When a medical office is in full swing and contending in today's high-tech market, medical billing and coding is a critical part of the equation. Any size practice needs the best electronic medical billing structures they can assemble, not only to provide quality care, but to keep the office financially solvent. There are several main goals in perfecting medical billing, coding and data handling systems, and all of them are important.

Online consulting companies and other sites can offer resources for doing all of the things necessary to improve the medical billing and coding system in an office. Managers, head nurses, physicians and others may look for:

1. Solutions for getting healthcare billing services compliant with national medical regulatory programs like HIPAA, JCAHO and other specialized industry standards.

2. Resources for improving medical coding software and other tools for data access and data handling in an office and generally making the most of medical billing and coding systems to gain efficiency.

3. Help dealing with accounts receivable problems.

Action Steps
The best contacts and resources to help you get it done

Find help for medical billing and coding regulatory compliance

In the medical biz, standards are everything, and regulatory systems aren't just directed at patient care. Sure, there are a lot of rules for treating patients, but there are also a slew of regulations around how medical billing and coding systems handle patient data and work with financial processes. Outside companies can help offices decipher the rules and get good at dealing with them.

I recommend: Get HIPAA compliance resources or consulting services from Millennium Medical Billing. The group at Outsource Management Group will get you answers on HIPAA and a number of other administrative issues for ratcheting up the effectiveness of your office.

Look for resources to improve your data handling in medical billing and coding systems

Another aspect of revolutionizing the medical billing and coding system within an office is to see if you can improve access to patient records and streamline data handling to perfect the office process and make life easier for staff.

I recommend: Get help with designing medical systems for best data access at Claricode. You can find great data storage software and tools from the popular medical provider Capterra online.

Find help with medical billing and coding for accounts receivables

It's no use having the perfect practice if you can't keep the money coming in, and in many offices across the country, this can be a real problem. If your self-paying patients can't cough up the dough for procedures, and the health insurance companies under contract are returning sheaves of claims for 'billing errors,' an office manager can find that the cash process just isn't flowing. Seek help and get back on top of the game.

I recommend: Get receivables billing and coding consulting from Medical-Billing.com, an online company with a track record of helping out with old accounts. Medical Account Solutions Consulting goes a step further. This company pledges not to collect fees until your office gets results in its receivables.

Tips & Tactics

Helpful advice for making the most of this Guide

• •  When collaborating with medical billing services, think about how your medical billing and coding could be better and what it lacks. Then communicate this to your new assistants, and develop a road map for getting where you want to be.

Software systems for medical billing and coding continue to advance, giving medical practices and healthcare facilities an unprecedented level of efficiency. With medical billing software and medical coding software, your medical practice can achieve smoother interactions with insurance payers, more accurate accounting, and ultimately, a healthier bottom line.

What can today's medical billing and coding software can do for you?

1. Medical coding software reduces coding errors and makes it easier to stay up-to-date on new coding requirements.
2. Medical billing software allows you to submit medical claims electronically.
3. Medical billing software simplifies the entire billing process so that your staff can attend to other responsibilities.

Action Steps
The best contacts and resources to help you get it done

No-hassle web-based medical billing software

Finally, billing is more convenient thanks to medical billing software that delivers web-based billing, electronic claims payment and code-checking.

I recommend: PiMS Medical Billing software takes care of the entire billing process and lets you customize your billing cycle. It also updates billing codes online so you can revise your invoices accordingly. Payerpath's claims management system includes CodeCorrect, which provides quick access to current local and national codes and verifies allowed amounts and bundling.

Use software for both medical billing and coding

Take care of medical billing and coding and most of your other office administration tasks with a single software package.

I recommend: AllegianceMD's practice management program includes medical billing software that is equipped with the ability to catch coding errors. Lytec Medical 2007 Professional medical billing software handles accounting tasks, scheduling and reporting. It also includes a medical coding software tool to help ensure that your codes are accurate.

Medical coding software prevents costly coding errors

Coding errors can slow payments and create additional work for your administrative staff. Medical coding software confirms that your coding is correct before you file claims.

I recommend: At Accuro Healthcare Solutions, physicians and hospitals can access online medical coding software that makes it easier to receive correct reimbursement for services rendered and ensures regulatory compliance. Among the company's other products is CodeCorrect, a claim scrubbing application that catches coding errors. The American Academy of Family Physicians offers an extensive list of online resources for medical coding software and other options.

