Medicare has been giving all doctors a “grace period” on coding to the specific level of specificity for DX codes.  This grace period ends Oct 1, 2016.  Contact us for our Encoder Pro $149 add on program to Medisoft that helps you code correctly.   Call us at 888-691-8058 or 941-743-6666

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Medisoft V21 should be available soon for your healthcare\physician back office this year, in 2016.  This new version will have features to help improve the revenue cycle management of your practice and help improve the medical and insurance billing functions of your clinic or office.

An available option for Medisoft Version 21 is Encoder Pro that helps with the medical coding of ICD-10 diagnosis codes and CPT procedure codes.  You can search using common terms or clinical terms, then pull that information back into Medisoft.  You can also cross code from ICD9 to ICD10 and vice-versa.  The program also allows you to enter a CPT procedure codes, and find the common ICD-10 codes that get billed with that procedure code.

Of course Version 21 will also come with built in compatibility with BillFlash patient electronic statement functionality.  This allows you to easily upload your patient statements electronically to BillFlash and let them do all the “heavy” work of printing, stuffing, and mailing your statements for only pennies more than the stamp you are already using.  Physician offices tell us this is a tremendous timesaver, and doctors love the fact that their statements gets out on a regular monthly cycle again!

Need custom insurance billing reports? Contact us at 888-691-8058 or 941-743-6666 and talk to us about your custom reporting requirements.

Medisoft Practice Choice is available as a cloud based EHR program to help you transition from paper medical records to online electronic health records, call us today at 888-691-8058 or 941-743-6666.

Are you still spending your valuable time manually posting EOB’s? If so, call us about signing up for electronic payment posting of your insurance checks, and in just a couple of minutes, post that large EOB quickly and easily without manual insurance payment posting.

Are you constantly having problems with your electronic clearinghouse?  Call us about our integrated clearinghouse that works right inside medisoft, and gives you information about your claims right in Medisoft and can help reduce your EDI frustrations and nightmares.

Call us today at 888-691-8058 or 941-743-6666 to talk to us about any frustrations you may be experiencing with your medisoft revenue cycle management and we’ll be happy to try to help you.

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Curious about what a Medical Claim is or looks like?

Medical claims are a printed or electronic document that contains information from a Medical provider, about a patient, regarding the visit or treatment.

The claim is usually printed on a CMS 1500 insurance claim form like the following:

 

Medical billing claim form

Medical billing claim form

 

The doctors office usually completes the insurance claim form for the patients and prints and mails it or sends it electronically to the insurance company.  Some medical offices do not submit this form, but instead print a basic “receipt” that has the doctors name and office address; and a list of CPT procedure codes they are billing for, and the associated Diagnosis codes assigned to the patient and the patient must file this with thier insurance company.

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Change Status

Pressing the Change Status button will allow you to change the status for a group of statements. Pressing this button will bring up the following screen.

The first thing you will need to specify is which statements you wish to change. This can be done by selecting the Batch option or the Selected Statement(s) option.

Batch: Selecting Batch will allow you to specify a certain batch number, and change the status for all statements within that batch.

Selected Statement(s): This option will allow you to change the status for a statement or group of statements regardless of batch number. In order to select multiple statements, you will need to hold the [CTRL] button down and click on the statements you wish to change. This must be done PRIOR to pressing the Change Status button.

After selecting which statements you wish to change, you will need to specify the current status of the statements you wish to change. The Status From field will allow you to only change statements that have a certain status. You also have the ability to change all selected statements regardless of status. This is done by selecting the Any status type field.

Once you have selected the current status you wish to change, you will need to select the new status you wish to assign to the statements.

If you would like, you can change the billing method from paper to electronic or vice versa. This is done using the Billing Method From and Billing Method To fields.

The process is completed by clicking the OK button.

 

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Condition

The condition tab contains various fields related to the patient’s condition. Most of these fields are necessary for insurance billing in certain situations. We will not discuss each of these fields. For information on when to use these fields, refer to the Clickable CMS (HCFA) form within the Help File, or your Electronic Claims documentation for information on how to populate these fields.

In this section we will focus on different functionality available within the fields listed on this screen.

As you can see, there are date fields that offer the drop down calendar, such as the First Consultation Date. There are also date fields, such as the Injury/Illness/LMP Date, that do not offer the drop down calendar. The fields without the drop down calendar are used to enter non-date values into these fields.

There are two valid non-date values for these fields:

G: This value is used to designate the field as Gradual. If you type a G and tab off of the field, you will notice that it fills in with the word Gradual.

N: This value is used to designate N/A or Not Applicable.


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A recent Wall Street Journal article reports that approx one fourth 1/4 of all claims submitted by nursing homes were incorrect based on a Federal Report due Thursday. The Journal claims the majority of claims were “up-coded” to a higher service than what was necessary. The Journal claims the report mentions that Nursing Homes inflates the cost of its bill to Medicare by claiming more intensive services were done than actually performed.

So whats new? Votes get inflated, so why not claims? lol… Do you think this is done on purpose or is it an honest mistake or poor training in medical billing? I”d like to hear your comments.

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