iMAXX Medical Billing Solutions Knowledge Hub

iMAX Medical Billing Knowledge Hub

HHS Challenges Industry to Improve Medical Billing Process


HHS recently created the “A Bill You Can Understand” challenge with the goal of significantly improving the medical billing process. It’s no secret that the current medical billing process is deeply flawed. To face this issue, the Department of Health and Human Services (HHS) recently announced the “A Bill You Can Understand” design and innovation challenge, which strives to encourage healthcare organizations, developers, designers, digital tech companies to design a medical bill that’s easier for people to understand and use. HHS will be giving $5,000 awards to the best submissions for two categories: the medical bill that is the easiest



Time Limits Matter for Claim Appeals


Provider agreements (or the ancillary documents) outline the formal processes to appeal payers’ payment decisions. You must review your agreement (or ancillary documents) with the specific payer to comply with the rules of the appeal process. A meritorious appeal may fail because you didn’t meet deadlines, follow the outlined procedures, or provide the necessary information. For example, the payer may set a time limit for when a provider may appeal a payment decision. These time limits may range from 60-180 days, or more. Also, state law may set certain time limits for such appeals. You will need to reconcile the



Telehealth Part B Reporting in 2017


If you are hoping the Centers for Medicare & Medicaid Services (CMS) will throw caution to the wind and spearhead the telehealth movement, think again. Based on the 2017 Medicare Physician Fee Schedule (MPFS) Final Rule, unless pressed by lawmakers, they are going to take their time adding to this line of coverage. There are just a few changes for 2017 reporting of telehealth services of which providers and their medical coding and billing staff should be aware. For Medicare Part B claims, you have a handful of new codes added to the list of payable telehealth services and a



4 Medical Billing Issues Affecting Healthcare Revenue Cycle


Addressing these four common medical billing challenges can have a positive impact on the healthcare revenue cycle. Medical billing is the backbone of healthcare revenue cycle management, but many providers experience significant challenges with efficiently and accurately billing patients and payers for services they perform. The medical billing process can be a pain point for some providers because it involves an array of healthcare stakeholders and each step to getting paid relies on the previous interaction. Healthcare organizations must communicate across departments and payers as well as ensure that crucial information is properly captured in each step of the process.



Comprehensive Health Services pays $3.9 million for allegedly double billing IRS


Company billed twice for vision screenings, resting electrocardiograms and collecting blood samples for IRS agents, DOJ says. Florida-based workforce medical services provider Comprehensive Health Services will pay $3.9 million to settle allegations it violated the False Claims Act by double-billing the IRS for services in connection with a contract Comprehensive had with them, the Department of Justice announced. Comprehensive contracts with government entities and companies for customized medical programs for large workforces. Their services include everything from pre-placement, pre-deployment and medical examinations to medical surveillance and health wellness programs. The firm entered into a contract with the IRS in February



Quick Billing Tips


For medical practices, there are few business operations more crucial than billing. A healthy revenue cycle is imperative to sustain the costly work of providing health care, but it’s not always so easy to make sure your practice is being paid for the services it has rendered. It can be particularly challenging since health care providers are reimbursed by third-party payers after the patient has already come and gone and there is a lag between rendering services and receiving payment. Moreover, insurance claims might be rejected or denied for a variety of reasons. So, what are the best ways your



Hospitals, medical groups increasingly turn to temporary physicians, survey shows


Freedom, flexibility, decreased bureaucracy are fueling the trend, with 94 percent of facilities saying they used them in 2016, Staff Care says. Hospitals and healthcare facilities are increasingly looking to temporary physicians, also known as locum tenens, to fill staffing gaps. That’s according to a new survey conducted by Staff Care, a temporary physician staffing firm and a company of AMN Healthcare. Results from their 2017 Survey of Temporary Physician Staffing Trends shows 94 percent of hospitals, medical groups, and other healthcare facilities used temporary physicians in 2016, a three percent increase over 2014 and a 20 percent increase from



Study links social problems with healthcare costs


As health care costs continue to rise, hospitals and doctors are trying to figure out how to get to the root of these issues. Donning a protective gown, rubber gloves and a face mask, Dayna Gurley looks like she’s heading into surgery. But Gurley is a medical social worker charged with figuring out why her client, a man who uses more health care services than almost anyone else in Houston, has been in three different hospitals in the last month. The patient, who asked not to be identified, has chronic massive ulcers, AIDS and auditory hallucinations. He rents a cot



Percentage of medical bills paid by check decline; stark generational differences dominate


Medical bills paid through the mail decline with each younger generation, with millennials paying by mail at a rate of 15 percent. Fewer patients are paying their medical bills by check as the shift to online payments accelerates, according to research conducted by electronic payment firm ACI. Bills paid by check declined 20 percent between 2010 and 2016. Meanwhile, the number of bills paid through digital and automated clearing house payments increased by 10 percent and those paid by credit card doubled to 15 percent. Overall, a little over 34 percent of health insurance one-time bill payments — payments paid



Adding Credentials Brings Both Short and Long-Term Benefits


Are you thinking about adding to your current credentials? Are you unsure which one to go for, next? The answer to that question isn’t the same for everyone. Ask yourself a few questions and do your research. The questions below can help most individuals quickly narrow down their list of potentials. (Side note: Did you know AAPC offers over 30 different credentials?) • What areas are you experienced in? • What are your goals? • Why do you want to add another credential? • How much time and money do you have to invest? If you have experience in an