ICD-10…more responsibility for providers?

So, I took a ICD-10 training course from AAPC, for professionals. I have to say that from a Medical Biller perspective I didn’t see a lot of drastic change. However, there was a lot more change for the providers/doctors.

Those of you who have been documenting extensively for your patients have nothing to worry about….Yes, it will take a while for the payers to start processing your claims correctly and get payment. But you will have a less change of a rejected or denied claim, based on the simple fact that your diagnosis did not correspond to the treatment codes and you have no supporting documentation to show for it.

ICD -10 are more focused and more detailed but they are also more descriptive and require the supporting documentation to accompany the diagnosis.

There is more pressure on the provider to make sure that the documentation is correct so that the coder could select and code the diagnosis properly.

Please do not be discauraged. There is plenty of help…Courses from AAPC or even Availity. Or maybe you prefer a mobile approach of having an app on your phone with the ICD-10 refences. Of course, lets not forget your EHR/EMR software which could be quiet useful.

So, cheer up and brace the new ICD-10 with open arms and ease!

Importance of trained Front Office Staff!

More often then not: I receive dissapointed feedback from patients about provider offices: their Front Desk Staff specifically.

It is disapointing to come to an office where the front desk looks like a Tornadoe went through or the fact that the front staff is chewing gum with their mouth open while talking on the phone with a friend….OK ….OK …LOL…this is the worst case scenario.

The more realistic could be the fact that the front staff is not customer friendly or does not know which insurances you as a provider accept or the biggi-how to check properly the patient benefits and elegibility!

The post possible scenario for you as a provider: you would lose your patients, therefore your practice would suffer from reduction in revenue or A/R will go down….The Cash Flow will decrease!….Not a good thing for you as a business.

Training your Front Desk staff will help you avoid the worst case scenario and better clean claim submission. Resulting in no loss of your A/R and a constant flow of cash or payments.

If you are looking for for comprehensive training programs for your staff please visit my website or my Front Staff Training Packages blog post: for available times and prices!

What is an EOB?….a scary monster?…LOL

Everyday I receive at least 10 phone calls from patients freaking out about a “bill” they received from their insurance company. No it is not a “bill” just an EOB.

What is an EOB? EOB stands for Explanatiin of benefits. Its a piece of paper or papers that have a couple of components to it.

Fist listed is the DOS (date of service or visit). Then the codes that your provider has billed or submitted to your insurance company. Next is the POS (place of service). So far so good, right…you still with me?…Yes?..OK. Now come the billed charges-the amount that your provider billed your insurance company. Then the allowed charges-what your insurance will pay. Next column will show any amount that will go towards you deductible or coinsurance – this is your responsability and you have to pay that given amount to the provider. Then you will see the non covered changes- self explanatory. You still following me?…OK. we are almost at the end….LOL

There are also the numerical expalantion codes (reason codes)-explaining why this was paid and why not. Last but not least is the column of paid amount: the amount that was paid to your provider for the services billed.

Please remember that it is NOT a BILL….only an explanation of your benefits that you would receive after your provider submits a claim to your insurance company.

I hope this will help you in understanding about EOB. If you do have any other further questions please feel free to contact me via email or my contact form on my page and I will be glad to assist you. (You will receive an answer within 1 business day)