Medical Billing, Coding and Documentation Services

What Coding Knowledge Does Your Medical Billing Company Have?

Posted by Harold Gibson on Thu, Oct 30, 2014

Medical_coding-2When it comes to medical coding services, it’s important to have knowledgeable specialists performing this task in order to reduce the odds of an audit and ensure timely payment. Do you know what coding knowledge your medical billing company has? Read on to find out why partnering with a knowledgeable, experienced team can make all the difference.

ICD-9 to ICD-10 Transfer

The change from ICD-9 to ICD-10 will result in an increase from 13,000 different codes to 68,000 codes. This new code set expands from five positions to seven, and requires more information be entered into a code as well, increasing the time it will take for each entry.

To make matters more confusing, the new code set will only be used to report procedures for inpatient claims, while the other codes sets will continue to be used for other circumstances. The confusing new set of rules makes it more imperative than ever that your medical coding services be performed by someone with precisely the right skill set.

We provide ongoing training to our specialists to help them adjust to changes in the industry. As such, you can ensure we are not caught off-guard by these changes, and in fact have been preparing for them for quite some time.
Other Benefits

In addition to being familiar with ICD-10 changes, knowledgeable coders will also:

  • Be familiar with the different requirements of various insurance companies to include contractual obligations
  • Accurately use CPT codes, ICD-9 or ICD-10 codes and HCPCS Level II codes where needed
  • Ensure the accuracy of their work so that clean claims are submitted with the first invoice
  • Be able to review medical records and assist with filing an appeal if the need arises

The right medical coding services can make all the difference when it comes to the amount of revenue your practice receives. It can greatly improve your efficiency, which will help you pad your bottom line. When working within such a complex system like medical codin, hiring someone with in-depth knowledge is of the utmost importantance.

So if you are curious about how M-Scribe can save your practice money, please contact us today for more information.

Tags: medical coding

Medical Coding & Billing Expertise is Critical to Practice Profitability

Posted by Harold Gibson on Tue, Oct 28, 2014

Revenue_Cycle_ManagementAccurate medical coding and medical billing expertise, always important, have become critical components for a medical provider's revenue cycle management success. Never before has revenue cycle management been more vital to physician, practice, clinic and hospital incomes.

More Critical Than Ever

The medical coding and billing landscape has changed dramatically during the early years of the 21st century. There are multiple reasons for these significant changes. The most important developments include the following primary items.·       

 - Obamacare, 

-  Pay for performance (P4P),        

- Meaningful use, both 1 and now 2,

- The coming ICD-10 diagnosis and treatment codes,        

- Electronic health records (EHRs) and prescriptions, and       

- Incentives for medical provider compliance with payer regulations and disincentives for non-compliance

Providers face potential revenue delays or outright losses by submitting inaccurate codes and claims. While the incentive programs offered by Medicare and Medicaid will increase revenue for some providers, the revenue penalties for inaccuracies or non-compliance will reduce income for medical providers submitting flawed coding and/or claim documentation.

The numerous implementation postponements applicable to the new features described are reaching critical mass because these initiatives, such as moving from ICD-9 to ICD-10 codes, have been consistently delayed in recent years. The accommodations to the physician and hospital community will be ending soon.

In all cases, the accuracy of coding and billing plays the critical role in ensuring former revenue streams, however. Successful revenue cycle management becomes ever more vital as these changes become reality.

Revenue Cycle Management (RCM) to the Fore

RCM has always been important to maintain consistent income streams, avoiding dangerous gaps in claim reimbursements and copay receipts. It does not matter whether managing a for-profit practice or a nonprofit clinic, maintaining a steady revenue stream is always vital to keeping the cash flow faucet running.

However, the noted changes force RCM to take center stage in practice or clinic income maximization. Yet, some practice and healthcare facility managers appear to be unaware of the components of the RCM process. Simple to state, RCM requires a bit more work to implement. According to Healthcare IT News vital process components include the following features

- Monitor and manage claims processing by using current technology that keeps track of the claim process at all points in its journey.·         ·

- Ensure the accuracy of coding and billing documentation by installing procedures that check for accurate claim data before submission.

