Medical Billing - DME Software Add Ons

Everybody loves the extras. Getting what you pay for is one thing, but when you get those extra items, is when you feel like you're getting more for your money. In the world of medical billing, this is no different. Unfortunately, most software systems don't give you those extras at no cost. Still, there nice to have when you want to do a little bit more than just bill for services rendered. So what are some of the more common extras that come with DME software?

One of the common items that come extra with DME software is what is called barcoding. Barcoding has actually been going on for quite some time in the retail world. Just go to the local supermarket and you'll find those Universal Product Codes, called UPC codes, all over the place. As a matter of fact, most supermarkets now have automated checkouts using these UPC codes. How UPC codes work is beyond the scope of this article, but briefly, what the manufacturer of the item does is place a special code on each package that needs a special reader to read the price associated with it. This price is then stored in the system so that when the code is read, which is the product code, the price comes up on the register and is added to the subtotal. This functionality is added to some DME software to enable billing houses to sell over the counter items to patients.

This ties into another add on module that is called the retail sales module. This module is actually more than just software. It includes an entire retail sales checkout system, similar to what you would see in your local supermarket. These have to be specially installed by a trained technician. These retail sales modules can read the barcodes that are programmed into the barcoding module. So most people who get the barcoding add on will also get the retail sales add on as well. However, some companies only use the retail sales module and do checkout the old-fashioned way before they had barcodes. Usually small ma and pa stores will do this. These stores usually only do limited medical billing either to Medicare or Medicaid and don't handle a lot of private insurance companies.

Another common ad on, which many people believe should really be standard, is the electronic billing packages. The reason this is an add on in many cases is because standard forms billing is still pretty much the norm. Honestly, why this is the case is a mystery as electronic billing is so much faster and has a higher claim acceptance rate because of fewer errors. Eventually, electronic medical billing will be the norm and will come standard with all medical billing software packages.

There are other add ons such as special inventory control packages, auto pricing update packages and other updated packages for diagnosis codes, procedure codes and forms. Again, some packages include all this as standard but for the most part, if you want this functionality, you're going to have to pay extra for it.

Michael Russell

Your Independent guide to Medical Billing

Dr. Brian Capra, Chiropractor and Expert in Office Automation and Billing Software - Part II

Dr. Brian Capra, a graduate of Life University, has been a practicing chiropractor and office automation expert. He routinely visits chiropractic offices around the nation while receiving raving feedback from his clients. In his blog on Chiropractic Office Billing Software Profitability, Dr. Brian offers practical solutions for building a profitable and completely paperless office. In the second part of his interview, Dr. Brian gives advice to chiropractors who are at the start of their professional career.

 

• How did your own viewpoints evolve from the time you started Billing Precision?

   

  Dr. Brian : My viewpoints evolved in step with the growing scope of our service. As the number and size of the practices we support grew, I realized that my initial conjecture about the importance of integrated office workflow is paramount to success. For instance, besides a solid billing process, perfect SOAP notes are critical for better care, for lower audit risk, and for full reimbursement.

  Two other critical points are practice owner's business focus and teamwork. An unfocused practice owner will always confuse profit, revenue, and costs. And insurance companies will always exploit the lack of teamwork between billing and front office personnel.

  Today I realize that focus and teamwork can be turned around from being points of vulnerability to the strongest weapon for improving practice profitability and making the insurance companies pay everything they owe you. You can lock them down. You can research your options, fight back, and help others to fight back too.

• When talking to practice owners who invite you to their office, what are the comments that stick out most in your mind?

   

  Dr. Brian: In many ways, working with practice owners reminds me of working with the patient: a practice is a very complex system, where the flow of information must be uninhibited in order to have the practice growing at a healthy pace. Patients must make progress and vital functions of the office too must perform optimally to grow and to avoid risks.

  Patients are notorious for saying "well, I just get these headaches about once a day." When they realize that a headache is a problem with blood to the brain and most chiropractic do not have headaches, they see a whole new reality they never knew is possible. When patients begin to understand the principles of how things happen, they understand that chiropractic is not just a treatment for headaches. They begin to appreciate their true potential.

  A systemic "subluxation" may not be immediately observable to a naked and untrained eye, yet it may cause major setbacks for the practice owner. Just like patients who lack education about their own body and their nervous system, practice owners are often ignorant about the reasons for their underpayment or for the lack of practice growth. Many are complacent, they think where they are is as good as it gets.

  Doctors and practice managers are no different with realizing the potential for the health and wellness of their own office. Their own resistance to change and education, not the payers or the lack of adequate technology, is their biggest enemy. Few practice owners are open immediately to the changes in attitude and self-discipline required for measurable improvement in collections and reduction of audit exposure. Some seem stuck on "I don't need this," "we have it under control," "we tried it and it did not work," "we can do it better" or "if it is so great how come nobody else is doing it?" Others have tasted previously awful experiences with outsourcing to billing services that neglected denials and underpayments and collected commission fees only on claims that were paid anyway.

• What would you advise to the chiropractor who is about to start a new practice?

   

  Dr. Brian: Keep the principles in mind. An office is in a lot of ways a living thing. Just as it is impossible to for the liver to do the job of the kidneys it is impossible for the chiropractor to do the job of the biller of front desk. Luckily, God made a centralized system to control and coordinate the intercommunication and function of every cell in the body. Obviously the system is the CNS and all organs and systems are accountable to it. A new doctor should see that he/she should leverage a technology and use it as the CNS of his/her practice. In that way they can act at times like the brain, sending messages and giving orders to the rest of the body through the technology, and at other times allow that system to sustain the life of the practice. The doctor can then pick and choose where his/her time is most effectively spent: IE, Marketer, Adjuster, or Manager.

