RE: various issues: learning billing, EOB grooming, and income

[Guest guest]

Assuming you have the appropriate

documentation, it would likely be a 99349 or 99350 with the added code of 99050

for both. Remember, only some insurances pay for home

visits and only some insurances pay for after hours codes. Good luck!

Re: various issues: learning billing,

> EOB grooming, and income

>

> From Dr Joanne in Drain, Oregon,

>

> The reason you haven't heard much from me recently

is that I am now

> starting to do my own billing. I had a billing expert who came in 10

> hours a week to bill for me, but I was seeing more patients, documenting

> the way she told me to, and not getting more money. So I decided to

> bite the bullet and learn Lytec well enough to bill for myself and find

> out why.

> As of two weeks ago, I have been billing the

day's patients the end

> of every day, and am starting to cream through my old EOBs and do all

> the challanges, rebills, charging to secondary billing, etc,etc that one

> must do to actually collect what you are allowed to get from these

> folks. It is irritating and time consuming, but it certainly is

making

> me a better coder as well as collecting a reasonable amount of money.

> What was happening with my (everyone says

including the MD she is

> working full time for) skilled billing person, is that she was skipping

> the tough ones: For example, Blue Cross Blue Shield 65 Plus is

supposed

> to have a primary care provider that they have to access first. Some

of

> them can come here for very acute problems if they can't get into their

> primary provider. They may be rejected for payment:

however; if so,

> one can rebill straight to Medicare and get them (mostly) covered,

> except for 15 or 16 dollars. I found 25 or 30 of those that never

got

> rebilled to Medicare.

> No, I didn't fire the part time worker. I

have a rule that " you can

> never hire anyone to do anything you don't all ready know how to do

> yourself, better. " I think it was my fault for not learning the

system

> myself first. And the worker is doing a much better job now, too.

> I think the business was just getting too busy for

one part timer,

> and I am not willing to hire someone full time for this; I refuse to

> become anything but a low overhead practice.

>

> Thinking about a second way increase income. I have been

here in

> Drain long enough that I seem reliable to the local businesses for

> on-the-job injuries. Workman's comp pays like a trooper, if you keep

> good documentation. I am starting to become the one they send these

> folks to, and I have started to visit the local factories/businesses to

> offer my services. Businesses tend to have habits of behavior for

> injuries, and if you are their first choice, you can get some good

> cases, with great followup coverage. Here, these businesses are

mills

> and machinist shops, with some logging companies, which have rather

> specific types of injury.

>

>

Joanne

> _____

>

> Love cheap thrills? Enjoy PC-to-Phone calls

> <http://us.rd.yahoo.com/mail_us/taglines/postman9/*http:/us.rd.yahoo.com

> /evt=39666/*http:/beta.messenger.yahoo.com/> to 30+ countries for

just

> 2¢/min with Yahoo! Messenger with Voice.

>

[Guest guest]

Assuming you have the appropriate

documentation, it would likely be a 99349 or 99350 with the added code of 99050

for both. Remember, only some insurances pay for home

visits and only some insurances pay for after hours codes. Good luck!

Re: various issues: learning billing,

> EOB grooming, and income

>

> From Dr Joanne in Drain, Oregon,

>

> The reason you haven't heard much from me recently

is that I am now

> starting to do my own billing. I had a billing expert who came in 10

> hours a week to bill for me, but I was seeing more patients, documenting

> the way she told me to, and not getting more money. So I decided to

> bite the bullet and learn Lytec well enough to bill for myself and find

> out why.

> As of two weeks ago, I have been billing the

day's patients the end

> of every day, and am starting to cream through my old EOBs and do all

> the challanges, rebills, charging to secondary billing, etc,etc that one

> must do to actually collect what you are allowed to get from these

> folks. It is irritating and time consuming, but it certainly is

making

> me a better coder as well as collecting a reasonable amount of money.

> What was happening with my (everyone says

including the MD she is

> working full time for) skilled billing person, is that she was skipping

> the tough ones: For example, Blue Cross Blue Shield 65 Plus is

supposed

> to have a primary care provider that they have to access first. Some

of

> them can come here for very acute problems if they can't get into their

> primary provider. They may be rejected for payment:

however; if so,

> one can rebill straight to Medicare and get them (mostly) covered,

> except for 15 or 16 dollars. I found 25 or 30 of those that never

got

> rebilled to Medicare.

> No, I didn't fire the part time worker. I

have a rule that " you can

> never hire anyone to do anything you don't all ready know how to do

> yourself, better. " I think it was my fault for not learning the

system

> myself first. And the worker is doing a much better job now, too.