- Track claims in process to be sure that-

  • Payments are received, and·       
  • Staff addresses delays or denials by fixing coding and billing errors.·         ·  
  • Verify copayment collections and in-force patient insurance to minimize errors and maintain revenue streams.

Coding or Billing Accuracy and Expertise Required

It is painfully obvious that accurate coding and billing submissions are the critical element in keeping income levels sufficient. Those with questions about “how to” must consider the two primary available options.  

   1. Improve staff training by offering additional education on the “how to” better ensure accurate claim submissions. Increase their knowledge of current diagnosis and treatment codes and create procedures that improve the quality of claims submission documentation  

   2. Outsource coding and billing functions to a top billing and documentation firm, such as M-Scribe Technologies, to ensure accurate claim submissions—and consistent income and cash flows. This option accomplishes multiple practice and provider goals

           - Provides effective cost control of coding and billing expenses,    

         Improves accuracy of claims submissions, and  

          Minimizes claim delays and denials. 

Option 1 involves more responsibility, cost and other demands on practice and hospital staff. Choosing this option can work if management is diligent and thorough. The downside is the time and money required to upgrade staff coding and billing expertise to more efficient levels. Further, during the necessary “learning curve,” revenues may decline to unacceptable levels.

Option 2 is often the best choice in the current changing healthcare provider landscape. Simply maintaining current revenue streams is challenging. Should the costs to do so spiral out of control, profitability may dissipate quickly. Increasing or maintaining current revenue must be matched by cost controls that prevent expenses from reducing profits.

Although not focused on profitability, nonprofit medical providers still need to exercise cost control. Since their margins and spreads typically are lower than those of for-profit practices, controlling operating expenses often is more important to nonprofit healthcare facilities. These tighter spreads between revenue and expenses dictate more, not less, cost control. Claim reimbursement delays and denials can be devastating to the sustainability of nonprofit medical provider organizations.

The critical nature of effective RCM systems cannot be denied. The future of healthcare providers depends on maintaining revenue streams and controlling costs. The policies, procedures and process that medical providers reach these objectives may differ. However, the best RCM system is the one that works for each organization.

The bottom line remains constant, however. Accurate coding and billing is the most vital element. Whether healthcare providers choose to accomplish this requirement in-house or by outsourcing these functions to the experts now becomes a "make or break" decision. The future existence and profitability of a practice depends on it. 

Why Medical Coding Companies Should Continually Train Physician Practices

Posted by Harold Gibson on Thu, Oct 23, 2014

Medical_Billing_Training  There are several reasons why medical coding companies should continually train physician practices, the most obvious being that it helps physicians and other medical professionals recognize errors and potentially abusive billing patterns. The more errors there are in a billing request, the more likely improper denials and audit risk will occur. That is why ongoing training of your staff to industry best-practices will not only make the medical billing process more seamless and accurate but it will also ensure that reimbursements are paid in full. This way, no company money is lost and your cash flow remains unimpeded.  

Many financially successful hospitals rely on professional medical billing companies for the reasons above, but they also rely on them because it makes their jobs as medical professionals easier. With so many responsibilities at the hospital, it is difficult for any physician, physician assistant, nurse practitioner, and/or medical assistant to be aware of every regulation that governs code assignments and claim submissions. Having a medical coding company there to train them is, consequently, a huge educational asset and aid.
What's more, medical coding consists of extremely technical terminology and requires specialized knowledge. However, with the right training from a great medical coding company, you and your employees will be able to understand the rules and regulations and know how to avoid coding errors. If you need recommended corrections for any errors that occur, medical coding companies will know exactly what you need to do, allowing you to maximize compliance and reimbursement.
Lastly, with the upcoming transition from ICD-9 to ICD-10 coding, it has never been more crucial to be well-trained in medical billing regulations. You can't control how frequently regulations change, so all healthcare teams should be able to adapt to them. If your healthcare team has received exceptional training and guidance from an outstanding medical coding service provider, navigating all the changes should be a breeze.
To learn more about the benefits of having your healthcare practice train with the best medical coding service providers in the country, please feel free to contact us at any time.

