Medical Billing - DME Software Item Inventory

In this installment of medical billing and DME software, we're going to cover the topic of item inventory. We're going to explain how the inventory functions work, what information inventory tables contain and how this all ties in with the medical billing of a claim.

Item inventory is a very large part of the DME system. Because DME billing is for durable medical equipment, thus the name DME, a lot of items get dispensed to the patient. These items range from small things like test strips for diabetics, to large items like wheelchairs, beds and oxygen concentrators. Some of these items are sold and some are rented. There alone lies a big distinction and the reason why the inventory tables have to be broken up into what are called purchased items and serialized items. Purchase items are pretty well self explanatory, but some explanation is needed for why rental items are referred to as serialized items.

Rental items are referred to as serialized items because each item that is rented has a unique serial number attached to it. This serial number is tracked for the purposes of billing monthly rentals, which is usually how either the patient or insurance company pays for these items. If a rental item has to be replaced because it is defective or broken, then a new item has to be issued and its serial number noted for future billing. The old item is then put back in inventory and either fixed or thrown away and deleted from inventory.

The information that is contained in inventory is more than what most people realize. It is more than just the description of the item. For purchase items, it includes how many of the items are in stock, how many sales of the item were made, so that companies can track how well an item performs, reorder points so that they don't run out and a number of other things. For rental items, the information includes when the item was rented, how many months of billing have occurred, when the item is scheduled for maintenance and a host of other items. Most normal inventory records contain anywhere from 30 to 100 fields depending on how much information the company wants to track and the capability of the software itself.

How does this all tie in with medical billing? Well, the biller has to know how each item needs to be billed. So for starters, they have to know if it is a rental or purchase item. They have to know the price of the item. They have to know when maintenance is due on a rental item so they can send a bill for that maintenance. They have to know when an item is low so that they can notify inventory, just in case they're not aware of it, which they should be. If a biller has to replace an item, they have to know what replacement items are available. The list of things that a medical biller needs in relation to inventory is endless.

Without item inventory tables, the medical billing process would be a total nightmare because billers wouldn't know where anything was, what it cost and if it was even in stock.

Michael Russell Your Independent guide to Medical Billing

Automotive Shop Billing Software

You have a busy automotive shop and not enough time in the day to take care of all your accounting yourself. Sure, you have an accountant, but you don?t even have the time to put together the materials to take to him so that they can do your bookkeeping. Automotive shop billing software is a great way for you to keep your business organized and functioning properly. The more organized the business is, the easier it will be to make a profit.

To find the best automotive shop billing software, you will first need to do your research. Ask other shops which software they like. Look online to find companies that have the software you are looking for. Find product review sites and magazines to see which program has the best reputation. You can also ask questions in forums to see what other people have to say.

In general you will want your automotive billing software to be easy to use yet still get the job done. Your software will need to keep track of your customer information. It will also need to keep track of work orders and be able to print invoices. You will also need to have their auto insurance on file. This is especially handy if you repair their car after an accident.

Once you find the automotive shop billing software that seems the best, you can then begin to comparison shop. Different companies often have completely different prices on their products. You can also consider buying the software used. Used software is much cheaper. However, you run the risk of getting it damaged, and the warranty may either be expired or it won?t transfer when the ownership switches.

Automotive shop billing software can help you manage your business better. Just do your research to make sure you find the program that best meets the needs of your business. Also research to find the best prices. Once you learn and use the program, you will feel much more organized.

Billing Software provides detailed information on Billing Software, VoIP Billing Software, Chiropractic Billing Software, Free Billing Software and more. Billing Software is affiliated with HIPAA Complaint Medical Billing Software

Electronic Medical Billing Dashboard Software - 9 Performance Indicators For Service Outsourcing

Arcane terminology and complex rules for payer- and time-dependent claim validity and pricing interpretation plague medical billing industry, resulting in massive payments of invalid or ineligible claims and denials of error-free claims. The amount and complexity of billing information make it very difficult for the doctor to maintain compliance and identify and resolve errors and underpayments.

"With integrated Billing Transparency, I see for myself how Vericle leverages every opportunity to expedite payments of healthcare insurance claims in a continuous 24 x 7 effort. It has enabled 27% revenue gain over past billing process," says Doug Cassel, M.D., Director of Interventional Radiology at Hoag Memorial Hospital in Newport Beach, California.