> I think the business was just getting too busy for

one part timer,

> and I am not willing to hire someone full time for this; I refuse to

> become anything but a low overhead practice.

>

> Thinking about a second way increase income. I have been

here in

> Drain long enough that I seem reliable to the local businesses for

> on-the-job injuries. Workman's comp pays like a trooper, if you keep

> good documentation. I am starting to become the one they send these

> folks to, and I have started to visit the local factories/businesses to

> offer my services. Businesses tend to have habits of behavior for

> injuries, and if you are their first choice, you can get some good

> cases, with great followup coverage. Here, these businesses are

mills

> and machinist shops, with some logging companies, which have rather

> specific types of injury.

>

>

Joanne

> _____

>

> Love cheap thrills? Enjoy PC-to-Phone calls

> <http://us.rd.yahoo.com/mail_us/taglines/postman9/*http:/us.rd.yahoo.com

> /evt=39666/*http:/beta.messenger.yahoo.com/> to 30+ countries for

just

> 2¢/min with Yahoo! Messenger with Voice.

>

[Guest guest]

My only experience billing home visits has

been to Medicare.  For peds patients, presumably they don’t have medicare, and I would be worried that private insurance may

not pay for home visits at all.   The

9934_series is for home visits, but it might be that those are not covered and

you’d be better off just billing as if it were an office visit.  Before I did a bunch of these, I would get

with my provider reps and try to get some idea of whether home visits are

covered.  If they aren’t, then I

would tell the patient/parent that if they want after hours service you will

open up the office for them (and bill 9921_ plus 99050) or if they want a house

call, they will have to pay out of pocket because it is not covered by their insurance.  Of course you can always make exceptions if

you want to build up some good will….but in my experience that sort of

thing builds more unreasonable demand than good will…..

Annie

Re: various issues: learning billing,

> EOB grooming, and income

>

> From Dr Joanne in Drain, Oregon,

>

> The reason you haven't heard much from me recently

is that I am now

> starting to do my own billing. I had a billing expert who came in 10

> hours a week to bill for me, but I was seeing more patients, documenting

> the way she told me to, and not getting more money. So I decided to

> bite the bullet and learn Lytec well enough to bill for myself and find

> out why.

> As of two weeks ago, I have been billing the

day's patients the end

> of every day, and am starting to cream through my old EOBs and do all

> the challanges, rebills, charging to secondary billing, etc,etc that one

> must do to actually collect what you are allowed to get from these

> folks. It is irritating and time consuming, but it certainly is

making

> me a better coder as well as collecting a reasonable amount of money.

> What was happening with my (everyone says

including the MD she is

> working full time for) skilled billing person, is that she was skipping

> the tough ones: For example, Blue Cross Blue Shield 65 Plus is

supposed

> to have a primary care provider that they have to access first. Some

of

> them can come here for very acute problems if they can't get into their

> primary provider. They may be rejected for payment:

however; if so,

> one can rebill straight to Medicare and get them (mostly) covered,

> except for 15 or 16 dollars. I found 25 or 30 of those that never

got

> rebilled to Medicare.

> No, I didn't fire the part time worker. I

have a rule that " you can

> never hire anyone to do anything you don't all ready know how to do

> yourself, better. " I think it was my fault for not learning the

system

> myself first. And the worker is doing a much better job now, too.

> I think the business was just getting too busy for

one part timer,

> and I am not willing to hire someone full time for this; I refuse to

> become anything but a low overhead practice.

>

> Thinking about a second way increase income. I have been

here in

> Drain long enough that I seem reliable to the local businesses for

> on-the-job injuries. Workman's comp pays like a trooper, if you keep

> good documentation. I am starting to become the one they send these

> folks to, and I have started to visit the local factories/businesses to

> offer my services. Businesses tend to have habits of behavior for

> injuries, and if you are their first choice, you can get some good

> cases, with great followup coverage. Here, these businesses are

mills

> and machinist shops, with some logging companies, which have rather

> specific types of injury.

>

>

Joanne

> _____

>

> Love cheap thrills? Enjoy PC-to-Phone calls

> <http://us.rd.yahoo.com/mail_us/taglines/postman9/*http:/us.rd.yahoo.com

> /evt=39666/*http:/beta.messenger.yahoo.com/> to 30+ countries for

just

> 2¢/min with Yahoo! Messenger with Voice.

