From: NGuinn555@comcast

From: NGuinn555@comcast.net
Sender: Practiceimprovement1@yahoogroups.com
Mailing-List: list Practiceimprovement1@yahoogroups.com; contact Practiceimprovement1-owner@yahoogroups.com
Date: Sun, 23 Oct 2005 22:35:20 +0000
Subject: [Practiceimprovement1] Billing/coding
Reply-To: Practiceimprovement1@yahoogroups.com

Like Gary, I was determined to learn billing. Unlike Gary, I was not organized enough to find a class, so I just read manuals, looked on internet and ran many "test claims" in the first year of practice to see what worked and didn't work. I gotta say Medicare was the best trainer I had. Whenever they didn't pay, I would call (almost never waited on hold) and chat with the women who answered the phone to figure out what I had done wrong.

While using modifiers is more complicated than just billing the basic part of each visit, it is essential for the financial success of this practice. Two of my major insurers will pay on both preventive and E/M coding on the same visit if I use a 25 modifier and all pay for use of liquid nitrogen or histofreezer (the 17000 codes) with the 25 modifier. Medicare reimburses well on 17000 and 17003 when combined with the 25 and 51 modifiers. All insurers pay for vaccinations if codes are added. The CLIA-waived tests pay for themselves if I remember to put in the codes. I don't break even on microscopy/CLIA fees, so do that for free.

It is cheaper for me to hire a partime person to come in and use my software to do billing for about 6 hours a week than send my billing out at the 6-8% rate. He enters and uploads my coding for the week's visits, enters EOBs (after I read them and make notes) and phones companies to argue about payments.

Nancy