2 – Medical Services

Is One Treatment Center Better Than Another?

A lot of drug and alcohol addicts say that there is a difference in the treatment of care that one rehab provides than another. Many addicts will often leave a program that is supposed to help them because they believe another rehab will do a better job.  It is important to feel comfortable with your treatment center before actually going there to get help. Many addicts forget that rehab should get them clean for life. Unfortunately, most rehabs do not have a high success rate. Most addicts end up going back into rehab more than 3 times before they actually take the road to sobriety. Treatment centers are not the only sources for help. In fact, many treatment centers take years to help an addict to get sober. It is not uncommon for a treatment center to get a person back into their program after only months of being released.  It takes a long time to get people interested in what you are doing.  It is important to look past the differences that you may have had previously.  It is important to feel connected to a treatment center that is willing to help you. When choosing a treatment center, look at the program before the location.  It is important to feel comfortable with what you will be doing every single day.  Are you going to enter into a rehab looking for help or because you want to fool around? Many addicts look at a treatment center as a luxury spa. Some have horseback riding, golf, television, cell phone usage and much more.  Treatment should not feel like a vacation….

Medical Codes: What Are Their Meanings?

A medical coder and biller have many stresses throughout the day.  For starters, coders often feel a sense of stress and confusion as to the many changes happening in coding today.  If your claim gets denied after all of your hard work efforts, your boss will be sure to let you know.  Many billers are getting pint slips these days because they fail to learn ICD-10 accurately.  Employers seldom realize how much time and experience it takes to be good in ICD-10 coding.  The good news is that coders have access to online copies of CPT and ICD manuals.   It is important to realize that medical coding doesn’t have to be all that hard if you will study and learn the correct codes and how to document them properly. CPT codes have 5 digit numbers.  Who maintains these codes?  It is the American Medical Association.  These codes get reported to private insurance companies and Medicare.  Whenever a physician gives treatment to a patient, these codes are used to properly document information to the insurance companies. When an insurance company receives these CPT codes or a claim, the doctor receives money for the services rendered.  The problem that insurance companies were having for the past several decades was proper reporting. It was known that many blood labs were abusing the healthcare system and sending in claims for patients receiving multipole blood tests. However, the claims were unjustly warranted. The patients did not need all of this blood work and many blood labs got shut down because of it.  Insurance companies had to pay out millions of dollars unnecessarily.  Today, there…

ICD-9 and ICD-10: What Changed in Medical Coding?

The international classification of diseases (ICD) went over a huge change on October 1, 2015.  Before this date, the United States knew of only ICD-9.  Other countries were already using ICD-10 for years before it was released here in the United States.  The codes are now longer and cause a lot of confusion for doctors, hospitals, treatment centers and so forth.  The healthcare world seems to be puzzled by how to code correctly. Only a certified ICD-10 coder can help a facility out that is having problems with their coding. ICD-9 codes started to get phased out all throughout the year 2011.  The transition costed the healthcare industry a lot of money because software had to be upgraded and new employees that understood ICD-10 had to replace those that did not know.  Many doctors today have decided to outsource their billing because they or their staff cannot understand how to file claims correctly. Today, if you filed your claim incorrectly, you would receive a rejected claim in your mailbox.  Claims today are processed and handled by insurance companies that are not always friendly to medical billers. The best part about ICD-10 is that it allows more clinical detail and keeps up with modern day technology. You can say that ICD-9 was a little bit outdated and could not keep up with technological demands. Also, insurance companies did not get a good understanding of what the patients were being treated for and why.  Insurance companies today want more detail about the patient. They even want to know how the doctor’s treatments are coming along for the patient. Is the patient…

Doctors Growing In Disappointment As Their Claims Get Rejected

Doctors in the United States are growing in frustration. They often ask the question, “How can I grow my practice if my claims keep on getting denied or my reimbursement checks are too low from the insurance companies? Some doctors think that by hiring other physicians, they can increase their patient flow and therefore, increase profits. However, many physicians are finding this not to the case. Instead of their profits increasing, their profits are decreasing faster. Doctors are getting used to having a pile of unpaid claims. How can they get these claims paid of the insurance companies keep on sending them back saying that they are filled out incorrectly? Doctors often review their clean claims vs. their claims that need to be manually reviewed and corrected. The problem that doctors are facing is that they have no idea who to blame for their billing because the topic is to complex. It takes a qualified medical coder to tell the doctor why their claims are not being paid. Doctors today are learning that they must better their billing for various reasons. For starters, a biller should have their ICD-10 certification and around 5 years + experience before you should allow them to work on your claims. Billers that have little experience often give the doctor excuses as to why their claims are being denied. Often, these reasons are fictional and made up so that the biller can keep their job. Doctors that are smart, turn to outsourced medical billing companies because they know ICD-10 coding. They work with it all day long. Of course they are better experts. Most…

