Medical Billing Companies

Medical Claim Billing Software

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Tip! A medical billing specialist performs many major services related to healthcare insurance including paper and electronic billing, annual code updates, dead claim recovery, super bill design, claim entry, electronic claim submission, physician on-line remote access, consultation, fee reviews, patient setup, insurance verification, eligibility testing, customized service for each practice, and reporting. Apart from these, he should have good knowledge in medical terms, coding, and human anatomy.

A simple, but crucial medical billing change has recently occurred. Beginning on October 1, 2005, the Medicare durable medical equipment regional carrier (DMERC) will no longer accept the diagnosis code 585.0. Instead of using ICD-9 585.0, medical billing should be done with the ICD-9 code 585.6 for home dialysis charges.

The code 585.0 means chronic renal failure. This code has now been discontinued and the DMERC will no longer be lenient on the code. The more descriptive code, 585.6 (end stage renal disease) much more accurately describes the diagnosis for home dialysis. It is important that your medical billing staff note this change. Failure to do so will result in unpaid future claims.

Situations like this depict the necessity to hire an outside medical billing firm. Many mistakes can be avoided by hiring one of these companies. Medical billing companies employ highly skilled individuals who are trained, certified, and updated on current medical billing/coding practices. By hiring these companies you are relieving your practice from the responsibility of training and updating your own medical billing personnel on changes.

Tip! I am a physician who has absolutely no time or interest in the medical billing aspect of my practice. I am completely reliant upon my office manager and billing staff.