E/M Medical Coding Basics
Medical students and residents are infrequently taught and we are often asked about basic coding skills. Today we will review basic outpatient/office E/M coding after the 2021 updates. Come back next week for sample cases to help understand. As always, please consult with your medical billers/coders should you have questions. If you are looking for […]
Mind your Modifiers
Managing your healthcare claims requires knowledge of CPT modifiers. They are critical to have a high clean claim rate and reduce denials. It is critical to make sure that the modifier is billed on the correct day, on the correct CPT code, and with sufficient documentation in the clinical note. At National Revenue Consulting, we offer […]
Unbundling Part 2
Happy Friday! Last Friday we discussed the principles around unbundling CPTs and how that can be inappropriate leading to denials and even legal action. This can occur either unknowingly or intentionally to increase revenue and is an important reminder to have a dedicated coder or knowledgeable billing reviewing your codes. As a reminder, the Medicare […]
Finding the Right Biller – One Size Does Not Fit All
One of the reasons we opened National Revenue Consulting was because we saw healthcare professionals who loved seeing patients but could not find the time or energy after a full day to manage the billing. Among other things, they also struggled with outsourced services and always had to manage those partners. Our number one commitment is […]
Unbundling CPTs
Unbundling is the topic for Friday’s Fraud Alert! Join us every Friday for tips on medical billing. Unknowingly or knowingly, offices sometimes improperly unbundle CPT (current procedural terminology) codes to increase reimbursement or due to misunderstanding. Unbundling occurs when an office will bill multiple CPT codes for services that should be covered by a single […]
Group Purchasing Organizations
Group Purchasing Organizations … What is a group purchase organization and what can it do for my business? How can this apply to my private practice? I find this topic one of those quick lessons that can be so powerful in healthcare and even more powerful for small practices where even small expenses can add […]
Key Billing Metrics
The number one thing we have recognized about many of our new clients is that in the past they have been completely in the dark when it comes to medical billing data in their practice. Monitoring your practice’s financial performance when it comes to revenue is critical for your group’s success and ensures that you […]
No Surprise Act
Let’s go over the 2022 new “No Surprise Act” created to protect patients covered under group and individual healthcare plans from receiving surprise medical bills. Okay so let’s break it down. There are a lot of details in this so hang in there with me. As always, these are recommendations only, please consult with your […]
Prolonged Patient Visits
We are often asked about how to manage prolonged patient visits when it comes to billing and coding. It is important to remember that you must have a true clinical reason for the prolonged visit and the documentation to support the extended care. We will review a few different types of codes to use with […]
