Billers: Are They Making These Mistakes with the Billing Service?

Billers: Are They Making These Mistakes with the Billing Service?

Billing is more than just submitting claims. It includes denial management, the ability to generate sophisticated reports and posting ERAs to patient accounts.

billersBilling companies or individual billers may have certain software or clearinghouses they’re used to working with and may be reluctant to change.

Billers may not even be aware that software exists with automatic functions that can make their job easier and more productive.

They’re often spending more time than they should on tasks that can be automated. In Touch Biller PRO was designed to make the biller’s job easier and facilitates quicker claim processing.

Automatic ERA

Electronic admittance advice (ERA), known to patients as their explanation of benefits (EOB), is manually posted to patient records in many practices.

Manual posting is one of the biggest time consuming tasks for billers.

With the touch of a button, In Touch Biller PRO automatically transmits ERAs to patient accounts to become part of their permanent record.

The software automates the payment process, saving time for billers and allowing clinicians to get paid faster.

Quick Compilations

Many billers are still compiling claims manually for transmission to clearinghouses and they aren’t scrubbing claims prior to submission.

In Touch Biller PRO has the ability to automatically collect claims for batch submissions.

It goes one step further, identifying areas where a potential problem exists and then notifying the biller. The software does the scrubbing work for billers and it can be set to conveniently send batch claims at pre-determined times.

Denial Management

Denied claims cost clinicians in lost or delayed reimbursements. They slow the work of billers, who must spend significant amounts of time in pursing those payments.

In Touch Biller PRO is a complete denial management system that relieves billers of the tasks associated with denials.

The software has tracking features that automatically assembles and monitors notes, communications, dates and documentation for easy recall and referral.

Reporting Results

billersReports help clinicians determine a wide range of information, from where referrals are originating to payment rates.

Billing software should be able to provide sophisticated reports on accounts receivable, payments made, referral rates, by CPT and ICD codes, or by clinic.

Over 200 reports can be generated with the sophisticated reporting mechanism of In Touch Biller PRO.

Clinicians will always have the needed figures at their fingertips to manage any aspect of their practice.

In Touch Biller PRO can be integrated with In Touch EMR™ and existing systems. To decrease denials and improve reimbursement approvals, clinicians should speak with their billing company about the software’s advantages. It makes their job significantly easier and increases reimbursements for practitioners.

The Difference Between an EMR, Billing Software, a Clearinghouse and Billing Service

The Difference Between an EMR, Billing Software, a Clearinghouse and Billing Service

An EMR has many capabilities and a fully integrated software system allows clinicians to handle every facet of the practice’s business, from patient documentation to submitting claims for billing.

billingConfusion exists about EMRs, the software’s capability and how therapists can use it for optimum efficiency, and the key word to remember is integrated.

EMRs – Primary Functions

An EMR provides the tools to create documentation on each patient.

It can be accessed by multiple providers for continuity of care and is instantly updated.

It should have the ability to create intuitive custom templates that are most effective and efficient for each individual practice.

The EMR should have the ability to upload documents to patient files, from photo identification and insurance cards to test results, referrals and x-rays.

Most importantly, it’s essential that the EMR be able to communicate seamlessly with billing software.

In Touch EMR™ has the ability to integrate with existing office systems.

Integrated Billing

A therapist’s billing software has several requirements. It must be fully integrated with the practice’s clearinghouse and have the ability to check insurance eligibility online.

Billing software needs the ability to scrub claims and notify users of any potential problems.

Automatic posting of ERAs, batch submissions and billing statement generation speeds up the reimbursement process and In Touch Biller PRO™ software does all of that.

Clearinghouses – The Path To Payment

Medical billing software submits claims for documentation, along with supporting documentation.

Clearinghouses scrub the claims for errors and either forwards it to insurance companies for payment or back to the practice as a denial.

Creating clean claims at the office level virtually eliminates denials and delayed payments that will occur if the billing software isn’t compatible and integrated with the clearinghouse.

Integrated Billing Servicesbilling

It doesn’t matter whether billing is conducted in-house or outsourced, it’s essential that billing personnel master the practice’s billing software to obtain the full benefit of its capabilities.

In Touch Biller PRO™ is designed to be fully integrated with clearinghouse software, submits claims, manages denials and scrubs claims before they reach the clearinghouse.

It also generates statements and tracks patient benefits.

In Touch EMR™ and In Touch Biller PRO™ are both specifically designed with the needs of the therapist in mind. The software systems streamline documentation and assists practitioners remain compliant with applicable laws and the requirements of insurance companies to get paid faster.

Are You Making These Mistakes with Your EMR?

Are You Making These Mistakes with Your EMR?

With mandatory EMR implementation looming large on the horizon, therapists need to seriously consider the system they’ll be using. The software should be integrated throughout the office, with automatic functions that allow clinicians to work smarter, not harder.

EMRThere are key abilities that every practitioner should demand from their EMR system for documentation, billing and mobile readiness.