Tags: medical coding

5 Reasons Compliance is Best Left To Medical Billing Professionals

Posted by Harold Gibson on Tue, Oct 21, 2014

 medical billing
No matter the industry, every business looks for ways to cut costs without losing value. Certain services in the medical industry such as transcription and administrative management can be outsourced or handled in-house without much loss in quality or increase in risk. In fact, administrative tasks are among the more common areas for cutbacks, but the one area that is best left to the professionals is billing. Physician billing can be filled with numerous hazards, many of which you may not know how to protect against or have time to fully deal with. Chances are you would be better off letting a specialist handle them. So just in case you don't believe us, here are five reasons compliance is best left to medical billing professionals.

Better Protection Against Fraudulent Claims

Fraudulent and abusive claims can cost you thousands each year. While the larger cases are more likely to garner the most attention, small claims can be just as expensive cumulatively. Good medical billing professionals have the resources and time to focus in on these small claims just as much as the large ones. Additionally, they have greater awareness of the red flags that you might otherwise miss, meaning that they are more likely to catch the thieves that might otherwise slip away. And that means you save more money.

Better Informed of Changes in Law and Industry

Changes occur within all levels of the law and industry on a daily basis. From the Fair Debt Collection Practices Act to the National Correct Coding Initiative, it's a difficult task for you to keep up with everything. As soon as the laws and code changes, you are liable. With medical professionals handling the matter for you, you will know exactly what you need to know when you need to know it.

Better Poised to Adopt New Policies

Being aware of and understanding the new laws is only one step in effective billing practices. As the new laws come into effect, you have to know how it will affect your policies and how you need to change your policies to avoid being penalized or losing more money. Since medical billing professionals specialize in this field, they have significant experience in adapting current policies to reflect the trends in the industry and protect your interests. Failing to adapt your policies or making the wrong choice can both be expensive mistakes.

Better Supervision and Advice Billing Practices

Billing practices themselves can be time consuming in their creation, but they also have to be managed. You may find some of your services becoming more expensive, or you may want to offer additional ones. A physician billing service can help keep track of these changes and provide expert advice on the changes you should consider.

Better Protection Against Investigations

According to the Coalition Against Insurance Fraud, more than 80 billion dollars is lost each year. While the perpetrators may not be hospital staff or medical personnel, hospitals and their staff are often subject to investigation when these claims are submitted. A good medical billing professional will offer extensive documentation and reviews for both pre and post payments.  Additionally, they will use standardized formats and strategies for handling billing matters that will simplify the process, giving the investigators the information they need.

For more information on the services we offer and how our medical billing services can assist you to run a more profitable and efficient practice, please feel free to contact us at your convenience. We look forward to hearing from you.

Tags: Medical Billing

The Difference Between Good & Great Medical Billing Companies

Posted by Harold Gibson on Fri, Oct 17, 2014

 medical billing
Understanding the difference between good and great medical billing companies can elevate your medical billing experience from mediocre to extraordinary. For one, great medical billing companies are diligent about producing consistent accuracy. It’s their first priority. To achieve consistent accuracy, medical coders must stay updated with industry practices, offer superb professional training, and provide specialized knowledge of medical billing to their clients.

1. Great Medical Coders Know the Latest Industry Practices

A great medical billing company always stays on top of changes in software requirements, documentation standards, and can cross walk unspecified ICD-9-CM codes into highly specific ICD-10-CM codes. This requires medical coders to regularly attend industry events and read industry news. Great medical coders should be able to use their up-to-date medical billing knowledge to ensure that all documents reflect any changes that have been implemented.

2. Great Medical Coders Are Experts

Great medical coders should have in-depth knowledge of medical coding. They should know every coding requirement, payer guideline, and contractual obligation. This being said, it’s necessary for great medical billing companies to invest in providing top-notch professional training and to recruit carefully.