  Steps to success:

  1. Get a system of practice
  2. Get a technology that will help measure that system and one that will help manage it
  3. Run the system
  4. Find inefficiencies
  5. Build in automation, leveraging technology and other people’s time, to prevent the inefficiency from reoccurring
  6. Measure the changes and adjust accordingly

     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.

Chiropractic Office Billing Software and Personal Injury Protection (PIP) in New Jersey (Interview

Barry Fredson has been practicing law for nearly four decades. His office specializes in collecting Personal Injury Protection Benefits (PIP) for medical providers in the State of New Jersey. Last week, we had a chance to speak with him.

Question: What is Personal Injury Protection?

Barry Fredson: The system as established in New Jersey requires that providers of medical benefits to those injured in automobile accidents are paid promptly and according to a fee schedule. The concept is excellent however, insurance companies tend to delay and deny payments.

Question: Is it difficult to get paid?

Barry Fredson: Insurance companies are in the actuarial business. Accordingly, the longer they keep the provider’s payment, or the more obstacles they create to avoid full payment, the better it works for the insurance company. To counter these tactics medical providers need the assistance of counsel who understands insurance company procedures and can efficiently resolve medical provider’s claims.

Question: Is it better to not treat accident victims and avoid these problems?

Barry Fredson: Definitely not. My office processes thousands of these claims for dozens of medical providers in the State of New Jersey. The claims are processed efficiently and promptly taking full advantage of shared distributed computing platform.

Question: Will using the services of your law firm increase any provider’s costs?

Barry Fredson: No. The Personal Injury Protection Law is structured so that when medical providers are not paid within 60 days of submission of their bill, the insurance carrier who has denied/delayed payment is required to pay the attorney’s fee. There is never an additional charge to the medical providers.

Question: What makes Personal Injury Protection Benefits different from other claims?

Barry Fredson: From the provider’s point of view, there is no difference. The legislature has created a formal arbitration system for PIP claims. Although this a technical area of the law, and the insurance companies have highly trained lawyers and claims adjusters who look for minor errors or non-complete submissions, we use a combination of doctor’s notes, supplemental documentation and certifications to eliminate insurance company objections and prevail in this lucrative but complex area of medical reimbursement.

Question: Do I need any particular volume of claims or any particular specialty to take advantage of this lucrative area?

Barry Fredson: No. Many providers of services to accident victims from small chiropractic offices to hospitals, diagnostic facilities, surgery centers, orthopedists, neurologist, chiropractors, physical therapist, pharmacists, and other providers, all can take advantage of this lucrative area of reimbursement.

Question: How do I take advantage of your service?

Barry Fredson: By using Vericle—Billing Precision’s unique integrated revenue cycle management platform with built in controls and accountability, you are on the way. Our staff would interface directly with Vericle and you would be kept notified in the usual efficient manner used by Billing Precision’s services.

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.

The Need for HIPAA Complaint Medical Billing Software

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) includes seven sets of rules that will affect your practice. The Department of Health and Human Services, or DHHS, issues these in the form of the ""Notice of Proposed Rule Making"" or NPRM. Every practice, regardless of size, must comply with HIPAA privacy, security and transactional regulations. Moreover, adherence to all subsequent regulations is also required. This covers most everything in your practice, including your medical billing software.

When you are shopping for medical billing software, ask how and for whom the system was designed, and whether the data will be safe and secure on backed-up, protected, HIPAA-compliant servers accessible only to authorized persons. Look for companies who provide free updates to ensure continued efficiency and HIPAA compliance. The new HIPAA standards require huge changes to how healthcare organizations deal with their patient information, including coding, security, patient record management, reimbursement and care management. HIPAA‘s provisions include stringent codes for the unvarying transfer of electronic data, including routine alterations and billing.

Clearly your approach to HIPAA medical billing software must include a serious investigation of software security. Most computer experts will agree that there is no such thing as absolute computer or software security, so working closely with your HIPAA software providers to help determine data deficiencies is a good idea. HIPAA Complaint Medical Billing Software can be easily expanded to meet future needs, and can be targeted directly to the size and complexity of your practice. Options for new HIPAA compliant software have never been better, as there is unlimited scalability, a wide range of customization choices, and a large selection of useful features that will prevent the patients' privacy from being compromised.

Innovations in the technology of medical billing software have created a new criterion for digital precision. Make certain that the HIPAA compliant medical software packager you chose includes all finalized aspects of HIPAA to guarantee full compliance with HIPAA standards as they relate to the electronic transfer of protected health information. The regulations themselves took effect in February 2003, and affect every medical practice in the United States. Effective April 2005, HIPAA mandates security measures to physically and electronically secure electronic protected health information (PHI) against unauthorized retrieval, reliably store the electronic data, and provide for emergency access to the data.

Since most medical billing software packages are now designed to be HIPAA compliant, it is just a matter of choosing the right software for your practice, and your medical billing software will run as smoothly and efficiently as ever.

Medical Billing Software Info provides comprehensive information about medical insurance billing software, HIPAA compliant medical billing software, easy and free medical billing software, and medical billing software prices and reviews. Medical Billing Software Info is the sister site of Medical Billing Web.