Tips & Tactics

Helpful advice for making the most of this Guide

• •  Ask other physicians and medical office managers how they like the medical billing and coding software they use.
• •  Take advantage of the free trial period that most medical billing and coding software suppliers offer. Ask for feedback from everyone in your facility who will be using the software.
• •  Confirm that the medical billing and coding software complies with the Health Insurance Portability and Accountability Act (HIPAA).

For anyone dealing with the medical billing and coding aspect of running any size of medical practice, it's clear that information about medical billing, coding and financial administration is a powerful asset. As medical billing and coding issues plague small medical offices as well as large care networks, managers at all levels struggle to implement solutions.

You can get breaking news on what others are doing in the medical coding and medical billing business online from sources that compile articles for comparing medical offices nationwide to see what the emerging trends are within the industry. Readers might look for:

1. News on how offices are battling medical billing errors, old accounts and other problems in the medical billing and coding sector.

2. New releases of tools and resources for working in the medical billing and coding industry, such as medical coding software or payer factsheets.

3. More on how to maintain best office practices and keep up with changes in government programs and big payer policies.

Action Steps
The best contacts and resources to help you get it done

Get news on account resolution in medical billing and coding

From old accounts that languish in the bowels of medical accounting systems, to costly billing errors, lots of problems threaten to sink the account balances of some practices. Learn from comprehensive medical news sources about billing issues and how to resolve them.

I recommend: The Healthcare BPO blog offers timely articles on medical billing errors and an array of other more exotic issues like ICD9 codes for spacecraft injuries. Get more at the Outsource Management Group Medical News Blog.

Look for news on new products and tools for medical billing and coding

Another way to stay on top what's happening in the medical billing and coding industry is to find out about the best improved tools for getting on top of billing in your office. Press releases and articles from online sources about billing and coding software or other products can help accomplish this goal for busy medical managers.

I recommend: Get breaking news on medical billing innovations at 24/7 press release. Find out more medical billing and coding news and trends at Innovative Medical Billing.

Get more on day to day medical billing and coding administration

Other medical news sources contain a wide and diverse set of informational articles on how to stay competitive in the medical billing services sector, with tips for adapting to the trials and tribulations of a system almost constantly in flux, from electronic medical billing to patient data safety.

I recommend: The blog at The Journal of Medical Practice Management from soundpractice.net covers news on medical billing and all aspects of managing healthcare. Find more on general medical billing and coding consulting and resources at Spot Healthcare.

Tips & Tactics

Helpful advice for making the most of this Guide

• •  If you're using medical billing services to improve your bottom line and manage your office billing, make sure you understand what's available, staying in contact with reps and working on overall compatibility, staff training and more to get the best out of what you already have as you scan the horizon for new strategies.

There are many terms involved in medical billing and coding, but some very important and significant ones help to provide an underlying structure to the relationship between hospitals and care facilities, physicians, insurers, and the professionals who do the work of medical billing and coding. Knowing the terms often used in "keeping the record straight" in medical billing and coding will definitely help a business involved in any aspect of this important work.

Action Steps
The best contacts and resources to help you get it done

HIPAA

What is known in the medical business as HIPAA, or the Health Insurance Portability and Accountability Act, governs much of how information is handled in any medical office or facility, or in any role during a medical career.

I recommend: Find out more about HIPAA at this U.S. Dept. of Health and Human Services page.

ICD code

An ICD-9 or ICD-10 code is a modern way to refer to a clinical diagnosis in medical billing and coding. The ICD system is an international way to standardize diagnosis on paper and facilitate good understanding for anyone who may use a medical record or chart.

I recommend: Find out more about ICD codes at the HHS Centers for Medicare and MedicAid Service site.

Reimbursement codes

Two other types of medical codes center not on diagnosis but on specific procedures. These codes also have a big impact on insurance results and are often called 'reimbursement codes.' The technical names are Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT).

I recommend: Find out more about HCPCS, CPT and more at ReimbursementCodes.com.

Place of Service codes

Another big aspect of medical coding and billing is making sense of Place of Service codes, which are reported at specific points on a claim form or other medical document.

I recommend: Find out more about Place of Service codes at Just My Passion.

EOB

An EOB, or Explanation of Benefits, is what a health insurer may send a member. This form gets a lot of use by medical billing and coding professionals who are involved in making sure everything on a form is correctly reported.

I recommend: Learn about an EOB from the Blue Cross Blue Shield Association.

Medical necessity

An insurer, and therefore a medical biller or coder, will also generally measure what's called 'medical necessity.' This term is a way of explaining how a company, care provider or insurer measures whether the claim will be covered according to whether the patient needed the specific care or procedures defined.

I recommend: Find out more about specifics on medical necessity from this page from insurer CIGNA.