Questions About Medical Billing

I have recently been informed that when I was on Medicaid, it was MY responsibility (as the patient) to make sure that the provider billed Medicaid properly. Is this so? 
I was on Medicaid last year, pregnant & had a miscarriage. During an E.R. visit, while still on Medicaid, the local hospital failed to file Medicaid properly ...

Ownership of Medical Data 
I have been doing medical billing for a client for about 4 years now and she has recently decided to incorporate with a family practice who is requiring ...

Registering & Contracting with Insurance Companies 
I am trying to get my own medical billing business started, mostly because I have a client already lined up. My question is, how do I go about getting ...

Hospital Billers & Coders 
Hospital billers and coders generally think that the purpose of diagnosis coding only billing (describing patient conditions and getting paid) What other ...

National center of Health Statictics 
How is the NCHS involved in the process of changes and modifications to the ICD-9-CM codes?

Response:

In the United States, the The National Center ...

Fraud - what are my responsibilities and how would I handle this? 
I have been working for a physician who is in a private practice for 8 months. I have started to see a pattern with several of his workers' compensation ...

Is the NHIT certification for Medical Billing and Coding important to obtain? 
I have a National Medical Billing/Coding specialist Certification from The National Healthcareer Association.

Is an NHIT Certification also important ...

I recently recieved my Certificate in Billing and Coding but have no experience. I 
I have a job history of strictly blue collar work. After my injury on the job I studied for and received my National Certificate for Medical Billing and ...

Is medical billing and coding a right field to go in to? 
I am fixing to start college and I am stuck on making the decision of either going for an EKG/Cardiovascular Technician or Medical Coding and Billing Technician....

Looking for Work in Medical Billing and Coding.  
I'm a Certified Medical biller and Coder that graduated on September 10th 2009. I have not work in the field because everyone one I talk to wants me to ...

Auto Insurance 
Can we use the auto insurance to pay for the ambulance bill?

Ultimately in the eyes of the ambulance company the patient is responsible. If the ambulance ...

Personalizing the call 
What do you think is the best way to personalize the call when dealing with the patient?

Sid,

Thanks for the question. I assume you're referring ...

What do medical billers wear to work?  
I am currently in school for medical billing and coding and would like to know if I will be required to wear scrubs or dress clothes to work.

Amanda,...

Re: Merkel cell carcimona 
Thank you for a very informative website.
Effective Oct 2009 Merkel Cell Carcinoma was assigned to ICD-9-CM category 209. Do you know where it is referenced ...

SALARY RANGE FOR MEDICAL CODERS 
I'M GOING TO SCHOOL NOW TO BE A MEDICAL CODER SO WHAT IS THE MEDICAL CODER SALARY LIKE THE FIRST YEAR OUT OF SCHOOL?

Answer:
The typical starting medical ...

Transition from ICD-9 Codes to ICD 10 Codes 
What's your opinion on the impact to billers of converting from ICD 9 codes to the ICD 10 code?

Answer:
I'm really concerned about how this is going ...

Housewife Interested in Medical Billing Career 
What is the first thing I should do if I am interested in a medical billing career?

Answer:

Great question. Medical billing and coding careers ...

Starting in HIT soon ...  Not rated yet
Hello,

My name is Debra and my fiance's name is Paul . We have been researching a career in HIT for quite some time geared towards having our own home ...

Unusual Questions About Medical Billing  Not rated yet
1. How much time do you spend on written or oral communication?

About 50% written communication and 50% oral.

2. What types of documents do you ...

List two reasons why the HIM Department reviews patient medical records.  Not rated yet
What is the answer to this question i can not figure it out and its a question on my paper that is due Sunday.

Response:

The Health Information Management ...

What do you Like and Dislike about Medical Coding  Not rated yet
I am doing a paper on medical billers for my medical insurance class. I am wondering a few things, like what you like and dislike of a biller. Do you have ...

Work from home ob/gyn billing jobs  Not rated yet
I am trying to do ob/gyn billing from home. Can you direct me to websites or employers who offer such employment?

Thank you for your help in this ...

Presentation for Interview  Not rated yet
I am getting an interview for a medical billing job and the potential employer is expecting a presentation. What should i prepare ahhhh!

Camille,

Wow ...

What does CO45 CHGS EXCEEDS CONTRACTED FEE MEAN  Not rated yet
I have a bill submitted to pay a portion not paid by medicare. The bill shows what was charged, what was paid by medicare, what was paid by the secondary ...

need to know the difference between CMS-1500 and the UB-04 ( CMS-1450 )  Not rated yet
This site sure has helped me out alot to answering my questions. I am just getting into medical billing and coding, this is a life saver. Just wanted to ...