Integrated Billing

The selected EMR system should be fully integrated with billing and have the ability to detect and identify potential problems before claims are sent to clearinghouses.

In Touch EMR™ does all that and provides billing specialists with the means to easily obtain data, scrub claims for errors, and submit reimbursement requests individually or through automated batch filings.

Custom Templates

Most EMRs have a preprogramed set of parameters and forms that require clinicians to conform to the software.

In Touch EMR™ is designed specifically for therapists and conforms to the way clinician work, not the other way around.

Therapists can create custom documentation templates that best fits the individual needs of the practice.

Voice Recognition

Technology has given practitioners the means to document quickly and efficiently without the need to type information into patient files.

In Touch EMR™ has one of the most sophisticated voice recognition capabilities available, allowing practitioners to dictate and document on the go.

Clinicians can combine voice and typing options if they choose.

Going Mobile

Mobile devices are part of everyday life, but few therapists realize how the technology can be a distinct advantage in their practice.

With In Touch EMR™, therapists can use an iPad to perform many of the functions that would normally fall to staff.

With the EMR, tablet technology can be used for patient check-ins.

Clients can fill out forms, take a photo of themselves for identification, and supply their insurance information with the iPad’s built-in camera.

Data goes straight to client record and maintained safely in the cloud. Using a mobile device frees staff to work on other projects.

Mobile needs for practices extend to the ability to send text and voice messages to patients, and In Touch EMR™ can do that automatically.

The system can communicate with patients to remind them of appointments, accounts due and ask for referrals, along with sending physical and electronic greetings and newsletters.

Eliminating Sneaky FeesEMR

Many clinicians are finding that EMR vendors have a long list of sneaky fees. Practitioners are being required to pay for each individual user and that they’re being charged for each function they utilize.

With In Touch EMR™ clinicians only pay for licensed therapists that use the system. Technicians and others who must have access can do so for free.

An EMR is supposed to work for clinicians, not against them.

In Touch EMR™ provides the tools to take advantage of modern communication and documentation methods. It conforms to the requirements of the therapist and integrates with billing systems for a more efficient and profitable practice.

Common Myths About the Medicare 8 Minute Rule

Common Myths About the Medicare 8 Minute Rule

There’s a lot of confusion about the Medicare 8 Minute Rule and how many units to bill. Calculating the correct number of units can be confusing without the proper training and understanding.

medical billingMany clinicians are unknowingly under billing and cheating their practice out of legitimate reimbursements.

The 8 Minute Rule is being used by Medicare and an increasing number of insurance companies.

Those that don’t follow the Medicare guideline typically bill in 15 minute increments.

For insurance companies that do follow the Medicare rule, each billable unit must be between eight and 22 minutes in duration, but it only applies to timed CPT codes.

The Total Is What Counts

Problems arise when an uneven number of minutes are dedicated to different tasks.

To bill accurately and ensure that they’re adequately reimbursed, clinicians must total all the minutes in the session for the maximum number of billable units.

To be included, only face-to-face time spent with the patient counts toward billable units.

The 8 Minute Rule applies as follows:

  • 1 unit is 6-22 minutes
  • 2 units is 23 to 37 minutes
  • 3 units is 38 to 52 minutes
  • 4 units is 53 to 67 minutes
  • 5 units is 68 to 82 minutes
  • 6 units is 83 to 98 minutes


Understanding Is Essential

Billing becomes more difficult when multiple procedures or services are provided.

When an uneven number of minutes occur, therapists should choose the code that best represents the majority of the treatment time.

To understand the 8 Minute Rule, therapists should talk with a professional biller. Without a full understanding of how the rule works, therapists will encounter errors and reimbursement denials.

Automatic Calculationsmedical billing

The In Touch EMR® automatically calculates the time for each CPT code.

The system knows if it’s a timed or untimed procedure and assigns the appropriate number of units.

Clinicians have full control and can change the claim before it’s sent.

Demonstrations can be scheduled to learn how the software works. It takes the guesswork out of calculations, increases efficiency, and ensures therapists are getting paid the full amount to which they’re entitled.

Billers Ethical Issues in Medical Billing and How to Avoid Them

Billers Ethical Issues in Medical Billing and How to Avoid Them

Professional medical insurance billers have access to patient information that’s protected by law. A career in the profession requires an individual with honesty, integrity and a highly developed sense of ethics.

Nitin Chhoda says that the professional life of an MIB contains multiple ways in which they can run afoul of ethical issues. An honest mistake can be corrected, but an ethical issue, either by commission or omission, can land a biller in trouble with the law. He explains further using the following factors which MIBs should be concerned about.

billersBreaking Confidentiality – The First Thing that Billers Should Avoid

Patient confidentiality is ensured by law. Violations by either word or deed will find clinicians and billers in trouble for a breach of HIPAA security regulations.

There are strict rules governing the sharing, release and transmission of health-related data and identity theft is a real concern.