3. Great Medical Coders Have Specialized Knowledge

The best medical billing companies have specialized knowledge, which means they can tackle tasks at a more efficient rate. Furthermore, having specialized knowledge can ensure that claims are paid on time and accuracy is guaranteed.

4. Great Medical Coders Work Well with Physicians

Great medical coders should be able to work well with physicians and the rest of the healthcare team. With their expert medical billing knowledge, medical coders can be an imperative asset to physicians, physician assistants, nurse practitioners, and medical assistants.  
Choosing a great medical billing company over one that’s merely good is well worth the investment. They can help reduce improper denials and audit risks as well as critically improve the entire medical billing process for clients.

To learn more about what makes a high-quality medical billing company, please feel free to contact us at any time.

Photo Credit: Flckr

Tags: Medical Billing

Two Essential Ways Specialized Medical Billing Companies Save You Money

Posted by Harold Gibson on Fri, Oct 10, 2014

Every year in the United States, hospitals, health care/medical facilities, and insurance companies spend nearly $400 billion on administrative costs. A substantial percentage of that money goes toward covering the costs associated with medical billing and coding. With these kinds of administrative expenses being as high as they are, doctors and physicians are having an increasingly difficult time maintaining their private practices despite the fact that such costs are considered an essential element thereof. It can be challenging, however, for healthcare administrators to find medical billers who do efficient, accurate, and timely medical billing and coding, particularly if they are looking for one that specializes in a specific area of the medical profession.

Healthcare claims require compliance and accuracy 100% of the time. Medical billing companies that perform billing work for all areas of the medical field tend to sacrifice some of that accuracy and compliance in order to grow their bottom line by having a broader client base. But there are distinct advantages to utilizing medical billers that focus on billing and coding only in specific areas of medicine and those advantages can end up saving you a lot of money.

Fewer Claims Issues

The billions of dollars that are spent every year on medical billing and coding represents not only the cost associated with the billing tasks themselves but the money spent on additional resources that are needed to compensate for the lack of specialty knowledge that should be implemented for many healthcare claims. That is to say, when medical billing companies do not have the knowledge required to bill for specific medical specialties, the chances for errors in billing and for claims being denied, underpaid, or flagged for audit increases exponentially. If medical billing was carried out exclusively by companies with specialty-specific knowledge, the annual costs associated with medical billing overall would decrease dramatically.

Less Time and Money Spent on Training

Medical billing and coding collectively constitute an endeavor that requires extensive training even for the specialty-specific variety. But extra time and resources must be spent when training to bill and code for all specialties and practices. People spend months or even years training and being educated for a medical billing career but that training does not end once the billing professional is hired by a hospital or health care facility. The industry is never static. It is constantly enduring changes and updates to processes and logistics that make ongoing training an essential part of accurate billing.

Specialization reduces the amount of time that is needed for billers to spend training so that they can spend that time doing what they’ve been educated to do. If medical billing companies don’t specialize, then they are forced to maintain ongoing training for all of their staff across all or many different areas. Specialization requires training only for the area or areas in which a particular company specializes and that means less training and more billing and coding.

ff you are looking to make your practice run smoother by with world-class medical billing and coding, feel free to contact us at any time to see what we can do for you. 

Tags: Medical Billing

How to Increase Revenue of a Clinic or a Physician Practice?

Posted by Harold Gibson on Thu, Oct 09, 2014

medical billing
The general public is well aware of the increasing cost of healthcare. Even with all of the new regulations that have been implemented over the past few years, many individuals and families are seeing higher costs with each passing year. 

For those who own or run a clinic or physician practice, the situation is even worse. While clinics and physician practices are also experiencing the same price increases that the general public is experiencing, they are also being squeezed from the other side as well. The fact of the matter is that, while the costs of treatments and procedures is in fact going up, insurance companies, as well as Medicare and Medicaid, have begun reducing their reimbursements at the same time. This puts clinics and physician practices in a uniquely difficult position, where they are being squeezed on the revenue side while also facing a demand problem as consumers find it increasingly difficult to pay for all but the most essential of procedures. This situation necessitates creative and aggressive means of increasing revenue for clinics and physician practices. 