What is a crib sheet?  Not rated yet
What is a crib sheet? I am studying for a certification test and have never heard of a crib sheet.

Response:

I assume what you're referring to an ...

Why is the billing process important? Explain.  Not rated yet
Why is the billing process important? Explain.

Response:

In short its important because that's how providers and their staff get paid.

The billing ...

What is the relationship between patient accounts, data flow and charge capture?  Not rated yet
What is the relationship between patient accounts, data flow and charge capture?

Response:

Charge Capture is the process of capturing the information ...

I am Planning to Obtain Training as a Medical Biller  Not rated yet
I would like to obtain training as a medical billing clerk. I am looking for some good online schools that cost under $1200. I noticed that a lot of schools ...

Fresh out of Medical Billing School - Where do i start getting an entry level job?  Not rated yet
Hi
my name is Carrie i have just recently finished an online medical billing class. My goal is to one day work at home. I'm a nursing assistant, have ...

What are the Requirements to Become a Medical Biller?   Not rated yet
Urgent - what are the requirements for becoming a medical biller?


Answer:

There are no real concrete minimum defined educational or government ...

I Just Finished a Course in Medical Claims and Billing  Not rated yet
I'm trying to find clients so I can work from home. Should I work somewhere first and get some experience. What do you recommend? Thank you for your ...

Getting Started in Medical Billing and Am Overwhelmed!!!  Not rated yet
I took a course and passed it but have never worked in a medical office before. I was told by talking with local physician staff and those who started ...

Requirements for billing Medicare and Medicaid.  Not rated yet
Gina,

I've been a inside sales rep for a one of the largest DME providers in the US for the last 2 years. In my position we cover everything from gathering ...

Changing Medical Billing Companies  Not rated yet
I need to know what is required from the billing company when a provider lets you go and hires another billing co. Are you required to give them a final ...

$500.00 monthly billed amount  Not rated yet
In the example contract it states percentage that would be due from the doctor, the $500.00 monthly minimum billed is this the billing service minimum ...

CPT Code - Removal of Malignant Neoplasm of Kidney and Ureter  Not rated yet
A patient is admitted for removal of malignant neoplasm of kidney and ureter. Under general anesthesia incision is made in the skin of the flank and carried ...

CPT & ICD-9-VOL III  Not rated yet
Should all payers be required to make standardized rules for coding or should each payer be allowed to designate the types of codes they require for each ...

Medical Coding for Dummies?  Not rated yet
I"m taking a medical billing and coding classes on line. I have no idea what I'm doing. My instructor is really nice but, I'm the type I have to be shown ...

Home Health Medicare/Medicaid Billing  Not rated yet
Hi, I am currently working for my friend's home health care business which focused on Medicare/Medicaid billing, like OASIS, IVANS AT&T portal, DDE related ...

Medical Billing - Facilities Served  Not rated yet
What type of facilities can a medical biller bill for?

Response:

Just about any health care provider or anyone who submits claims to a health insurance ...

Patient Statements  Not rated yet
Can you recommend an inexpensive way to produce patient statements?

Answer:

We use the service provided through our clearinghouse - ENS Health. I ...

Can you charge the patient a special fee on an exam and then give the patient a claim to send to insurance for the full UCR fees?  Not rated yet
Can you charge the patient a special fee on an exam and then give the patient a claim to send to insurance for the full UCR (Usual, Customary, & Reasonable)...

How do I become licensed in billing and coding in IL?  Not rated yet
I have earned a certificate in Medical billing & coding from a Jr. College, and I am very interested in starting my own home based business. I need to ...

Is it legal for patient medical infotmation to br transmitted by Fax machine?   Not rated yet
I am starting a home medical billing business and I plan to have my providers transmit patient information by Fax machine. Is this legal under HIPAA?

Charles,...

Do Diagonastic Codes Affect Reimbursement From Insurance Carriers?  Not rated yet
Do diagnostic codes affect reimbursement from insurance carriers?


Answer:

I would be inclined to say yes because the diagnosis determines the treatment ...

CPT Code for Post Op Office Visit   Not rated yet
What CPT code would be used to report an office visit two weeks after major surgery?

Response:

Sorry I'm so rusty lately on my coding that I don'...

Finance MBA - Medical Billing & Coding Course?  Not rated yet
I finished my MBA with finance specialization. Can I take a medical billing & coding course?

Please tell me my qualifications are eligible for this ...

Reasons why HIM department reviews patient medical records?  Not rated yet
Can you give me reasons why HIM department reviews patient medical records?

