Wednesday, 22 November 2017

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Importance of Medical Coding and Billing in the Healthcare Industry


Medical coding and medical billing are two of the most vital segments of the healthcare system in the USA. To maintain patient safety, quick payments for treatments provided and effective operations of a healthcare facility, both of medical coding and medical billing are needed. These two require professionals who are skilled at reading, understanding, recording and tracking critical medical information at a quick pace and at the same time maintaining confidentiality. But, why and how are these two fields important for the healthcare industry? Let’s see how medical billing and medical coding play an essential role in modern medicine and medical industry.

Medical coding is all about patient care:
Medical coding jobs require taking information related to diagnoses, treatments, procedures, medications and translating them into alphanumeric codes. All this information is collected from a wide range of sources that include physician notes, transcription reports, electronic records and various lab results which consist of blood tests, urinalysis and pathology and radiologic assessments.
Professionals in medical coding jobs also transfer the codes to medical billing systems and patient records. Coding is a significant step in the process of preparing and submitting medical claims and bills to insurers and patients.

Coding is very important as there is a great scope of it indirectly affecting medical care because it relates to insurance reimbursements. In these days of high dependence on insurance reimbursements for medical services, physicians are under the obligation to list all the underlying conditions, untreated diagnoses, and preconditions. Giving accurate codes to all services provided ensures that insurers have all the diagnostic codes required for appropriate payment. Going further, coding is also critical to study prevalence of the diseases, results of various treatment methods and demographic assessments.

Abiding by compliance:
All the healthcare providers have to deal with medical billing and medical coding as they fall under many state and federal guidelines. One of the most significant compliance issues is related to the Health Insurance Portability and Accountability Act (HIPAA) which protects patient confidentiality that requires any healthcare provider to follow proper safeguards to protect confidential patient information. HIPAA guidelines also talk about the electronic medical records and the International Classification of Diseases (ICD-10) codes issued by the World Health Organization (WHO).
Moreover, in many instances, medical practitioners are in contracts with insurance companies where the contracts define negotiated rates for various medical services. Appropriate use of codes and accurate billing procedures are required to ensure that practices are in contractual compliance.

Helping the cash flow:
Medical billing is that practice of healthcare industry that ensures proper cash flow to the provider and improves the smooth operation of the revenue cycle. For this to happen medical billers have to understand various rule and regulations with respect to the different private and public insurance plans. They need to gain specialized skills in the procedures of claim follow-up, claim denial management. 

The role of medical billers and coders is very critical these days which is increasing their demand. Avontix is the best choice for aspirants who want to join medical coding and medical billing jobs in Hyderabad.

Publisher: Avontix - 02:11

Monday, 20 November 2017

Stop Procrastinating and Become Successful

                                     

Do you remember when is the last time you wanted to do something and did it immediately? It’s very common for all of us to have an agenda to do something and then conveniently postpone that work for some indefinite time. It happens many times that you want to clean up the mess at your home, but put it away for the next day. Then again you postpone it to another day. This kind of procrastination is common in everyday life, whether it’s personal work or official work. There is a momentary feeling of goodness when we procrastinate doing something. But, it also builds up some pressure or tension on us and sometimes we may even lose out on achieving something due to this kind of behavior.  When you are really exhausted and can’t do some work, it’s alright to postpone it. But, postponing things just because of lethargy will impact negatively on your personality and your productivity. Here are some tips to keep procrastination away from you.

Go for small tasks:   Usually, it happens that we procrastinate doing some work because it is a gigantic task and requires great efforts. In such cases, to avoid procrastination what we can do is, divide a big task into few small tasks. In the case of cleaning up the mess at home, it seems to be a big task when we think of the home in totality. But, break the task into smaller tasks by cleaning one room at one time, then, you will not find the task difficult at all. Work with one room a day and you will finish your task easily without exhaustion. You can follow this trick in whatever kind of work. Whenever you feel that your work is overwhelming, then, break the work into smaller tasks and you will never procrastinate doing things.