Greater visibility of internal process activities promotes teamwork, increases client satisfaction, and assists in process streamlining. Billing service transparency allows participants of the billing process to expedite error identification and resolution, resulting in reduced over- and under-payments and improved regulatory compliance.

1. Billing Dashboard as Main Transparency Mechanism

Selection of meaningful and intuitive indicators for billing process performance is a mission-critical stage in the process of creating a useful transparency mechanism. A dashboard presenting such most meaningful data must be easy to find and simple for interpretation. Cumulative experience of hundreds of doctors using Vericle-like billing technologies, has shown that a dashboard containing nine specific indicators expedite the development of intuitive and powerful transparency mechanisms:

 

1. Month-to-date collections

    

    

2. Total failed or denied claims

    

    

3. Aggregate failed or denied claims in follow-up queue

    

    

4. Dollar Accounts Receivable (AR) below 30 days,

    

    

5. $ AR in ( 30, 120] days

    

    

6. $ AR > 120 days

    

    

7. Percent Accounts Receivable (AR) below 30 days,

    

    

8. % AR in ( 30, 120] days,

    

    

9. % AR > 120 days

    

    

 

Note that national average of percent accounts receivable above 120 days hovers around 18%. Therefore, a well-performing outsourced billing service must deliver % AR > 120 days significantly below 18%. Specifically, to justify its fees, an outsourced billing service must measure its AR > 120 days anywhere around 5%.

2. Drill-down Functionality, Reporting, and Transparency

Advanced dashboard allows drill-down for more detail directly by pointing and clicking the cursor at the dashboard. At the minimum, the following features must be available:

 

 

 

• Operational Report shows total claims and $ amounts submitted, paid, adjusted, written off, and failed. It allows breakdown by CPT code, payer, referral, or a combination of such dimensions.

   

   

   

• Denials Report shows the list of denied claims and a log of followup actions. By sorting it by amount paid, you can tell the smallest payment the billing service will fight for.

   

   

   

• Compliance Report shows the potential for post-payment audit and itemizes compliance violations.

   

   

 

These reports allow multiple dimensions for data presentation, by single parameter, such as, payer, CPT code, provider, or referring physician, or by more complex parameter combinations, such as pairs of payer-CPT code, provider-CPT code, or referring physician-CPT code.

3. Complexity Considerations

Note that even a small single-provider practice working with 20 CPT codes and 20 payers, has 400 (20x20) payer-CPT code pairs. Therefore, an on-line report comparing month-to-date collections between current and previous years requires powerful database query capability. Moreover, automation of such queries like "find the worst performing payer for the best performing CPT code" requires OLAP technology.

4. Summary

Billing Transparency is a necessary feature of a modern and accountable billing service. Billing Transparency allows the practice owner to know both the big picture and minute detail of billing process. To be able to observe every step of the billing process on a continuous 24 x 7 basis, reporting must be available using a secure HIPAA compliant connection over the Internet. While traditional services delivered monthly paper reports, modern technology allows the delivery of continuously updated and meaningful billing performance data.

Yuval Lirov, PhD, author of "Practicing Profitability - Network Effect for Revenue Cycle Control in Healthcare Clinic and Chiropractic Office: Scheduling, SOAP Notes, Care Plans, Coding, Billing, Collections, and Audit Risk" (Affinity Billing) and "Mission Critical Systems Management" (Prentice Hall), inventor of patents in Artificial Intelligence and Computer Security, and CEO of Vericle.net - Distributed Billing and Practice Management Technologies. Yuval invites you to register to the next webinar on audit risk at BillingPrecision.com.

Electronic Medical Billing Software Products in Press (June - July 2006)

Medical Billing technology has witnessed continued expansion during the first two months of this summer, as evidenced by press releases about some ninety products accumulated in BillingWiki. A practice manager may find it difficult to select the best product from such a large product variety. This article roughly tabulates some eighty-five press releases about medical billing technology products and/or vendors across two-dozen service categories.

Asset Life Cycle Management: Products that help healthcare organizations optimize the performance of their capital assets, uncover hidden expenses, gain more visibility and control over their asset and facility operations, and improve safety. Such systems also serve as repositories for hazards, alerts and recalls facilitating a closed-loop process that documents the hospital's course of notifications and corrective action. See St. Croix and LYNX.

