What Is A Medical Coder And What Do They Do?
Accurate medical billing plays a critical role in ensuring that physicians get paid consistently and at a reimbursement level that is appropriate for their credentials, the type of treatment administered, and any specialist services they offer. Of course, this reimbursement also affects their ability to do other essential things like pay administrative staff, update their medical equipment, purchase new medical supplies, and even pay their in-house administrative staff. Errors and missing information in a claim that’s accidentally submitted to [...]
How To Determine Relative Value Units In Medical Billing?
The world of medical billing, procedures and medical coding is rife with terminology that seems to change all the time. This includes abbreviations that you might not be familiar with like RVU. What Is Medical Billing RVU? In the world of medical billing, RVU stands for Relative Value Units. Total RVU-based compensation requires paying a physician base on the type of work they administer in the process of treating a patient. If you aren’t familiar with the term, RVU [...]
Top ICD-10 Codes for Mental and Behavioral Health
Accurately medical billing is not an easy task for a lot of small practices and solo practitioners. The wide range of evolving terms and acronyms used for even the most simple of services can be exceedingly complex. An incorrectly used code or even a simple piece of missing information can lead to significant delays in your revenue stream as well as increasing the risk for a claim rejection or claim denial. As the various code books continue to evolve [...]
New 2021 E/M Coding Changes You Should Know
Every year payers and public health institutions like the Centers for Medicare and Medicaid Services and the American Medical Association implement changes to their Evaluation and Management coding. Like clockwork, these changes were implemented on January 1, 2021. Physicians and medical practices of every scale need to educate themselves and their staff on these changes to minimize any delays and reduce the risk for potential questions when filing a claim or requesting prior authorization. This also helps ensure that [...]
What Is A Medical Billing Clearing House?
There are many important facets to the medical billing process. One of the most important steps includes the use of a medical billing clearing house. Though not everyone is fully clear about what a medical billing clearing house is, why it’s important and how to choose the best medical billing clearing house to meet your practice’s needs? What Does A Medical Billing Clearing House Do? A Medical billing clearing house essentially acts as a middle man helping to connect [...]
How To Use Medical Billing CPT Modifiers Correctly
Medical billing professionals often have to use modifiers to affect the description of a diagnostic process, treatment plan, or other service performed for a client. This also includes things like prescriptions or other medical supplies that may have been provided to a patient as part of an effective treatment plan. What Are CPT Code Modifiers? A CPT code modifier is a two-digit code that is specifically linked to a CPT code that needs a further description of the [...]
What Is Medical Billing Prior Authorization & When Do You Need It?
Prior authorization plays a critical role in the process of diagnosing, treating, and accurately billing claims that meet a patient’s important medical needs. Medical insurance providers often require it for specific services and specialty treatments. With prior authorization, the patient, and the physician administering treatment are more likely to see a fast, and efficient payment of a claim. With little to no headaches. Without prior authorization, a claim for specialty diagnostics or treatment is more likely to be delayed [...]
How To Maximize Mental Health Insurance Reimbursement Rates?
Most small sustainable mental health practices require the therapist to wear many hats. Often all at the same time. This includes things like being your own administrative assistant, a medical billing specialist, marketing maven, and perhaps even the office janitor. This can be a real challenge, as these other tasks can end up taking your focus off your chosen specialty which is providing your patients with the highest levels of care. Ultimately, the better you understand the business aspect [...]
What is Prompt Hierarchy In ABA Therapy?
Applied Behavior Analysis therapy offers a wide range of techniques to help teach children with autism. Prompt hierarchy may especially helpful for teaching autistic children a new task. This represents an important step in helping a child develop a greater quality of life as an adult. With this ABA treatment strategy “Prompting” refers to the level of instruction a child is given when you ask them to complete a task. It can be a physical, visual, or verbal cue [...]
What is CPT Code 90791; When & How To Use It
CPT Code 90791 is one of the CPT codes most commonly used by licensed behavioral health providers. It is used as part of an integrated biopsychosocial assessment, this includes key details like the patient’s mental state, their history, and recommendations. CPT Code 90791 is typically used for diagnostic evaluations that are related to new behavioral health concerns or illnesses. It’s usually billed for the initial intake appointment and evaluation that each new patient needs to go through at the [...]