There are three specific areas where clinics and physician practices can improve their revenue models: The front-end (or patient acquisition process), coding and management of records, and accounts receivable strategies. 

Front-end revenue generation 
Even the most efficient clinic or physician practice will be unsuccessful if there are no patients to treat. This means ensuring that there is both quantity and quality in the appointments that are scheduled. Before scheduling an appointment with a new patient, be sure to get their insurance information, and make sure they are aware of whether they are in or out of your network. If a patient is out of network and is not willing to pay the increased costs associated with seeing a doctor out of their network, the worst thing that can happen is that they show up at the office without that knowledge. Not only will you have a disgruntled patient in the waiting room, but they will have taken up an appointment space that could have been taken by an actual patient. Nobody wins in this scenario. 

In addition, when a new patient comes to the office, the front office staff should make a copy of their insurance card and their driver's license. This will make it easier to find out the specific insurance information if and when it is needed without contacting the patient, and it will also ensure that your office has the most up to date information about where the patient lives. 

Increasing revenue through coding and records management 
Depending on the size of the practice, there should be at least one person in the front office whose sole (or primary) responsibility is coding and records management. These have always been important tasks, but with the rapidly changing and increasingly-complex nature of medical billing and coding, these tasks are more important than ever before. Whoever is in charge of coding and records management should also be responsible for staying up to date on any and all changes that are made on a national, state, and local level. 

Increased revenue through aggressive accounts receivable strategies
The last thing your clinic or physician practice needs is to not get paid by patients after a procedure or treatment is completed. One of the best ways to ensure payment is to set up an electronic remittance process, which allows payments to be automatically deducted once they are approved and sent to the paying party. The other key element to aggressive accounts receivable is to have well-published and followed collections procedures, so patients know exactly what to expect when they owe your office a payment.

To learn more about how to streamline your front office through outsoucred medical billing and coding, please free to check out out website and/or contact us at any time, and if you would like to read more about what we do and how we can help you, please see our recent blog article.

Tags: Medical Billing

How To Improve Your Practice's Front Desk Collections?

Posted by Harold Gibson on Tue, Oct 07, 2014

Front_office_and_profitabilityMany physicians still hold the traditional belief that their front desks are a cost, not a profit, center. However, in the modern world of healthcare, while a front desk can certainly be a cost center, a practice's profitability is often dependent on making front desks a profit center.

Necessity of Front Desks as Profit Centers 
The changing face of the healthcare industry and medical practice management has made this front desk staff attitude a necessity--not a practice luxury. The factors requiring front desk employees to recognize this requirement are many. The most important reasons for physicians to encourage or mandate a collections approach for their front desk personnel include the following factors. 
* Existence of Obamacare and the Affordable Care Act (ACA), 
* Changing realities of medical billing, 
* Impending changes in medical coding rules, 
* Physician Quality Reporting System (PQRS) responsibilities, and 
* Installation of Meaningful Use 2 regulations. 
These are but the most important factors influencing the philosophy and behavior of front desk personnel as primary collectors. While this attitude has been vital to practice profitability for at least five years or longer, front desk collections is now a necessity because of the noted factors. 

Improper or Inadequate Front Desk Staffing 
The risks of not treating the front desk as a profit center impact more than profitability. The fallout from not staffing a front desk properly or adequately leads to the following negative results, at a minimum. 
* Front desk employee "burnout," 
* Unhappy, irritable patients, and 
* Crowded, disorganized work space, increasing employee and patient dissatisfaction. 
Not instilling an outstanding customer service philosophy in front desk staff provides unwelcome results in both short- and long-term situations. Conversely, encouraging front desk employees to adopt a superior customer service and profit philosophy can increase practice collections by 5 to 10 percent. 