Go for small time slots: Forget doing work continuously without a break. We cannot concentrate on any work for more than a couple of hours. Even if you have a big task to be completed, apart from breaking down it into multiple tasks you will also have to work in multiple schedules. Take short breaks in between doing tasks or rather take a break after every one and half hours of work. This will relax your mind and lets you work better after the break which will force you to stop procrastinating. To avoid procrastinating working you can even try juggling with one easy task and one tough task alternatively to boost your enthusiasm towards work.

Make up your mind: Many times we procrastinate doing something because we fear it will consume all our energy and time in doing so and at last the result is also not predictable. In such cases, it is mostly a psychological feeling that we won’t be able to do a particular task, so we procrastinate doing it indefinitely. To avoid such situations, we have to make up our mind that we can do it and we will succeed in our efforts. We can also recollect the times when we finished such similar tasks successfully before.

Procrastination is a bad habit that can be rectified with some sincere efforts. It may not be dangerous, but can make you struggle with everyday work. To enjoy life the most, don’t procrastinate your work and have a peaceful day.

Publisher: Avontix - 03:17

Sunday, 19 November 2017

Steps to Minimize Medical Claims Denials





One of the biggest challenges faced by healthcare providers and medical billing industry is the claims denial. Constant changes in various regulations and updates in ICD-10 are resulting in increasing claims denials that prove to be a hindrance to several healthcare providers.

Adequate Monitoring of Denials:
Medical billing industry is facing revenue losses to the claims denials. To avoid denials the main requirement is to monitor the regular billing and claim submission processes precise and less time-consuming. The primary goal of professionals in medical billing jobs is to see that the financial stability of the healthcare providers is maintained while the physicians provide the most optimal health care to the patients. One of the most significant and influencing factors in this aspect is achieving proper reimbursement for services provided. Claims denials play a critical role in the financial well-being of healthcare providers.

Monitoring and managing denials of medical claims is an important task for the healthcare providers. But with innovative technologies and software that simplify processes has made the identification of claims denial easier, which reduces the risks and costs associated with denials. With numerous changes in the regulations and different procedures of various insurance payers, it becomes essential for healthcare providers to develop effective strategies to handle insurance claims and manage denials. It gets mandatory for healthcare practices to invest both time and human resources in monitoring and managing the claim denials.

Achieving good revenue generation is one of the goals for every organization, regardless of the type of industry. Professionals in medical billing jobs also cannot ignore this. By following some steps, medical billers can lower the denial rates and improve revenue generation for the healthcare facilities.

  • Every medical biller has to be aware of the current denial rate. Denial rate and factors associated with denials like reasons, payer company rules need to be understood well so that proper remedial actions can be taken.
  • Denials can occur due to various reasons for different practices. Medical billers and the related people should b able to understand all the various reasons and these should be mapped into categories and analyzed periodically to identify the root cause of the problem and how it can be overcome.
  • A claim denial management team should be created consisting of different professionals such as billers, coders, physicians and accountants for collecting and reviewing relevant data which will help create a systematic workflow to monitor and manage the denials.
  • All the staff that is directly or indirectly related to the documentation and data entry of patient information, billing and claims procedures should be educated and trained to achieve accuracy and minimize errors which lead to claims denials.
Following some simple steps and working in accordance with the various rules and regulations will help in minimizing claims denials and improving revenue cycle of the healthcare providers. Avontix is one of the best medical billing companies in Hyderabad that provides the best medical billing services and revenue cycle management for its clients.
Publisher: Avontix - 22:33

Is Medical Coding a Tough Job?



The process of assigning proper universally accepted codes to the documentation reports of patients’ medical records which are used to submit health insurance claims to the insurance providers is called medical coding. The person in the medical coding jobs, who performs this process, is called a medical coder, and a coder needs to allocate appropriate medical codes like CPT, HCPCS, and ICD codes to patients’ claims. In other words, when a patient visits a healthcare facility due to any reason, his or her visit is recorded in certain medical codes that help in tracking the patients’ visit’s reason and the services received which have been billed.

