Are you looking for new medical billing software, but do not want to buy a bunch of new hardware?  Do you need have an Apple computer and require Mac medical billing software? Do you want to get rid of that clunky server under your desk? Do you want access to your billing system online from anywhere, even home, day or night? Is …

Commercial Insurance Carriers develop Medical Coverage Policies/Clinical Guidelines as a basis for the reimbursement for medical procedures. Since many are updated at varying intervals, it is important to regularly review as many of your Commercial Insurance Carrier's Medical Policies/Clinical Guidelines as possible for important changes. The Carrier's websites typically allow you to search for this information by procedure name and/or …

Each Fiscal Intermediary (FI) has the authority to produce their own “Local Coverage Determination” (LCD), based on national guidelines. The LCD basically defines under which circumstances a particular procedure is covered under the patient's Medicare benefits. As new procedures are developed, the FI will then set out to create an LCD. The FI will also review existing LCDs to see …

Many people are intimidated by the word “audit” and run in the other direction. Why should every practice do chart audits? It is important to inspect and verify your charts and billing practices before an insurance company calls for medical records. Doing regular chart audits sets you up for a sense of calm when the auditors do come knocking. Audits …

Medical practices are almost as diverse as people in regards to the arrangements and agreements that exist between physicians and facilities. The existence of different fiscal arrangements requires that medical entities bill their charges based on the specific level of service that the entity is providing to the patient.  CMS has created billing rules to accommodate these different scopes of …

A medical business should always be making steps toward improvement.  That is how we retain clients in all businesses.  Have you ever thought, “Every worker is busy. The appointment calendar is full.  The piles of work get bigger, but the money is shrinking.  It feels like everything is out of control.”   These are common thoughts for many executives and employees …

Set aside a specific amount of time to work the denials received. The practice will be better off for this approach, because consistent data entry problems or billing errors can begin to show a pattern in poor workflow or training needs. Insurance companies also have time limits on adjusting and reviewing appealed claims, so time is of the essence. When …

Secondary insurance plans often pay deductibles, co-pays, or coinsurance that is due after the primary insurance plan has paid on the claim. Secondary claims process through the insurer’s regular claims progression, so it may be somewhat of a surprise when a denial EOB shows up for a secondary claim. Remember, a patient’s secondary insurance plan has its own benefits and …

Coding claims is tricky. Radiation oncology is especially difficult because of the planning and staging processes that occur prior to treatment. On a bad day a coder can create future problems that are difficult to remedy.  Fortunately, Iridium Suite offers a safety net to help you avoid the pitfalls of improper coding. A claim scrubber is a built-in editor, like …