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Medical Billing Questions Every Professional Should Know

12 March,2018

Medical billing activities are an important part of a healthcare facility’s daily work. It should always go as planned. However, we all know that medical billing is a complicated procedure, and often things do not go the way you would like them to. This can increase the cost and time of the claim’s filing procedure. There are several steps to take between the first claim submission and final payment posting. In order to ensure your medical billing process is flawless, you need to first know what additional steps might require being taken when things don't go according to plan. We have put together this list of the medical billing questions every professional should know to in order to do the task successfully.

Question 1: What is ICD-10?

Answer: The International Classification of Diseases code set is latest at version 10 and medical organizations in the United States were needed to switch to it from ICD-9 last October. The new codes allow for more care when describing diagnosis and cure. Therefore, medical billing software should be necessarily updated to ICD-10.

Question 2: How do you evade claims being sent back for errors?

Answer: Medical billing software should include features that show each claim for general mistakes and kick it back so you can fix it on the spot, typically with an idea about how to proceed. This is a very useful tool that medical practices should always have in their in-house software.

Question 3: Should our practice consider a cloud computing solution?

Answer: Your medical billing organization and the payment data they are working with will be easier to you and your worker when you go with a firm that has a cloud computing answer. This gives you the choice and flexibility to see data while on the go. Cloud computing services also permit for robust encryption to protect info and serve as remote, redundant backup servers as well.

Question 4: Who is the payer of last resort?

Answer: Medicaid is for all time the payer of last resort when the patient also has coverage below other health plans. Medical providers must inform Medicaid of any third party insurance information they are aware of, furthermore to informing them as to any payments they receive on behalf of the recipient.

Question 5: What set of questions are asked to determine MSP situations?

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

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