Is medical coding a tough job?
As it is with any other job, the right person with right attitude and skills will not find medical coding difficult. Medical coding jobs basically need an eye for detail because one cannot afford to miss any information while working with crucial patient information and every diagnosis, treatment or service needs to be given appropriate codes. Usually, it happens that beginners will find it a little difficult. This is because medical coding field demands a good understanding of medical terminology along with the knowledge of human anatomy, and physiology to master the nuances of coding systems.

Challenges for a beginner in coding:
There are many medical coding companies in Hyderabad that provide opportunities to beginners. We know expertise cannot be attained so easily. It needs solid determination combined with a learning program that gives necessary knowledge and confidence to perform a job perfectly. Let us see some common challenges faced by a beginner in medical coding:

  1. Translating complex medical conditions and symptoms into appropriate and clear code
  2. Coders have to gain sufficient knowledge to understand particular symptoms related to a disease or illness so that when physicians pass on case sheets with signs and symbols regarding the symptoms they can conveniently pull out the critical information from those and document them accurately.
  3. Eye for detail is a must in medical coding. Understanding the details of diagnosis and treatments and including all the information without missing any details and rechecking the work properly is laborious, but is essential to do error-free coding.
  4. Many changes happen in the healthcare industry often which requires constant updating of industry knowledge by medical coders. If medical coders are not adaptive to changes they may not be able to give appropriate codes to the services provided by healthcare provides.


Though it is a little bit challenging in the beginning, medical coding is an interesting career and can be enjoyed with some perseverance. To code error-free, here are some tips to achieve perfection in medical coding.
  1. Participate in quizzes and keep updating your knowledge on a continuous basis because practice makes perfect and helps to remember information for a long term.
  2. Don’t settle for anything less. Total grasp of the subject is required to excel.
  3. Do some online exercises or watch online videos that help in honing your skills and knowledge in medical coding. 


Although medical coding does seem to be a difficult job, it is not rocket science. With determination and perseverance, one can become an excellent coder. As government makes it mandatory to document all the patient information into electronic health records and more and more people are covered under various health insurance plans, medical coding has gained further significance. For a bright career, join Avontix, the best medical coding company in Hyderabad.

Publisher: Avontix - 22:06

Wednesday, 15 November 2017

Acquaint Yourself Further with Medical Billing


In our previous article, we have already understood that to catch the medical billing nuances fast it is very helpful if the terms that are commonly used in the medical billing jobs are understood first. As a continuation of our efforts to understand the various medical billing terms, in this article, we shall see some more terms that are commonly used in the medical billing industry.
Fiscal Intermediary – Fiscal Intermediary (FI) is a Medicare representative who processes Medicare claims.

Guarantor – Guarantor is a party that pays for an insurance plan of a patient but he himself is not a patient.

HCPCS – Healthcare Financing Administration Common Procedure Coding System (HCPCS) is a coding system to explain the various services, treatment and devices used in providing healthcare. These codes are commonly used by medical billers to file health insurance claims.

Healthcare Provider – Entities that provide healthcare services to patients like hospitals, physicians, clinics, nursing homes and all healthcare facilities are called healthcare providers.

Hospice – Hospice is medical care and treatment for inpatient, outpatient or home healthcare for terminally ill patients.

ICD-10 Codes - International Classification of Diseases codes are set of codes that are used to represent the diagnoses of patient medical conditions. These codes consist of 3 to 7 digits.

Managed Care Plan - This is a health insurance plan in which patients are required to consult doctors or hospitals that operate in the insurance company’s network only to receive coverage.

Medical Coder – A medical coder is one who is in the medical coding jobs and assigns different medical codes to the services provided by the healthcare facilities.

Medical Billing Specialist - A medical billing specialist processes insurance claims to receive payments for services rendered by a healthcare facility. Professionals in medical billing jobs ensure that the codes and all other critical information entered in the insurance claims are accurate while submitting them to the insurance companies.

Medical Necessity – This term refers to the services a patient requires for the treatment of a serious medical illness or condition and does not include cosmetic or investigative services.
Medical Record Number - This is a unique number given to a patient’s medical record so that it can be differentiated from other medical records.

