A few months ago, we mentioned a great resource we found for Medical Administration and/or Billing/Coding students to practice their skills. Now, to give you an inside look at their website, we've included a guest blog from their company below:
No matter the size of the practice, today’s nurses, medical assistants and healthcare workers need to have a basic understanding of the software used in that practice, clinic or hospital.
The interaction with software starts with registr
ation and scheduling
then
continues through the visit
by
recording in the electronic health record,
then
to billing the insurance company.
All these areas are related
and information flows between them.
Registration and Scheduling
The first interaction with the EHR is when a patient calls for an appointment and is scheduled. Scheduling may seem matter of fact and not important to the back office but the daily schedule can mean the difference between a day that goes smoothly and one that is chaotic. Each provider and practice has rules for scheduling,
and
a good scheduling system will have these rules built in:
how man
y patients are seen in an hour
on what time intervals are patients seen
(ex, 15, 20, 30 minutes apart)
what kinds of patients are seen (new, return
ing
, pre-surgery, post-surgery, other) and what times
Registration is when the patient’s important information such as address, referring physician,
and
insurance information is recorded into the computer system. Registration information is
then
pushed to the EHR.
In small offices, a medical assistant or nurse may need to step in to help by scheduling a follow-up visit, checking in, or checking out a p
atient. During either the check-in or check-
out process, patient information may need to be verified and co-payments recorded. For these reasons, it is a good idea for a student to become familiar with registration and scheduling and to practice scheduling patients and checking them in and out.
Medical Billing
Billing insurance companies require
s
clinical data and that data is obtai
ned from the EHR or at least
supported by the recorded visit in the EHR. The information must be accurate and must pass an audit from the insurance company.
The billing data from the EHR that is used for billing is the service codes (CPT4 and HCPCS codes) and the diagnosis codes. In order to bill for the correct service, the CPT4 or HCPCS code must be accurately identified. The ICD-9 diagnosis codes must reflect all the diagnosis codes that influenced which services were provided.
In addition, the order of the services and listing the diagnosis in the correct order determines what the insurance will allow and what they will pay. Getting either of codes out of order can cause a rejection, underpayment or trigger an audit. All of these results are time-consuming, delay payment and impact cash flow so it is critical that the EHR be updated correctly.
The dependency on accurate recording will become even more critical when ICD-10 is implemented on October 1, 2015. The number of rejections because incorrect diagnosis codes are used is expected to sky rocket.
Because the clinical information is critical to getting insurances billed and payment received, the student should understand the basics of billing and how their input can make a difference.
AskaMedicalBiller.com
Askamedicalbiller.com provides introductory courses, with videos and practice questions so to augment your education at EHRTutor.
At our site you will have access to:
Eleven (11) videos to watch
Practice Billing Software
Record a visit, post charges, post co-payments and view the claim.
Explore further to post payments and collection activities
Practice Scheduling softwar
e
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For the student, use AskaMedicalB
i
Iller.com to learn about scheduling and medical biller. By understanding what information flows to the claim and how it affects billing, you can be more successful in your first job!