First Impressions 
The phrase, "You never get a second chance to make a good first impression," is never more true than with a practice's front desk. Patients form opinions, consciously or subconsciously, about a physician's quality of care by viewing the front desk area and staff communications. 
A disorganized, crowded front desk area and unacceptable personnel behavior diminish patients' evaluation of the care they are about to receive. However, a neat, organized front desk, with welcoming staff, heightens patients' perceptions of the care they'll receive. 
According to the St. Louis Pediatric Associates, Inc., having multiple (up to 10) physicians, they use a "Snap" introduction to welcome patients and their adult caregivers. 

"Snap" is an acronym for 
* Smile, 
* Say the Name of the patient, 
* Asking, "May I help you?" and 
* Making a positive Parting comment. 

Increasing Front Desk Collections 
Higher copays and high-deductible health insurance coverage mandate that front desk collections increase to better ensure profitability. Research indicates that copays and front desk collections can account for up to 20 percent of a practice's revenue currently. To say that indication is significant is an understatement of reality. 

Front desk collections typically involve two components at a minimum. 
* Copays and deductibles, and 
* Collecting previously incurred, but overdue, balances. 
Increasing front desk collections is not terribly difficult. In fact, it is relatively easy. Here are some simple tips that work. 
* Ask patients (with a sincere smile), "Did you realize you had an outstanding balance?" 
* Install a credit/debit card device at the front desk, making it convenient for patients to settle copays, deductibles and outstanding balances. 
* Keep front desk staff up-to-date on each patient's account standing and current insurance plan. 
* Always verify patients' in-force health insurance coverage--and its terms. 

These simple steps for personnel to follow will increase front desk collections enormously. Along with increasing the practice's cash balance on a daily basis, these tips will help keep claim delays and denials to a minimum. 

To know more about how to increase profitability for your practice - 

Five simple steps to streamline your medical billing process

Along with increasing revenue, treating a front desk as a profit center changes the mindset of staff, physicians and practice managers. This change in approach makes this group more efficient, reinforces the wisdom in outsourcing medical billing functions and creates a more pleasant job and patient experience. 


Tags: Medical Billing Service, revenue cycle managment

6 Bits of Information That Will Improve Medical Billing Collection

Posted by Harold Gibson on Fri, Oct 03, 2014

 physician billing
Physician billing can be a daunting process. Those working in doctors' offices have enough to worry about without constantly trying to keep up with the ever-changing regulations behind collecting medical payments. Unfortunately, collecting payments efficiently is the key to running a successful medical business. So in order to help you achieve that goal, we created this list of the 6 most important pieces of information that will improve collection procedures:

  • Name
  • Address
  • Phone Number
  • Employment Information
  • Social Security number
  • Driver's License Number

It also helps to verify a patient's medical insurance before the date of the appointment. The reason for this is it can lower the cost of securing a loan and reduce the odds of forgiving a loan, and it can increase your cash flow. This is also a good time to discuss outstanding balances and co-pays. The more funds you have at your disposal the more you will be able to acquire. It is important to understand some billing systems are simply out of date, so your staff may need proper training to take the next step. Relying on technology is a given these days, so you might as well embrace it sooner rather than later. 

The revenue cycle will be supported by having a financial policy in writing with the approval of legal counsel and the patient's signature. The patient should also have a copy. This document should detail the collection of co-pays and unpaid balances, other payment options for services not covered by insurance, and a description of pre-paid services. Your collection modules  automatically make statements with messages and ongoing collection letters. The beginning stages of the cycle includes a check sheet to confirm all relevant information is recorded at the time of appointment setting.

All basic demographic information should also be verified. The patient information form must be filled out by new patients. For established members they should review their information once a year. Copies of their insurance card will assist in keeping track of patients. Always look over the form to make sure it is complete and all signatures are in place. Another point that must be noted is it may be imperative to have a staff member entrusted to work on pre-certification and prior authorization work. This is an essential position in surgery, orthopedic, and neurology offices.

Lastly, reimbursement from the government is projected to decrease and it is in your best interest to monitor all areas of the collection procedure. To reduce gaps in physician billing you need access to quality resources. So if you would like to ask us any questions about how we can make your practice run more efficiently, please feel free to contact us at any time.