Medicare - Medicare is a federal program that provides health coverage if you are 65 or older or have a severe disability, irrespective of your income. 

Medicaid - Medicaid is a state and federal program that provides health coverage if you have a very low income.

Modifier – These are CPT codes that are used additionally to explain any alterations or modifications to a treatment or service.

NPI – National Provider Identifier Number is a unique 10-digit number given to every healthcare provider in the USA.

Primary Care Physician – A physician who gives the basic healthcare services for a patient and recommends additional services if necessary for serious treatments.

PEC – Pre-existing condition is a medical condition of a patient that is in existence before receiving coverage from an insurance company.


For a bright prospective career in medical billing in Hyderabad, choose Avontix which is one of the top medical billing companies in Hyderabad.

Publisher: Avontix - 21:46

Technology and Its Role in EHR Solutions



The technological advancements have changed our lives tremendously. The impact of technology can be seen in every field of life. In the healthcare industry, technology has not only helped improve the quality of life with new machines and medicines but also has helped both the healthcare providers and patients with patient information at the fingertips which facilitate faster decisions. The electronic medical records and electronic health records are a result of the technology. Let us a take a look at some of the recent trends in the electronic health records arena.

Using mobile technology: With more and more people using smartphones, there is an increase in the demand for access to medical records on mobile phones. Since patients move from one place to another and visit different specialists, it is understood that it becomes necessary to be able to access the information from anywhere.

Using cloud technology: The cloud technology comes with its own benefits of cost-effectiveness, more storage capacity and security. This induces healthcare providers to use cloud technology to maintain their electronic health records.

Linking pharmacies: Using the technology more and more pharmacies are getting linked with healthcare providers and this facilitates easy access to medication prescribed by physicians and helps in reducing errors that occur due to the illegible writing of the physicians.

Integration with medical billing: With the growing use of technology many healthcare providers are looking for vendors who can provide both medical billing and EHR solutions as integrated services.
Integration with telemedicine market: The telemedicine market is seeing a growth and many physicians are searching for opportunities that help them in providing best healthcare to their patients even remotely. In such scenario, it becomes important that such remote care providers integrate their services with the electronic health records to be compliant with the healthcare regulations.

Avontix provides to ASCs through its EZchart, a complete chart management solution that is designed to bring efficiency EHR solutions and savings to ASC patient record management. Our EHR solutions utilize the latest technology and simplify processes.

Publisher: Avontix - 21:01

Clear your Medical Coding and Billing Myths



Though medical coding and medical billing have emerged as the most sought-after career options with lucrative pay packages, many candidates are still thinking to get into this field. This is because of the myths that are common to this field. Let us see some of these myths and the truth regarding them that is beneficial to those who wish to join the healthcare force that makes a difference to the revenue cycles of the healthcare providers.

Only medical knowledge is required: It is true that medical coding and medical billing jobs require medical knowledge of medical terminology, anatomy, diseases and procedures. However, it is not just medical knowledge that is required for these jobs, but knowledge of insurance policies and procedures, coding guidelines and HIPPA regulations are also required to master the skills. So, not only people with medical knowledge but anyone with good math skills and an eye for detail can pursue a career in medical coding and billing industries.

These jobs are data entry jobs: Though these jobs need the transforming of medical reports into codes, they are not just data entry jobs. The medical coding jobs require that the coder reads and understands the physician’s records and translates them into codes. So, these jobs are not just data entry jobs but, they require good analytical skills to understand the physician’s reports and decide which information is relevant to be translated into codes.

Automation will take away jobs: It is one of the biggest concerns for people joining the medical coding and billing industry that newer technologies and automation will reduce the need for human medical coders and billers. But, this is nowhere near to the truth. The truth is that there would be a growth of up to 15% in the demand for medical records technicians in the coming 5-10 years. Also, with the growing aging population and their medical needs, the demand for medical coders and billers will increase.

Remove the blocks created by these myths and make a challenging career in medical coding and billing industry. Avontix provides the best opportunities in medical coding jobs and medical billing jobs in Hyderabad.
Publisher: Avontix - 20:55
 

 

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