Response:

The Health Information Management (HIM) department is typically ...

I just went to school and want to know how to work from home!  Not rated yet
I've graduated from college. I have my medical billing and coding specialist certificate. I am pregnant and I can't find a job in my area, I would love ...

Is this the right career for me?  Not rated yet
Hey, I am Ashley and I am very interested in doing something like this so my husband and I can start our family in a few years once he is out of the military....

Taking Kaiser Business Rep test  Not rated yet
What does TPL mean?
I answered the questions Third party Liability?
Not sure what it means on the medical side of Insurance billing?

Thanks very ...

Why is the billing process important? Explain  Not rated yet
Needing help with this question.

Answer:

The medical billing process is important because it's the means by which providers (and their employees)...

Electronic Claim Submission   Not rated yet
Do we always have to use clearinghouse to submit electronic claims?

What about the software that is sold online? Can I just use that software and ...

What HCPCS code do you use for Vitamin B12, 1000 mg?  Not rated yet
Where do I find this in the CPT book?

Response:
I don't know if there's a straight forward answer as it depends on the diagnosis and conditions and ...

What are the billing guidelines regarding fees to patients with different financial classes or self pay?  Not rated yet
My office provides a service which we have just become approved to bill for. My office is state run. Some patients are not enrolled in this program and ...

Should i buy one software specific for dental or one that supports both medical and dental billing?  Not rated yet
Hi again,

Thanks for your reply on the medical software...i am looking into Kareo for medical billing as i also heard really good reviews about it....

Billing the Responsible Party  Not rated yet
What are the rules for the patient being the guarantor?

Response

It depends on the patients policy but typically the patient is responsible for ...

North Carolina Prompt Claim Payment Timing Law  Not rated yet
What is the NC Law on insurance claim payment timing?

North Carolina has the General Statute 58-3-225 on prompt claim payments under health benefit ...

License Requirements to work from home  Not rated yet
I am a certified Coding and Billing specialist but am struggling to find the licensing requirements. I would like to obtain work from home as I am a new ...

Dislikes of Medical Billing  Not rated yet
What part of your job would you say you dislike or is complicated?

Sandra,

Great question.

Here's a list of my least favorite things a medical ...

Is this cost of education for billing and coding to high?  Not rated yet
Hi I am considering a medical billing and coding program at a local school called the Health Training Center. They are based out of Cambridge, MA.

The ...

dme  Not rated yet
When you are billing a rental for DME equipment and then convert it to a sale in the 2nd or 3rd month what modifier would you use?

Response
Thanks ...

I Would Rather Take Classes Online For a Fee - Medical Billing Coding Training Question  Not rated yet
I have done a lot of research as to what school to
apply with. Some want $1500 up to $15,000. I want to be ready and hire-able when I finish, but the ...

2 transports on the same date of service  Not rated yet
A patient was transported from the nursing home to a doctor appointment and 2 hours later was transported back to the nursing home. These transports involve ...

Anethstesia billing for codes 00740 and 00810  Not rated yet
Where do I find the unit fees for codes 00740 and 00810 for a CRNA in Texas with QZ modifier, For Commercial payers?

Response:
Thanks for the submission....

Medical billing certification - Is it good in the state you got the cert or can it be good in any state?  Not rated yet
I am a current Medical Specialties student and majoring in Medical Billing and Coding along with pharm Tech, Med Assistant, and ECG reader. I hope to get ...

How to Complete a Referral for MDIPA  Not rated yet
How to Complete a Referral for MDIPA?

Response:

I'm not familiar with MDIPA but will post on the website so hopefully someone else can respond. I ...

I would like to know if I was to place an order for the books, how would I go about becoming a certified Medical Biller? Or sit for the state exam?  Not rated yet
If I was to place an order for the Medical Billing Books how might I go about sitting for the state exam in my state? Also will the certification be good ...

How to I file a Medicare Part A claim and which form do I use to file it?  Not rated yet
Can u please briefly let me know how do I file the claim for Medicare Part A?

Medicare Part A claims (Inpatient Hospital care) are filed using form ...

HIPAA and Home Medical Billing  Not rated yet
Is there a concern using home billing and protecting privacy? Is there any stipulation that the biller needs a separate and/or secure office?

Yes - when ...

Where can i get a printed copy of the insurance companies policy and procedure manual?  Not rated yet
Hi,
I'm hoping to open my own home based medical billing business soon and would like to know where to get printed copies of the policy and procedure ...

