2 New Business Listings GoDBI.com

$720,000 SDE Commercial Cleaning Service in North Carolina
Asking: $1,400,000
Gross Income: $1,150,000
Cash Flow: $720,000
Established: 1991
Inventory: $15,000 Included!
82 Employees

$9,500,000 Gross Collection Agency in Illinois
Asking: $1,300,000
Gross Income: $9,500,000
Cash Flow: $520,000
Established: 2006
39 Employees

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5 Medical Billing Questions You Should Know The Answers To

Staying well informed on the latest changes in medical billing will ensure your practice runs as effectively as possible with the fewest amount of denied claims. Unfortunately this industry can change quickly, so you really have to make an effort to not just get on top of all the knowledge but also to stay on top of new information. It can become quite difficult to sort through all of the nonsense sent your way, and since some information is more important than others, we have put together this list of the 5 medical billing questions you should know the answers to in order to perform the task successfully.

Question 1: Who can bill claims using the CMS-1500?

Answer: Any non-institutional provider and/or medical supplier may use the CMS-1500 for medical billing purposes. Some examples of providers and suppliers that may qualify include:

Ambulance services
Certified registered nurse anesthetists
Clinic nurse specialists
Clinic psychologists and social workers
Nurse midwives
Nurse practitioners
Physician’s assistants
Providers of clinical diagnostic laboratory services
Providers of home dialysis supplies and equipment

Question 2: What refers to Medicare benefits when Medicare is not the primary insurance?

Answer: Medicare Secondary Payer (MSP) is the medical billing term used to describe benefits that are available when Medicare is not the primary insurance carrier. Medicare is the primary insurance when the patient is 65 or older and:

Has a small group plan through their own or a spouse’s employer
Has insurance made available through a retirement plan
Medicare is also the primary insurance when an individual is disabled and has a small group plan through their own or their spouse’s employer, regardless of age.

Question 3: Who is the payer of last resort?

Answer: Medicaid is always the payer of last resort when the patient also has coverage under other health plans. Medical providers must notify Medicaid of any third party insurance information they are aware of, in addition to informing them as to any payments they receive on behalf of the recipient.

Question 4: What set of questions are asked to determine MSP situations?

Answer: The Medicare Secondary Payer Questionnaire is given to determine MSP situations. The questions contained in this questionnaire should be asked during each admission for those who have other insurance coverage outside of Medicare. Doing so will also enable providers to determine whether or not other payers are primary or secondary.

Question 5: Which procedure codes are most often used by physicians rendering services?

Answer: CPT codes, which have been developed by the American Medical Association (AMA) in order to identify the most common medical billing codes used by physicians when treating patients. The most frequently used procedure codes are those relating to medical evaluation and management, a few of which include:

99201-05 New Patient Office Visit
99211-15 Established Patient Office Visit
99281-85 Emergency Department Visit
99241-45 Office Consultation

The answers to these five questions are important for anyone who does medical billing on a regular basis to know. It is important that you have a strong working knowledge of each of these situations. If you were unable to answer all these questions correctly, you may read the attached whitepaper or feel free to contact us to find out more information.   Source

Selling HealthCare Businesses for 25 Years, DBI Can Help Increase Your Companies Value!

Frank Davidson

Personal Cell: 704-999-9728

Direct Email: BizBroker@Hotmail.com

Live Chat: http://www.GoDBI.com

How Obamacare will impact medical billing in 2015?

It’s now been over four years since the Affordable Care Act, otherwise known as “Obamacare”, officially went into effect in the United States. However, we are just now learning the wide-ranging impacts the legislation has had on the healthcare industry, and in particular on medical billing in hospitals and doctor’s offices throughout the country. While we still don’t know the scope of changes that are yet to occur, there are some undeniable trends that seem to be making their way down the pipeline, particularly as we prepare for the oft-mentioned “employee mandate”, which, if all goes according to the (often revised) plan, goes into effect in 2015.

Medical billing has never been a particularly popular activity in doctor’s offices and in hospitals. Now, with the increasing number of medical coding requirements resulting from the Affordable Care Act, medical professionals are continuing the trend of outsourcing this work to companies that specialize in it. According to a report in Seeking Alpha, large outsourcing companies such as Firstsource Solutions and WNS are increasing their domestic US presence to accommodate a growing number of medical professionals who are choosing to outsource medical billing to them.

By 2015, more doctors and hospitals are projected to outsource their medical billing than ever before, in large part thanks to Obamacare and growing administrative costs. The other less discussed (but no less important) consideration is that outsourcing medical billing reduces liability on the hospital or doctor’s office.

While outsourcing is certain to increase in 2015, The Bureau of Labor Statistics estimates that the medical billing industry as a whole will increase in 2015 as well. In fact, it is estimated that the industry will grow by about 22% between 2012 and 2022. While some of this increase is in fact due to regulatory and administrative burdens resulting from the Affordable Care Act, many experts also believe that the changes from the ACA will actually reduce administrative issues, increase efficiency, and ultimately grow the medical billing industry at a slower rate than it otherwise would have in the absence of the Affordable Care Act.

The other key reason why the medical billing profession is expected to grow is the simple fact that, under the Affordable Care Act, more people will have access to healthcare, which means more medical coding and medical billing will be required. While increased access to healthcare for the overall population (and particularly the poor) is a worthy goal, it comes at the very real cost of increased administrative and regulatory issues, at least in the short-term.

While it’s true that one of the original promises of the Affordable Care Act was reduced difficulty for hospitals and doctor’s offices that needed to pre-certify or verify eligibility of a patient for a particular procedure, reality has proven itself to be more complicated. Early reports indicate that, at best, this process is as slow and cumbersome as it has always been, while critics claim that it is in fact less efficient than before the ACA was passed into law. Part of the problem stems from the fact that many insurance companies and medical offices still aren’t even sure how to properly code procedures and medical services; a problem that, while severe, should hopefully improve gradually in 2015 and onward if all goes well.

Obamacare is causing significant changes in the medical billing industry. Hopefully the negative aspects will diminish over time, while the promised benefits of the law start to take hold.   Source

Selling HealthCare Businesses for 25 Years, DBI Can Help Increase Your Companies Value!

Frank Davidson

Personal Cell: 704-999-9728

Direct Email: BizBroker@Hotmail.com

Live Chat: http://www.GoDBI.com