>

[Guest guest]

My only experience billing home visits has

been to Medicare.  For peds patients, presumably they don’t have medicare, and I would be worried that private insurance may

not pay for home visits at all.   The

9934_series is for home visits, but it might be that those are not covered and

you’d be better off just billing as if it were an office visit.  Before I did a bunch of these, I would get

with my provider reps and try to get some idea of whether home visits are

covered.  If they aren’t, then I

would tell the patient/parent that if they want after hours service you will

open up the office for them (and bill 9921_ plus 99050) or if they want a house

call, they will have to pay out of pocket because it is not covered by their insurance.  Of course you can always make exceptions if

you want to build up some good will….but in my experience that sort of

thing builds more unreasonable demand than good will…..

Annie

Re: various issues: learning billing,

> EOB grooming, and income

>

> From Dr Joanne in Drain, Oregon,

>

> The reason you haven't heard much from me recently

is that I am now

> starting to do my own billing. I had a billing expert who came in 10

> hours a week to bill for me, but I was seeing more patients, documenting

> the way she told me to, and not getting more money. So I decided to

> bite the bullet and learn Lytec well enough to bill for myself and find

> out why.

> As of two weeks ago, I have been billing the

day's patients the end

> of every day, and am starting to cream through my old EOBs and do all

> the challanges, rebills, charging to secondary billing, etc,etc that one

> must do to actually collect what you are allowed to get from these

> folks. It is irritating and time consuming, but it certainly is

making

> me a better coder as well as collecting a reasonable amount of money.

> What was happening with my (everyone says

including the MD she is

> working full time for) skilled billing person, is that she was skipping

> the tough ones: For example, Blue Cross Blue Shield 65 Plus is

supposed

> to have a primary care provider that they have to access first. Some

of

> them can come here for very acute problems if they can't get into their

> primary provider. They may be rejected for payment:

however; if so,

> one can rebill straight to Medicare and get them (mostly) covered,

> except for 15 or 16 dollars. I found 25 or 30 of those that never

got

> rebilled to Medicare.

> No, I didn't fire the part time worker. I

have a rule that " you can

> never hire anyone to do anything you don't all ready know how to do

> yourself, better. " I think it was my fault for not learning the

system

> myself first. And the worker is doing a much better job now, too.

> I think the business was just getting too busy for

one part timer,

> and I am not willing to hire someone full time for this; I refuse to

> become anything but a low overhead practice.

>

> Thinking about a second way increase income. I have been

here in

> Drain long enough that I seem reliable to the local businesses for

> on-the-job injuries. Workman's comp pays like a trooper, if you keep

> good documentation. I am starting to become the one they send these

> folks to, and I have started to visit the local factories/businesses to

> offer my services. Businesses tend to have habits of behavior for

> injuries, and if you are their first choice, you can get some good

> cases, with great followup coverage. Here, these businesses are

mills

> and machinist shops, with some logging companies, which have rather

> specific types of injury.

>

>

Joanne

> _____

>

> Love cheap thrills? Enjoy PC-to-Phone calls

> <http://us.rd.yahoo.com/mail_us/taglines/postman9/*http:/us.rd.yahoo.com

> /evt=39666/*http:/beta.messenger.yahoo.com/> to 30+ countries for

just

> 2¢/min with Yahoo! Messenger with Voice.

>

[Guest guest]

Thanks. Are there any modifiers I need to add? Can I go with the 99349 and /or 99050 and icd-9 (786.07-wheezing,786.2-cough, 493.02- extinsic asthma) and cpt code(99213)for each? Want to get this right the first time. We are having a wicked allergy season here!!!n" Brady, MD" wrote: Assuming you have the appropriate documentation, it would likely be a 99349 or 99350 with the added code of 99050 for both. Remember, only some insurances pay for home visits and only some insurances pay for after hours codes. Good luck! Re: various issues: learning billing,> EOB grooming, and income>> From Dr Joanne in Drain, Oregon,>> The reason you haven't heard much from me recently is that I am now> starting to do my own billing. I had a billing expert who came in 10> hours a week to bill for me, but I was seeing more patients, documenting> the way she told me to, and not getting more money. So I decided to> bite the bullet and learn Lytec well enough to bill for myself and find> out why.> As of two weeks ago, I have been billing the day's

patients the end> of every day, and am starting to cream through my old EOBs and do all> the challanges, rebills, charging to secondary billing, etc,etc that one> must do to actually collect what you are allowed to get from these> folks. It is irritating and time consuming, but it certainly is making> me a better coder as well as collecting a reasonable amount of money.> What was happening with my (everyone says including the MD she is> working full time for) skilled billing person, is that she was skipping> the tough ones: For example, Blue Cross Blue Shield 65 Plus is supposed> to have a primary care provider that they have to access first. Some of> them can come here for very acute problems if they can't get into their> primary provider. They may be rejected for payment: however; if so,> one can rebill straight to Medicare and

