ollielooya
True Blue
List,
Lately I've come across a few fok who do medical billing for a living, and I was a little surprised to find out that they submit the charges as given to them and DO NOT have access to the chart notes. Modifiers for the most part aren't on the charge slips, so it is up to the biller to decide if they should be applied. How is that possible? And then I heard one say, well, if it's an office visit with a procedure you should always add modifier 25, and so on. Really? So, how can they work the AR from the back end if the chart notes are not available? And how can modifiers be appropriately assigned without access to medical records? All my training a few years ago tells me this is not the most compliant billing, and since I've only been doing this for going on 4 years now and with the same employer would like to know if this is really a common practice?
Then I had another friend in the business who audits the back end, AFTER the charges have gone out and AFTER the insurance companies have paid, but this same process is not done ahead of time. Is this the norm too? I would really like to know, because it just seems backwards and I would like to know if this is just accepted medical practice from the past that is being carried forward to the present and will ultimately face a big shake-up. Please remember, I'm only a four-year-old, so this is still sinking in for me...
Comments and thoughts, please!
---Suzanne E. Byrum CPC
Lately I've come across a few fok who do medical billing for a living, and I was a little surprised to find out that they submit the charges as given to them and DO NOT have access to the chart notes. Modifiers for the most part aren't on the charge slips, so it is up to the biller to decide if they should be applied. How is that possible? And then I heard one say, well, if it's an office visit with a procedure you should always add modifier 25, and so on. Really? So, how can they work the AR from the back end if the chart notes are not available? And how can modifiers be appropriately assigned without access to medical records? All my training a few years ago tells me this is not the most compliant billing, and since I've only been doing this for going on 4 years now and with the same employer would like to know if this is really a common practice?
Then I had another friend in the business who audits the back end, AFTER the charges have gone out and AFTER the insurance companies have paid, but this same process is not done ahead of time. Is this the norm too? I would really like to know, because it just seems backwards and I would like to know if this is just accepted medical practice from the past that is being carried forward to the present and will ultimately face a big shake-up. Please remember, I'm only a four-year-old, so this is still sinking in for me...
Comments and thoughts, please!
---Suzanne E. Byrum CPC