Tags: Medical Billing

How to Accomplish Provider Credentialing

Posted by Harold Gibson on Thu, Oct 02, 2014

Physician_Credentialing_ProcedureSince Obamacare and the Affordable Care Act (ACA) have become reality, along with Meaningful Use 2 guidelines, provider credentialing has taken center stage for health centers. According to the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) in Policy Information Notice (PIN) 2001-16 credentialing requires that "all Health Centers assess the credentials of each licensed or certified health practitioner to determine if they meet Health Center standards." 

The issue of provider credentialing poses some challenges to offering a simple explanation. Since this is more a "process" than a condition, explaining credentialing does not lend itself to a short, all-encompassing definition. Yet, provider credentialing is vital to ensuring quality care, which has become a critical measurement rule for healthcare providers. 

HHS Definition 
The Department of Health and Human Services (HHS) definition of "credentialing" reinforces the process-focus of this requirement. According to HHS, credentialing is "the process of assessing and confirming the qualifications of a licensed or certified healthcare practitioner." 
This official definition area of PIN 2001-16 also offers primary and secondary sources of information to properly vetting healthcare providers' credentials. HHS suggests the following sources to verify physician credentials. 

Primary Verification Sources 
* Electronic or mail correspondence, 
* Telephone live-person verification, 
* Internet investigation that offers verification, and 
* Published reports offered by credential verification organizations (CVOs) and entities. 

Secondary Sources of Verification 
Should primary source verification be unnecessary, HHS recommends using these secondary sources to credentialing healthcare providers. 
* Get evidence of the original credential, 
* Secure a notarized copy of the credential, and 
* Make a copy of the credential from the original document (must be approved by appropriate Health Center staff). 

How to Accomplish Physician Credentialing 
To accomplish sufficient credentialing, the following are acceptable evidence of primary and secondary verification of credentials. (P = primary source; S = secondary source) 
* Current, in-force license for a licensed independent practitioner [LIP], (P) 
* Evidence of appropriate education, training and experience, (P) 
* A statement of satisfactory health fitness from the health care provider and confirmed by the chief of staff, training program director or another licensed physician appointed by the health care facility. (P) 
* Government-issued picture ID, (S) 
* Drug Enforcement Administration (DEA) registration confirmation, (S) 
* Hospital privileges verification, (S) 
* Immunization and PPD (purified protein derivative) skin test status, (S) and 
* Current life support training evidence. (S) 
Please note: These requirements are somewhat different than health center accreditation standards. When a health care facility seeks accreditation, management should consult the HHS standards for accrediting a health center.

Outsourcing Medical Billing, Coding and Meaningful Use 2 

These requirements also generate challenges in medical billing and coding. While the Centers for Medicare and Medicaid Services (CMS) initiated the Meaningful Use regulations, other payers are adopting some provisions, particularly the use of electronic health records (EHRs). 
Physicians who began complying with Meaningful Use Stage 1 in 2011, are ready to advance to Stage 2, satisfying the required two years of Stage 1 compliance. After releasing a final rule in August 2014, CMS permits physician flexibility in using Certified Electronic Health Record Technology (CEHRT) due to the delays in CEHRT certification implementation. 
In many cases, physicians involved in becoming credentialed, have little time to install CEHRT. Providers and facilities involved in credentialing should consider outsourcing their medical billing, coding and documentation tasks.


By outsourcing these duties to a top firm, such as M-Scribe Technologies, physicians, hospitals and health centers reap multiple benefits. Two primary benefits alone are worth evaluating this option. 

First, physicians can control their practice costs. With cost certain accuracy, third party billing and coding organizations afford physicians with impressive budget control. 
Second, since the best firms offer compliant billing and coding efforts by well-trained staff, physicians have the comfort of knowing their critical billing/coding functions are being properly managed. 

Follow the HHS roadmap to properly credential physicians. The way you implement the process is your call, but the HHS is specific on the best primary and secondary evidence needed to fulfill this necessity.

Tags: Provider Credentialing

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