Best Medical Billing Training Program  Not rated yet
Like you, I would like to spend more time with my family. I've worked for a corporate company for the last 17 yrs. only job I've ever had since college ...

Ten Questions on Medical Billing  Not rated yet
Can you answer the following questions:

How would you describe the responsibilities of a Medical Biller and Coder?
Well they differ. Medical Billing ...

CODING INSTRUCTION  Not rated yet
I have questions on trying to learn how to code and was wondering if I am going in the right direction with this. OK when you start out coding you start ...

USE OF A1 MODIFIER  Not rated yet
I WORK FOR A HOSPITALIST WHO SEES PATIENTS AS WOUND CARE AS WELL AS FOLLOW UP. I'M CONFUSED IF I SHOULD USE THE A1 MODIFIER FOR HIS CONSULT CODE THAT WE ...

Are there dental insurance programs that you can purchase to do dental insurance billing from home?  Not rated yet
I was interested in starting up my own business from home with dental insurance billing. I am currently looking into how might I start this. I was wondering ...

Bill Question about Medical Billing Process  Not rated yet
Is it proper to say that we billed a specific insurance company even if it were denied or is it more appropriate to say that we sent a request for a claim?...

Patient Satisfaction When Considering Ambulance Billing Service  Not rated yet
What are the things that would affect the patient's satisfaction when calling for an ambulance billing service?

Sid,

When selecting a billing service ...

Just a Question on Billing Coding Medical Online Training  Not rated yet
I found a class that is offered through our votech here in town, but is an online course. It is 300 hours and its $1895.00

I currently work in a hospital ...

Is there a Book that shows how to create a crosswalk for CPT to ICD-9-CM  Not rated yet
I am doing some research PhD. Can you tell me what book(s) or file I can buy that will show me how to create a link between CPT codes and their associated ...

We've got a medical billing funding resource that your users will love....  Not rated yet
Hello,

I was checking out all the great information on your site and I think visitors to your site might also find www.prnfunding.com interesting since ...

Time Away From Work  Not rated yet
Hi Gina,

My name is Blanca, and I'm definitely looking into starting my own medical billing business from home. I have found your website to be very ...

Can we file Primary and Secondary insurance claims at same time? Or does it have to be done one at a time?  Not rated yet
Can we file Primary and Secondary insurance claims at same time? Or does it have to be done one at a time?

Typically the Primary insurance claim has ...

What ICD & CPT Code would you use for Toe Pain  Not rated yet
What code to use if New F pt came in complaining of lt great toe pain, incised, drained, and cleaned area around nail?

Maquetta,

For toe pain I would ...

Pointers on Starting a Medical Billing Business  Not rated yet
I enjoyed reading your links. I am starting a new medical billing business myself and I wanted to get a few more pointers from someone well experienced ...

What is TOS and POS and its meaning  Not rated yet
I hope this answers your question Anitha:

POS is an abbreviation for Place of Service and is used on medical insurance claims - such as the CMS 1500 ...

Average Salaries for Medical Transcription  Not rated yet
Your website is great! Very useful information.

Do you know where can I find good information on the average salaries for medical transcription? I'm ...

Online Jobs for Medical Billing  Not rated yet
Are online jobs for Medical Billing very hard to find? Do pretty much have to start a business to work online or at home in this line of work?

Yes - online ...

Can we take writeoff for Medicare secondary?  Not rated yet
If medicare is paying as secondary insurance can we take writeoff for the remaining balance?

Thanks for the question - here's my attempt to answer....

What are my options in providing a timely filed claim that was denied?  Not rated yet
What can I provide to show proof of timely filed claims to commercial payors?

Answer:
The only success I've had with commercial carriers is to submit ...

I had sent a request to interview you...here are my questions if you could answer them for me.  Not rated yet
Dawn,

Thanks for the questions - I've attempted to answer below each question....

1)What type of computer skills are needed on the job currently?...

Are you doing any hiring? or do you need someone to help you?   Not rated yet
If not I'm thinking about starting a medical billing service from my home. Is it hard or easy to start a business like this? And how much will it cost ...

explanation of benefits. plz explain this in detail.  Not rated yet
I just need to clear my thoughts regarding explanation of benefits (EOB). Sorry to say but I have not yet cleared this so plz will you explain this.


Thanks!...

Effects of the Recession on Medical Billing Coding Jobs  Not rated yet
How will this particular profession be affected if and/or when the President's Healthcare proposals are approved and enforced, or predictably anyway?

Answer:...

Medical Billing Certification  Not rated yet
Can you work as a medical biller with out being certified, rather is it a must that you are certified?

Answer:
There are no state or federal government ...