Archive for October, 2011
The Importance of Medical Billing Codes
Posted by admin in Insurance, Medical Billing on October 30, 2011
The process of medical billing is an interaction between a health care professional and the insurance company. By submitting and following up on insurance claims, healthcare providers receive payment for services they render. Medical billing codes play an important role in this process because they determine the amount of reimbursement the healthcare provider receives. Various codes exist for diagnosis, treatment, drugs, dental services, Medicare, and hospital treatment.
When a patient visits the doctor, a medical record is created. The doctor issues a diagnosis or cites a reason for the visit. A level of service is established, based on patient history, comprehensiveness of a physical examination, and complexity of medical decision making. This service level is subsequently converted to standardized procedure code taken from the Current Procedural Terminology (CPT) database. The diagnosis is also translated to a numerical code, taken from an ICD-9-CM database.
To arrive at these codes, medical coders translate the doctor notes from the patient visit into the proper numerical sequences. Treatment and diagnosis codes are listed on the claim form transmitted to the insurance company. Electronic transmission is the most common method, replacing paper forms used in the past. Medical claim adjusters or examiners with the insurance company process the claims. An approved claim is reimbursed at a certain percentage of billed services pre-negotiated by the insurance company and healthcare provider.
If a medical coder does not understand how to determine and assign the correct codes, the claim will be rejected by the insurance company. A rejected claim is returned to the healthcare provider, usually in the form of an electronic remittance advice or explanation of benefits, also called an EOB. The provider must then decipher the information, reconcile the details with the claim originally submitted, make any necessary corrections to the claim, and submit the revised claim to the insurance company.
Though these extra steps may not seem time or labor intensive for one claim, consider the hundreds of claims submitted by a single healthcare provider each week. In some cases, claims may be rejected and resubmitted multiple times before they are paid in full. It is not uncommon for a provider to eventually give up and accept incomplete reimbursement. To avoid loss of income for the provider, medical coders should assign the correct codes the first time the claim is submitted.
Nearly 50 percent of the time, a claim is either denied, rejected, or overpaid. This is due to the highly complex nature of some claims and errors resulting from similarities that exist with diagnoses. In some cases, the insurance company is to blame for attempting to get away without covering certain services. After the medical coder makes a small adjustment and resubmits the claim with relevant documentation, the denial may be overturned.
On October 01, 2013, the ICD-10-CM database will replace the ICD-9-CM version. Medical coders must become familiar with the medical billing codes contained in this database, so they can hit the ground running when submitting insurance claims in the future. Properly coding each claim ensures that the healthcare provider is accurately reimbursed.
How To Find the Best Insurance Agents
Posted by admin in Agents Marketers, Insurance on October 30, 2011
Protection. It’s what helps make your life stable. And if you’re not protecting yourself based on the advice of professional insurance agents, you’re taking a risk. Think about it. You trust your health to your family doctor. You rely on your real estate broker to find you the best home. You believe your car salesperson is putting you behind the wheel of a safe automobile. So, given all that you have to protect, your home, your auto, your life, your family, shouldn’t you have a knowledgeable insurance professional to advise you?
The best insurance agents will get to know you and your situation. They will make coverage recommendations based on their knowledge. Sure, we’re all tempted to go for the cheapest coverage available. You know… those sweet-talking, 1-800-do-it-yourselfers with low-cost promises. This is your future and the future of your family at stake. You deserve the quality advice provided by a professional. And the best insurance coverage for your money.
The Personal Touch and Service Advantage
Unlike large impersonal call centers where you rarely speak to the same person twice, you have a personal relationship with professional insurance advisors at independent agencies. They will know you by name, learn your history and tailor a policy that best meets your needs and the needs of your family. When your situation changes or when you have questions, you have someone to call who can advise you. It’s a personal touch that isn’t offered by those bigger companies. By working with an agent to coordinate all your policies, you can be sure you are adequately covered and not paying for any unnecessary coverage. You can expect personal attention and customized services like annual coverage reviews that will address your ever-changing needs and keep your policies up to date. After all, life can change at the drop of a hat.
Save Time & Money
Professional insurance agents will advise you and eliminate the guesswork on coverage choices and claims questions. When it comes to settling a claim or changing your coverage options, you’ll find that having someone there to advise you is better – saving you time, money and headaches in the long run. And unlike other insurance companies that tout saving you money in 15 minutes, your agent will actually take the time to consider your needs and lifestyle before making any recommendations. The fact is that 15 minutes is often only enough time to reduce your coverage and increase your risk.
Knowledge
Sometimes the claims process can be frustrating, but having someone experienced and knowledgeable by your side can give you peace of mind. If you’re wondering how to get an agent, first you want to choose one who is a knowledgeable professional. As you know, there are infinite combinations of insurance options available to you. Insurance agents are state-licensed and must adhere to state-regulated continuing education requirements. They can help narrow down exactly what you need and what amount of coverage is best for your situation. Whatever trauma led you to the claims stage was no doubt stressful enough. Your agent will know how to avoid the “red tape,” making headway through it quickly and efficiently.
Reputation
Reputation and stability are important in insurance. Insurance agents backed by a reputable, well-established insurance company will give you the assurance of reliability and excellent service. They’re more likely to be there when you need them. After all, the more resources and support insurance advisors can draw from, the better they will be able to work for you. And word of mouth goes a long way when you’re figuring out how to find an agent. Ask around or research company and agent reviews online to get a good idea of whom you’re dealing with.
Useful Strategies to Get Cheap Car Insurance For Young Drivers
It quite seems like a contradiction when as a parent you look for cheap car insurance for young drivers. The teenagers as it is automatically tend to hike the cars premiums through various companies. There are, however, many car insurance companies which offer cheap insurance for young drivers, though there are not too many of them. The most common way to get the cheapest quote is to find the quotes of various companies. The best way to do this is to do an online search for insurance comparison rate search. Before you start looking for car insurance for young drivers it is helpful if you can ensure that there is no violation of traffic rules in the past one year. You can also get a cheaper quote if the driver is over the age of 19 years. Traditionally for someone who has a bad traffic record or is a new driver, to get a cheap car insurance is not easy. In such cases, the insurance companies tend to severely punish the car owner by charging a higher premium.
However, there are many agents who can help you to get comparatively cheaper car insurance policies even if you fall in the high risk bracket. Being one among the high risk drivers seeking cheap car insurance, you can get one by paying higher deductibles. Thus by paying higher deductibles if there is a collision, you can pay a lower premium.
But being a young driver with a cheap motor insurance policy, you will not be covered if you are driving a rental car. Thus any accident involving a rental car will not be covered by the cheap insurance cover. As a young driver another way you can avail a cheap insurance policy for your car is to get a limited insurance. Getting a limited insurance coverage for your car means that there will be no windshield cover and also there will be very limited anti theft coverage. So if you are getting your insurance through a company which generally does not offer young drivers car insurance, than chances are that you may end up paying a higher price than what is necessary.
In order to ensure that you get the best quote, go online and compare the rates of various motor insurance companies which offer insurance cover for young drivers. By doing a careful research and comparing the insurance rates offered by various companies you can save on thousand of dollars. If you do careful research you can actually find several motor insurance companies which specialize in offering the best deals to the young car drivers and the high risk drivers. Most of these companies are well recognized in the insurance field. They are especially well known for offering great insurance rates for young drivers and are reliable firms. Thus it is wise to deal with these specialized companies as they have carved out a way to make insurance cheap for young drivers who are looking for cheap motor insurance. So go online and do a thorough research before you zero in on any particular company.