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Discussion/ Billing and coding Essay

Gater (2004), states that medical billing errors slip ups are due to unfinished data or putting incorrect data into the system. The most likely slip up is not being able to fulfill the insurance policies. “The medical billing advocates of America” (MBAA), are assisting patients to make sense of there medical fees (Gater, 2004). The process used in Medicare for a diagnostic mammogram is, a person does not require written form (Linver, 2002). A diagnostic mammogram is necessary in a situation where screening has found an abnormality, then no doctors permission is needed (Linver, 2002).

Causes that delay reimbursement of claims from insurance companies The first cause of delay in compensation is due to errors they are many types of errors. Typographical slipups can lead to the delay of compensation as the wrong data is processed into the system. There are times that patients use different insurance covers without giving there recent forms to appropriate people this can lead to delay in compensation (Gater, 2004). Staff members record data rather fast and end up entering the wrong data. Staff members do not pay attention to detail (Gater, 2004). The Explanation of Benefits (EOB) is often misunderstood.

The other cause of delay in paying out compensation is lawsuits. Dawn (2005) argues that lawsuits assist in being compensated your money, as well as frustrate physicians. It takes along time for the cases to be tried in courts. A class action suit filed in 1999 was resolved in 2004(Dawn, 2005). What causes delays in reimbursement from Medicare? Declusin are protesting due to delay of there reimbursements from Medicare claims are changing there policies (GBA, 2008). The other issue is when they changed there cover they did not plan for it carefully therefore creating mayhem to the insured people.

Compensation delays have cropped up mainly due to the use of the national provider identity card, which sometimes doctors do not fill in properly (GBA, 2008). Conclusion The coding and billing process can be rectified by using software that assures all insurance forms are completed and the right codes are entered. In addition, staff members should make sure the data entered is to the point and accurate (Gater, 2004). A class action according to Dawn (2005) helps in fighting for physicians rights, as they do not permit physicians to negotiate for a just contract.

Reimbursement for mammography process should be adopted to steer clear from money problems (Linver 2002). References Gater, L. (2004). Deflated by denials, Medical Imaging, — Laura Gater’s medical and business trade. Medical Imaging, 24×7, Podiatry Management, Veterinary Forum, Corrections Forum, and other national and online publications. Retrieved on July 22nd 2009. Available at http://www. fortherecordmag. com/archives/ftr_100404p38. shtml Potkey, R. (2008). Delays in Medicare payments hurt Doctors. Scripps Interactive Newspapers Group.

Retrieved on July 22 nd 2009. . Available at http://www. venturacountystar. com/news/2008/oct/06/delays-in-medicare-payments-hurt-doctors/ Linver, N. M. (2004) . Coding and Billing in Breast Imaging ascend Media LLC Retrieved on 22nd 2009. Available at http://www. imagingeconomics. com/issues/articles/2002-04_08. asp Lipthrott, D. (2005). Ethical Health Partnerships Reimbursement: Health Insurance companies Held Accountable by courts. Retrieved on July 22nd , 2009. Available at http://www. ethicalhealthpartnerships. org/inscolawsuits. html


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