Medical Billing Terms and Medical Coding Terminology
Those in medical billing and coding careers have a terminology of unique terms and abbreviations. Below are some of the more frequently used Medical Billing terms and acronyms. Also included is some medical coding terminology.
Aging – Refers to the unpaid insurance claims or patient balances that are due past 30 days. Most medical billing software’s have the ability to generate a separate report for insurance aging and patient aging. These reports typically list balances by 30, 60, 90, and 120 day increments.
Appeal – When an insurance plan does not pay for treatment, an appeal (either by the provider or patient) is the process of formally objecting this judgment. The insurer may require additional documentation.
Applied to Deductible – Typically seen on the patient statement. This is the amount of the charges, determined by the patients insurance plan, the patient owes the provider. Many plans have a maximum annual deductible that once met is then covered by the insurance provider.
Assignment of Benefits – Insurance payments that are paid to the doctor or hospital for a patients treatment. Read the rest of this entry »
Democracy at Its Best – The Swiss Style!
‘Government of the people, by the people and for the people’, it was Lincoln on democracy. The democracy that he defined prevails in his mother country, US. Thanks to the US constitution which plays the balancing act between the three premiere institutions of democracy, the legislature, the executive and the judiciary in the US with a series of powers given to these institutions to control each other, known as ‘checks and balances’. Though the President of US is said to be elected directly by the people of US, it is an electoral college that ultimately decides who is to become the President. Election to the upper house, meant for the Senates is held once in two years; similarly members to the House of Representatives are elected by the people periodically. The democracy that prevails in the US is an indirect form of democracy through the elected representatives of the people.
In India, considered to be the largest democracy of the world with a population of more than 120 million, people are delegating their power to their representatives through the election process. The elected members are sometimes participating in the voice voting and in rare cases involving important issues as well as electing the President or the Vice President of India they exercise their vote in a secret ballot. Though illiteracy plays its havoc in having a healthy democracy in India, by and large, it is successful. Read the rest of this entry »
What is Medical Billing Software & Who Are Qualified Medical Billers?
Few people today realize how complex the process of accurate medical billing has become. This has created a flood of new medical billing services and new medical billing software solutions. Not surprisingly, medical billing software scams abound.
It is critical therefore that both health care providers and those looking for employment as medical billing workers understand the advantages and disadvantages of various types of medical billing software and what it takes to become a qualified medical biller.
Medical Billing Is Hard!
If anyone thinks that processing medical claims is hard and confusing now — just wait, it’s about to get worse.
With the anticipated growth in Medicaid and payments linked to outcomes (because of health care reform), plus the coming huge expansion of diagnosis codes (from 14,000 ICD-9 codes to over 100,000 ICD-10 codes), the complexity is only growing – and at an accelerating pace.
Fortunately, sophisticated medical billing software exists to help health care providers automate and manage data. The danger, however, is that the software systems that have been developed in response to an increasingly staggeringly complex medical billing process have become themselves increasingly complex, and this has created a situation that is ripe for misusing these tools to not only accidentally over-reimburse but to submit false claims-with the attendant risks and penalties. Read the rest of this entry »