get them (mostly) covered,> except for 15 or 16 dollars. I found 25 or 30 of those that never got> rebilled to Medicare.> No, I didn't fire the part time worker. I have a rule that "you can> never hire anyone to do anything you don't all ready know how to do> yourself, better." I think it was my fault for not learning the system> myself first. And the worker is doing a much better job now, too.> I think the business was just getting too busy for one part timer,> and I am not willing to hire someone full time for this; I refuse to> become anything but a low overhead practice.>> Thinking about a second way increase income. I have been here in> Drain long enough that I seem reliable to the local businesses for> on-the-job injuries. Workman's comp pays like a trooper, if you keep> good

documentation. I am starting to become the one they send these> folks to, and I have started to visit the local factories/businesses to> offer my services. Businesses tend to have habits of behavior for> injuries, and if you are their first choice, you can get some good> cases, with great followup coverage. Here, these businesses are mills> and machinist shops, with some logging companies, which have rather> specific types of injury.>> Joanne> _____>> Love cheap thrills? Enjoy PC-to-Phone calls> <http://us.rd.yahoo.com/mail_us/taglines/postman9/*http:/us.rd.yahoo.com>

/evt=39666/*http:/beta.messenger.yahoo.com/> to 30+ countries for just> 2¢/min with Yahoo! Messenger with Voice.>

[Guest guest]

Thanks. Are there any modifiers I need to add? Can I go with the 99349 and /or 99050 and icd-9 (786.07-wheezing,786.2-cough, 493.02- extinsic asthma) and cpt code(99213)for each? Want to get this right the first time. We are having a wicked allergy season here!!!n" Brady, MD" wrote: Assuming you have the appropriate documentation, it would likely be a 99349 or 99350 with the added code of 99050 for both. Remember, only some insurances pay for home visits and only some insurances pay for after hours codes. Good luck! Re: various issues: learning billing,> EOB grooming, and income>> From Dr Joanne in Drain, Oregon,>> The reason you haven't heard much from me recently is that I am now> starting to do my own billing. I had a billing expert who came in 10> hours a week to bill for me, but I was seeing more patients, documenting> the way she told me to, and not getting more money. So I decided to> bite the bullet and learn Lytec well enough to bill for myself and find> out why.> As of two weeks ago, I have been billing the day's

patients the end> of every day, and am starting to cream through my old EOBs and do all> the challanges, rebills, charging to secondary billing, etc,etc that one> must do to actually collect what you are allowed to get from these> folks. It is irritating and time consuming, but it certainly is making> me a better coder as well as collecting a reasonable amount of money.> What was happening with my (everyone says including the MD she is> working full time for) skilled billing person, is that she was skipping> the tough ones: For example, Blue Cross Blue Shield 65 Plus is supposed> to have a primary care provider that they have to access first. Some of> them can come here for very acute problems if they can't get into their> primary provider. They may be rejected for payment: however; if so,> one can rebill straight to Medicare and

get them (mostly) covered,> except for 15 or 16 dollars. I found 25 or 30 of those that never got> rebilled to Medicare.> No, I didn't fire the part time worker. I have a rule that "you can> never hire anyone to do anything you don't all ready know how to do> yourself, better." I think it was my fault for not learning the system> myself first. And the worker is doing a much better job now, too.> I think the business was just getting too busy for one part timer,> and I am not willing to hire someone full time for this; I refuse to> become anything but a low overhead practice.>> Thinking about a second way increase income. I have been here in> Drain long enough that I seem reliable to the local businesses for> on-the-job injuries. Workman's comp pays like a trooper, if you keep> good

documentation. I am starting to become the one they send these> folks to, and I have started to visit the local factories/businesses to> offer my services. Businesses tend to have habits of behavior for> injuries, and if you are their first choice, you can get some good> cases, with great followup coverage. Here, these businesses are mills> and machinist shops, with some logging companies, which have rather> specific types of injury.>> Joanne> _____>> Love cheap thrills? Enjoy PC-to-Phone calls> <http://us.rd.yahoo.com/mail_us/taglines/postman9/*http:/us.rd.yahoo.com>

/evt=39666/*http:/beta.messenger.yahoo.com/> to 30+ countries for just> 2¢/min with Yahoo! Messenger with Voice.>

[Guest guest]

You should not need any modifiers, but the

9934_ code is the E & M code so you don’t need the 9921_ code. Hope it

works!