Audit and Compliance: Products that help providers and payers to manage compliance by facilitating internal audits and planning external audits respectively. Such systems assist an auditor to spot errors, omissions, fraud, and abuse. Solutions span spectrum from basic audit reporting to complete automation of the audit process by using data mining, natural language processing, and statistical methods to produce a random sample of medical records, data scoring, and potential revenue loss estimate.

• Claim Audit: A-Life, CodeRyte
• EFT Audit: GlobalSCAPE
• HIPAA Privacy and Security Compliance: MedicalSuite

   

   

 

Certification and Awards:

• Best in KLAS: KLAS is a leading source of information on Healthcare Information Technology vendor performance, with information gathered from users at more than 4,500 healthcare facilities nationwide. Performance data collected from 300 Healthcare Information Technology vendors and 500 of their products is evaluated and made available to subscribers through the KLAS website as well as through periodic reports and custom research. See press releases about VantageMed and athenahealth.
• CCHIT Certification: The CCHIT Certified mark - a "seal of approval" for EHR products - provides the first consensus-based, consistent benchmark for ambulatory products. See LSS Data Systems and Misys.
• DOQ-IT Testing: CMS, an agency of the U.S. Department of Health and Human Services, established the DOQ-IT initiative program to encourage physicians to adopt EHRs and, in turn, improve the quality, safety and efficiency of health care. In order to gain official DOQ-IT recognition, vendors must meet all 35 DOQ-IT reporting requirements. See Misys

   

   

 

Deals: This category shows business development activity based on leveraging reciprocal client relationships and complementary product capabilities. See A-Life, Affinity Billing, athenahealth, eClinicalWorks, Eclipsys, GE Centricity, H-Quotient, Healthnostics, IngeniousMed, JPI Data Resource, LEAPpm, Massachusetts Medical Society, MedLink, Misys, medFORCE, medHost, MediSys, Nexplicit, Nicka & Associates, Nightingale On-Board Communications, PatientKeeper, Quantum Group, RXHub, Scandent, Streamline Health.

Electronic Charge Capture: MedAptus

Electronic Data Interchange (EDI): The ability to access one single source of continuously updated claims tracking data to perform real-time status checks directly from local PCs instead of spending hours on the phone calling one insurer after another to track down the status of submitted claims. See MicroSys.

E-learning: AlphaQuest, Care2Learn

Enhanced website: CAP-MPT, Companion Technologies, Patientrak

Factoring: Factoring provides healthcare professionals with automated electronic insurance claims management solutions and advance funding on medical claims, as submitted, through a revolving line of credit. See MDWerks

Integration: Products that expedite revenue cycle by integrating office management functions, which in the past used to be performed separately. Integration eliminates data entry repetition, reduces errors and costs, and streamlines revenue cycle. See press releases about four integration aspects outlined below.

• Billing and Coding: ChartLogic
• Billing and EMR: Affinity Billing, MediEMR, Siemens, NextGen, athenahealth.
• Billing and Compliance: Billing Precision.
• Billing and Imaging: IMPAC, AMICAS, Fujitsu, MedLink.

   

   

 

New clients: Ingenious Med For, Lumetra, Misys, Per-Se, MediSys, Craneware, PaperFree, athenahealth, Picis, MicroMD, intraNexus, Visionary Medical Systems, AllScripts, LUMEDX, Streamline Health, LYNX, Sullivan Group, PHNS, Streamline Health, ECDS, McKesson

New billing products and services: Automed, HealthWare, JP Morgan, Physmark-Transplant, LabDAQ

Online Supply Store: Antek HealthWare

Patient Payment Ability Verification: Offers predictive reporting functionality to determine a patient's ability to pay for services and verify a patient's billing address in real time. See Per-Se.

Payer-side automation: See Guidewire ClaimCenter, XPERT Connect.

Personal Health Record Smart Card: Patients and health care providers can access medical health records, and send and save their most vital personal medical information instantly using the Internet or multiple devices, such as smart cards, USB keys, mobile phones, PDA's and Tablet PC's. See Patientrak.

Telemedicine: eNotes.

