In-house vs outsourced medical billing comes down to total cost and results. In-house billing costs more than salaries: add benefits, software, clearinghouse fees, training, and coverage for time off and revenue lost to denials. Outsourcing replaces most of those with one fee, usually a percentage of collections. The right choice [...]
To switch medical billing companies without losing revenue, plan a 60–90 day transition: give notice under your contract, agree on who works the old accounts receivable (AR), move ERA and payment routing, transfer your data, and run both teams in parallel until the first payments post. Most cash-flow gaps come [...]
Z13.89 is the ICD-10-CM code for an encounter for screening for another disorder. It is used when a patient without symptoms is screened for a condition that has no more specific Z13 code. Screening means testing people who show no signs of the disease; if symptoms are present, the test [...]
Z51.89 is the ICD-10-CM code for an encounter for other specified aftercare. It sits in category Z51 (encounter for other aftercare and medical care) and is used only when no more specific aftercare code fits. It is often searched as a “medication administration” code, but most drug administration encounters are [...]
Z51.81 is the ICD-10-CM code for an encounter for therapeutic drug level monitoring. Use it when a patient is seen to confirm a medication is at a safe, effective level, for example, a blood test for a patient on warfarin, lithium, digoxin, or an anti-seizure drug. ICD-10-CM also instructs coders [...]
The ICD-10 code for a medication refill is Z76.0 – Encounter for issue of repeat prescription. It is used when a patient’s only reason for contact is to get a prescription renewed, without an exam or a change in treatment. When the provider evaluates the condition the drug treats, code [...]
The fall ICD-10 code for an unspecified fall is W19.XXXA (unspecified fall, initial encounter). Falls are coded in the ICD-10-CM category range W00–W19, and the right code depends on how the patient fell: on the same level, from furniture, from stairs or a ladder, or from a height. Fall codes [...]
Review focus: Accounts receivable calculation, aging analysis, collections workflow, and denial management A practice can collect a large amount of money every month and still have a cash-flow problem. That sounds strange until you look at what is sitting unpaid. Claims may have been submitted but not processed. Some may [...]
Source review: Current CMS Medicare guidance and AMA CPT resources A psychotherapy claim can look completely reasonable when it leaves the practice. The diagnosis is there. The note is signed. The therapist spent meaningful time with the patient. The claim goes out with the code that seems to match the [...]
Getting credentialed with health plans can feel like one long administrative task. You gather your license, education history, work history, malpractice information, practice details, and other records, then enter much of the same information into another system. CAQH proview set-up was created to reduce some of that repetition. For a [...]