Fighting The War With Heroin Addiction

Heroin addiction is an actual battle being fought today. It is infecting America today and being used by many young men and women living in suburbs across the USA.  Heroin was once a popular drug in the 1980’s. However, it is making a comeback in the 21st century.  Many addicts say that it’s hard to get off of heroin alone.  Many celebrities have overdosed on heroin and even speed balling. No matter how you look at it, heroin is not going anywhere anytime soon. Drug dealers are everything trying to make a living off of someone else’s addiction. Heroin is a drug that is synthesized from morphine.  The main area where heroin is being manufactured is said to be in Afghanistan. The main reason is because a necessary ingredient is called opium poppy.  This is mainly grown in Afghanistan.  Many young men and women first get introduced to the drug in recreation. After years, they begin using it and actually telling others about the drug as well.  Before you know it, a person is hooked on this drug and cannot get off the drug. In order to get off of heroin, a person must go through detox. Detox is a stage in which a person gets rid of the drug safely in a supervised facility.  There are certain medications that are available to make the process easier.  In the 1980’s, many addicts feared heroin withdrawal because of how withdrawal made them feel. At first, the drug enters the body and makes the addict feel happy, peaceful and like they have no problems. After that, the body craves more of…

Doctors: How To Deal With A Difficult Patient

Doctors often find it difficult to deal with a patient that has a difficult road ahead of them. Many patients can be difficult to work with because they don’t want to follow your treatment schedule. Often, a patient has their own idea of how they want to get better. Often, their way will not allow t hem to get better. They will often feel more depressed because of what is happening to them in their life.  A doctor’s job is supposed to make the client feel happier and better. However, what happens when you don’t feel appreciated or like nobody cares about you?  This can make your job ten times more painful.  It is your job to make everything work out accordingly.  In time, your mind will become clearer as to what is important and what is not important. A doctor today has a lot of information in regards to doing what is right. You often have to work in difficult tasks in order to make your patient feel comfortable. When a patient is being difficult, it is often necessary to refer them to a psychologist for help. Many physicians forget that counseling is available to their patients that need extra care.   Many patients will not listen to their doctor in fear that they are being misdiagnosed. Many patients today are watching a lot of television and videos that give them incorrect information.  There are some “gurus” out there that say a person can be healed of cancer because they are eating a certain type of plant. However, most doctors are trained in medicine and don’t see the useful…

Medical Claims: What You Need to Know

Treating patients today has changed drastically over the years. Medical billing has also changed to an EMR system and now we have HIPAA laws to comply with.   Many doctors today are confused by the whole medical billing process. Physicians are finding that it is now necessary to outsource their coding or find an in house biller to fulfill their ICD-10 coding needs.  There are HMO’s, PPO’s, Medicaid and Medicare insurance plans that one must understand as well. Doctors went to school in order to study medicine.  Today, physicians are finding that they must get educated in proper medical billing procedures as well. It is important to work with a medical biller that understand which codes get attached to which particular treatment.  There are many software programs that are available to a coding expert. Most medical billers today want to allow someone to do billing correctly.  Medical claims can only get paid on if the coder inputs the correct codes. Many doctors are finding that their in house billing team is having a lot of rejected claims since ICD-10 was released in October of 2015.  Today, medical billers have a lot to be thankful for.  For starters, they are higher in demand in the work force. It is estimated that the billing industry is going to grow by 20%.  Most billers are finding it challenging to get their ICD-10 certification.  Did you know that EMR allows a physicians to have a 30% hire chance of seeing success because of computerized programs? Today, software companies are creating software specific to a doctors industry.  ICD-10 coders are finding it useful to have…

Electronic Medical Records: Why They are Effective in Today’s World

Even the USA Olympic team is required to have their medical records in electronic form. Electronic medical records are often a requirement for patients all over the world. Many patients today required their medical records to be positioned in a way that makes complete sense for them. It is important to ask someone how a medical record works exactly.  Medical offices across the United States are required to keep their records electronic. Did you know that physicians often know when they are giving care to a patient because of something that was reported previously? There is a quality of care that must happen with billing as well.  Every time that you see a patient, a doctor has to look at their previous care. A doctor often asks the patient who their doctor was before they saw them. What treatments have been previously given to you?  Many patients lose track of their doctors and therefore, an EMR system works best for locating patient information.  Hospitals need to have a record of a patient’s information because their life may depend on it. Often, an ambulance is called for a patient.  Once the patient arrives at the hospital, the emergency room physician has no idea who the patient is or what their history is either. If they have a record of the patient on file, they can often see if they are diabetic or got a recent surgery. Many patients do not understand how they can benefit a doctor by having their information easily accessible. Electronic medical records also save costs on file storage space. Years ago, hospitals and doctors’ offices often…

EMR Billing Practices: What Works and What Doesn’t?

The world of healthcare is becoming computerized. Patients from all walks of life are learning that they can get their information quickly through computerized efforts. Physicians are learning that they can access your data a lot faster if they can just type in a few words and your entire medical profile exists.   Web based computer applications is the main reason for many businesses doing well.  Your software should allow you to do the following: input data, store patient information and report information about the patient. Your medical billing software must be 100% HIPAA compliant as well. A doctor should be able to retrieve input data almost immediately. A lot goes into the creation of appropriate software for a healthcare company.  Details such as a patient’s personal information and correspondence of details is an important fact that has to be taken into consideration. You may find that a patients records are useful in determining what works and what does not work.  A lot of doctors find that patient records are easy to understand when you put your mind to it.  Everything begins to work itself out with time and data. A patient has a social background and insurance details that must be recorded as well.  Usually, the medical biller will ask a client a series of questions. Their data is kept private in a system in which the biller can have access to it 24 hours daily. Many billers today want to have assistance with their billing for various reasons. For starters, medical billers today enjoy giving out necessary information whenever needed. The software also stores family medical history and…
 




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