Yuval Lirov, PhD, author of Practicing Profitability - Network Effect for Revenue Cycle Control in Healthcare Clinic and Chiropractic Office: Scheduling, SOAP Notes, Care Plans, Coding, Billing, Collections, and Audit Risk (Affinity Billing) and Mission Critical Systems Management (Prentice Hall), inventor of patents in Artificial Intelligence and Computer Security, and CEO of Vericle.net - Distributed Billing and Practice Management Technologies. Yuval invites you to register to the next webinar on audit risk at BillingPrecision.com

Intelligent Electronic Medical Billing and SOAP Notes Software Requirements

Doctors and therapists must produce clinical documentation in ever increasing volumes and detail to ensure best healthcare, get medical claims paid in full and on time, and protect the practice from post-payment audits and unfair litigation.

But visit documentation speed conflicts with documentation accuracy and thoroughness. For insurance companies, patient visit documentation must be precise and comprehensive. If the quality of documentation is high, the medical billing appeals on unpaid claims are paid faster and at a higher rate. Otherwise, appeals are denied and the practice becomes vulnerable to post-payment audits, refunds, and penalties.

Insurance companies do not care how long does it take to produce good documentation. But for provider, slow documentation impedes practice profitability and wastes valuable time. The doctor must be done with visit documentation by the time the patient leaves the office.

To ensure comprehensive note coverage, healthcare industry adopted a two-pronged structured approach. First, the doctor uses SOAP notes format, which reflects four key stages of patient care, starting from Subjective observations, to Objective symptoms, to diagnostic Assessment, and culminating with treatment Plan:

 

1. SUBJECTIVE: The initial portion of the SOAP note format consists of subjective observations. These are symptoms typically expressed verbally by the patient. They include the patient's descriptions of pain or discomfort, the presence of nausea or dizziness or other descriptions of dysfunction.

    

    

2. OBJECTIVE: The next part of the format include symptoms actually be measured, seen, heard, touched, felt, or smelled. Included in objective observations are vital signs such as temperature, pulse, respiration, skin color, swelling and the results of diagnostic tests.

    

    

3. ASSESSMENT: Assessment is the diagnosis of the patient's condition based on Subjective observations and Objective symptoms. In some cases the diagnosis may be a simple determination while in other cases it may include multiple diagnosis possibilities.

    

    

4. PLAN: The last part of the SOAP note is the treatment plan, which may include laboratory and/or radiological tests ordered for the patient, medications ordered, treatments performed (e.g., minor surgery procedure), patient referrals (sending patient to a specialist), patient disposition (e.g., home care, bed rest, short-term, long-term disability, days excused from work, admission to hospital), patient directions and follow-up directions for the patient.

    

    

 

Next, each one of the four key SOAP stages consists of templates reflecting multiple possibilities for each stage. Templates, organized according to SOAP order, ensure comprehensive coverage and allow the doctor simply check multiple selection boxes on the screen driven by a computer program.

Templates have attracted two-fold criticism both from the provider and the payer sides. The providers dislike the lack of built-in intelligence to reflect individual doctor's preferences to treat patients. The payers often suspect template-generated notes of low quality and poor reflection of true patient state and treatment progress because template susceptibility to mechanical clicking and difficulty of interpretation.

The challenge is to combine the advantages of template and verbose formats without their shortcomings to describe precise patient condition, ensure productive medical billing, prepare for regulatory scrutiny, and improve practice productivity. To overcome the perception of mechanically generated notes while saving the doctor the time to type, some vendors have created specialized products that use randomized wording for each template. Such automatically generated notes include sentence structures, which closely resemble natural speech patterns.

Flexibility and integration must be key design features of SOAP notes. In the opening section, for example, you create new patient files that grow organically with each visit or treatment. Built-in intelligence allows you to customize a document to your own preferences and observe the entire patient progress history in a single screen. Native system integration with medical billing systems, enable automated claim generation, validation, and submission to payers for payment.

SOAP notes must not merely emulate the paper folder that every doctor has for every patient. They must use computer technology to help automate routine tasks and create a faster, easier, and error free process to increase practice profitability and reduce its audit risks.

Yuval Lirov, PhD, author of "Practicing Profitability - Network Effect for Revenue Cycle Control in Healthcare Clinic and Chiropractic Office: Scheduling, SOAP  Care Plans, Coding, Billing, Collections, and Audit Risk" (Affinity Billing) and "Mission Critical Systems Management" (Prentice Hall), inventor of patents in Artificial Intelligence and Computer Security, and CEO of Vericle.net - Distributed Billing and Practice Management Technologies. Yuval invites you to register to the next webinar on audit risk at BillingPrecision.com.