The Blame Game

It takes only moments to obtain clarification for coding questions. Billers that submit inaccurate codes and try to shift the blame to others when the error comes to light won’t be employed for long and will earn the ire of their co-workers.

The billers’ job is to maintain the revenue stream by coding accurately and honestly.

They Should Not Ignore Errors

Billers are only human and an error is inevitable. However, when an error is uncovered, it’s imperative to bring it to the practitioner’s attention, correct it and submit a corrected claim immediately.

Failure to do so can result in a payment deficit, or an over payment that can have adverse financial ramifications for the clinician. The same ethics apply if an insurance carrier handles a claim incorrectly and inadvertently over or under pays the practitioner.

No More and No Less

Ambiguous information calls for clarification. Not every act performed by the clinician is billable. Eligibility for an increased level of payment requires additional skill or work by the practitioner.

IMPORTANT:  Code and bill only according to what the documentation indicates.

To Bundle or Not Unbundle: A Biller’s Concern Too

Each code is designed to include multiple actions within the treatment process. They’re billed as a whole rather than individually. There are times that billers should know when unbundling is appropriate, but the technique must be used with extreme caution.

Billers must also know that some codes aren’t compatible with others and documentation must support that extra time or expertise was required.

They Must Protect Patients

Many payers require patients to receive treatment from their network of physicians. Seeing an out-of-network provider may not be covered or the patient may have to pay additional out-of-pocket expenses.

Billers should endeavor to protect patients from this and explain the practice’s protocols for handling these types of situations.

medical billersTo reiterate, the billers must always consider the following factors during the process of medical billing:

  • Confidentiality of patients’ information
  • Avoid blaming others for errors they committed
  • Minimize errors as much as possible
  • Provide just coding – no more, no less
  • Awareness of bundling and unbundling codes

Protecting the patient includes verifying their coverage, obtaining a pre-authorization when needed and making referrals within the patient’s network.

Failure to do so can result in the patient being hit with an enormous bill they can’t afford. Following the dictates of the patient’s insurance also protects the clinician from non-payment.

Ethical issues for medical insurance billers can come in many guises and MIBs must be vigilant. They must code accurately, act honorably and perform ethically. Doing so will demonstrate their honesty, integrity and professionalism, while ensuring the best reimbursements for practitioners.


Flow Sheet and EMRs Increase Reimbursements

Flow Sheet and EMRs Increase Reimbursements

Flow sheet helps clinicians track what they did for a patient on previous and current visits, but they’re much more than a means of patient management. They hold the key to obtaining reimbursements.

Claim denials and delays result in fiscal hardships for practices and in a time of shrinking healthcare payments, and in this article, Nitin Chhoda explains how the flow sheet is a critical element in the reimbursement process.

flow sheetFlow Sheet and its Important Role to Claim Reimbursements

The flow sheet has to justify the billing amount and should be designed to reflect the CPT code in the reimbursement claim.

It forms the basis of the billing, streamlines the reimbursement process and supports medical necessity.

A properly designed flow sheet provides all the information needed for billing and supports each prior step.

The flow sheet provides a permanent record of care, supplies and products dispensed that are eligible for reimbursement. They’re essential for patient care and management, reimbursements, and can be used for research and quality improvement.

A flow sheet offers a birds-eye view and summary of changing factors that includes vital signs, diseases, treatments, medications and test results.

It’s used to document findings for each patient encounter, allowing practitioners to tell at a glance if the patient is being seen for a new condition or something that has occurred in the past.

No matter what type of practice is being operated, the flow sheet is one of the greatest assets available to determine when patients are due for check-ups and tests, and facilitates moving patients through the office in a timely manner.

 –> Clinicians don’t have to start from scratch when working with established patients.

The Value of an EMR in Creating Flow Sheet

Maintaining flow sheets to expedite reimbursements is much easier with an electronic medical record (EMR) system.

The In Touch EMR, which is also integrated with billing software called, In Touch Biller Pro, is an example of an “intelligent” EMR that advises and prompts users when information is entered to ensure each element of the reimbursement claim matches and all the necessary components support each other.

EMRs offer portability to help clinicians provide a superior level of care, while allowing practitioners to see more patients within the day.

flow sheet

Clinicians can move easily through the office without the need to find and retrieve paper records before patients can be seen. They also support the creation of custom forms and templates.

The systems encompass built in calendars, calculators and treatment reminders. Clinicians can pull up photos, videos and print information for patients to take with them.

It ensures patients have data from a reputable source instead of letting them surf the web and obtain erroneous information.

An EMR can be implemented on tablet technology, allowing practitioners to diversify the practices services. The systems can be updated by multiple healthcare professionals and utilizes electronic communication to save time, money and resources.

Data can be retrieved whenever needed, for printed reimbursement claims, RAC audits or litigation. Errors due to illegible handwriting are eliminated.

To file reimbursement claims that are paid quickly, the flow sheet must reflect the CPT codes used and all the documentation must support the billable expenses. EMRs are an essential component of the process, with prompts to ensure each step supports the next, for clean claims that are paid quickly.