8 Ways How BristolByte Increases Your Cash Flow!

Medical coding and billing is an invisible engine in the healthcare industry. No healthcare entity can sustain itself without consistent cash flow. Efficient medical coding and billing is an essential part of the revenue cycle management. Keeping track of the documentation between patient, provider and payer is vital and a well-designed Workflow Management Software will keep you on top of the situation.

In this regard, BristolByte, a unique cloud-based workflow management software, can give you numerous advantages. It is created by professionals with their experience and expertise of working with thousands of providers. (more…)

What is a superbill?

A medical superbill or encounter form is the primary source of data for preparing claims and contains the list of services provided to a patient. Along with the list of services, the superbill will show the costs and codes for each exam, treatment, or procedure. It will also contain information about the patient, provider, CPT codes, ICD-10 codes. These details have to be accurate so that claims can be prepared correctly.

A superbill is not necessarily needed for preparing claims by the provider. However, a patient would require a superbill in case (i) the provider is not part of their insurance company’s provider panel, (ii) they are having a Health Savings Account (iii) they are utilizing out of network benefits and need to meet a deductible(s). In these cases, the superbill helps the patient to work directly with their insurance plans. (more…)

Denial Management is essential to a practice

Claim denials may be nothing unusual in healthcare, but the amount denied actually adds up to a substantial sum in the long run and is a loss of revenue for the practice. Studies have shown that many practices do not appeal to denial as they consider the denial management process expensive compared to the amount they will receive from payors.

This erroneous thinking results in leaving money on the table as statistics show that I in 5 claims is denied. Denial management is, therefore, something that every practice should take seriously.

The quantum of claim denials in a facility can be brought down by following the 5 approaches listed below: (more…)

What is HIPAA?

The Health Insurance Portability and Accountability Act of 1996, known as HIPAA, is a series of rules and regulations that govern the use and disclosure of protected health information (PHI). HIPAA compliance is monitored by the Department of Health and Human Services (HHS) and enforced by the Office for Civil Rights (OCR).

It is essential that a HIPAA Covered Entity or a Business Associate with access to Protected Health Information understands the rules and how to become HIPAA compliant. Ignorance of rules is no defense against enforcement action.

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What constitutes Eligibility Verification?

Insurance Eligibility Verification Service is an essential front-office process whereby a patient’s insurance eligibility/ insurance coverage is verified to know the extent of benefits a patient is eligible for under their insurance plan. The verification has to be done thoroughly and accurate details obtained. The amount of co-pay that the patient has to bear can be determined through proper insurance verification. Hence it is best to carry out this verification before the patient visits the physician.

At Bristol Healthcare Services, our team of billers will verify the patient’s health insurance and note all the information necessary that will enable us to prepare clean claims. Next, we check with the payor regarding the insurance coverage, the current status of the policy and then follow-up with the patient. (more…)

WHAT IS MEDICAL CODING?

The AAPC defines medical coding as “the transformation of healthcare diagnosis, procedures, medical services, and equipment into universal medical alphanumeric codes.” The codes for recording diagnoses and procedures are decided based on medical records, such as transcription of physician’s notes, laboratory and radiologic results, etc. Medical coding services are carried out by professional coders who are certified.

WHY IS CODING NEEDED? 

Even for a simple visit to the doctor, symptoms are recorded, procedures are performed and prescriptions for medicines are made out. And all of this information is coded by professional coders. As illnesses get more complicated, the amount of data to be conveyed to payors is much more. Thus, medical coding enables the efficient transmission of vast amounts of data. Moreover, it allows for uniform documentation of illnesses and treatments between medical facilities. At a national level, federal agencies use coding to track the prevalence of diseases. (more…)