paid in 7 days. In 7 days we send the account to collections unless the patient has contacted us to set up arrangements. (We never make idle threats.)
Your question about the amount you can expect per patient is a difficult one since payment varies by contract.
You asked about a book on managing receivables, Beth Jezek at PMIC is a great resource for this type of information. (1-800-633-7467x547) Tell her you are from the Association of Medical Billers, and you will receive a 10% discount. The book we used to write our patient collection letters was "Collections Made Easy" by Michael J. Berry.
I hope this helps.
:-) Liz
online coding classes
From: medtech@bright.net
Date: 3/14/99
Time: 2:15:06 PM
Remote Name: 205.212.154.57
Comments
Hi,
I'm a new billing center and I have been looking for some online coding classes, but I havn't had any luck. If anyone has any information please let me know. Thanks
Tina
Billing Allergy Injections
From:
Date: 3/21/99
Time: 5:36:24 PM
Remote Name: 208.225.239.200
Comments
Starting New Billing Center
From: Montoya Christian
Date: 4/6/99
Time: 2:10:37 PM
Remote Name: 206.107.102.2
Comments
I am very interested in starting a Bill Center in my area. I have talked to several people, and most of them were unable to get any physician accounts, although I have spoken with some other billing centers who are doing very well. Why is getting doctor accounts so difficult. Is there a secret marketing stratgy, because direct mail does not work for most people? Can anyone help with some marketing stratgies on accuring doctors. You may repley to chrismp@bellsouth.net. Thank for you help.
Billing J codes
From: Michelle Gray from Las Vegas
Date: 6/4/99
Time: 4:23:43 PM
Remote Name: 205.188.197.56
Comments
Hi,
Can someone please get this straight for me. When billing a J code, do you also bill 90782 as the injection fee? And does this apply to NV Health Health Solutions but not regular medicaid. I'm very confused. And how does this relate to office visits on the same day.
New ICD-9 Coding and E&M Coding Tools for PalmPilot Handhelds
From: Austin Physician Productivity
Date: 6/16/99
Time: 2:24:17 AM
Remote Name: 24.28.69.140
Comments
STAT E&M Coder is a unique application that guides you through the HCFA 1997 Evaluation and Management coding algorithms to arrive at the correct level of service that you have documented for an office visit, hospital visit, inpatient or outpatient consultation, emergency department encounter, etc. It works like an interactive reference card and runs on any PalmPilot handheld organizer. The general multisystem exam is included along with the ten organ specific exams defined by HCFA.