Re: various issues: learning billing,

> EOB grooming, and income

>

> From Dr Joanne in Drain, Oregon,

>

> The reason you haven't heard much from me recently

is that I am now

> starting to do my own billing. I had a billing expert who came in 10

> hours a week to bill for me, but I was seeing more patients, documenting

> the way she told me to, and not getting more money. So I decided to

> bite the bullet and learn Lytec well enough to bill for myself and find

> out why.

> As of two weeks ago, I have been billing the

day's patients the end

> of every day, and am starting to cream through my old EOBs and do all

> the challanges, rebills, charging to secondary billing, etc,etc that one

> must do to actually collect what you are allowed to get from these

> folks. It is irritating and time consuming, but it certainly is

making

> me a better coder as well as collecting a reasonable amount of money.

> What was happening with my (everyone says

including the MD she is

> working full time for) skilled billing person, is that she was skipping

> the tough ones: For example, Blue Cross Blue Shield 65 Plus is

supposed

> to have a primary care provider that they have to access first. Some

of

> them can come here for very acute problems if they can't get into their

> primary provider. They may be rejected for payment:

however; if so,

> one can rebill straight to Medicare and get them (mostly) covered,

> except for 15 or 16 dollars. I found 25 or 30 of those that never

got

> rebilled to Medicare.

> No, I didn't fire the part time worker. I

have a rule that " you can

> never hire anyone to do anything you don't all ready know how to do

> yourself, better. " I think it was my fault for not learning the

system

> myself first. And the worker is doing a much better job now, too.

> I think the business was just getting too busy for

one part timer,

> and I am not willing to hire someone full time for this; I refuse to

> become anything but a low overhead practice.

>

> Thinking about a second way increase income. I have been

here in

> Drain long enough that I seem reliable to the local businesses for

> on-the-job injuries. Workman's comp pays like a trooper, if you keep

> good documentation. I am starting to become the one they send these

> folks to, and I have started to visit the local factories/businesses to

> offer my services. Businesses tend to have habits of behavior for

> injuries, and if you are their first choice, you can get some good

> cases, with great followup coverage. Here, these businesses are

mills

> and machinist shops, with some logging companies, which have rather

> specific types of injury.

>

>

Joanne

> _____

>

> Love cheap thrills? Enjoy PC-to-Phone calls

> <http://us.rd.yahoo.com/mail_us/taglines/postman9/*http:/us.rd.yahoo.com

> /evt=39666/*http:/beta.messenger.yahoo.com/> to 30+ countries for

just

> 2¢/min with Yahoo! Messenger with Voice.

>

[Guest guest]

Why were they seen in the home rather than

office?  It can not just be for convenience.  Also, you can not code both a

house call code (99349) and an office code (99213).  If these patients are “homebound”

that should be documented in the note & why/how they are homebound.  Unless

these peds patients are ventilator kids or something like that I doubt very

much if the claim will get paid & you did not see them in the office so you

can’t fall back on the 99213/99214 code either.

Re: various issues: learning billing,

> EOB grooming, and income

>

> From Dr Joanne in Drain, Oregon,

>

> The reason you haven't heard much from me recently

is that I am now

> starting to do my own billing. I had a billing expert who came in 10

> hours a week to bill for me, but I was seeing more patients, documenting

> the way she told me to, and not getting more money. So I decided to

> bite the bullet and learn Lytec well enough to bill for myself and find

> out why.

> As of two weeks ago, I have been billing the

day's patients the end

> of every day, and am starting to cream through my old EOBs and do all

> the challanges, rebills, charging to secondary billing, etc,etc that one

> must do to actually collect what you are allowed to get from these

> folks. It is irritating and time consuming, but it certainly is

making

> me a better coder as well as collecting a reasonable amount of money.

> What was happening with my (everyone says

including the MD she is

> working full time for) skilled billing person, is that she was skipping

> the tough ones: For example, Blue Cross Blue Shield 65 Plus is

supposed

> to have a primary care provider that they have to access first. Some

of

> them can come here for very acute problems if they can't get into their

> primary provider. They may be rejected for payment:

however; if so,

> one can rebill straight to Medicare and get them (mostly) covered,

> except for 15 or 16 dollars. I found 25 or 30 of those that never

got

> rebilled to Medicare.

> No, I didn't fire the part time worker. I

have a rule that " you can

> never hire anyone to do anything you don't all ready know how to do

> yourself, better. " I think it was my fault for not learning the

system

> myself first. And the worker is doing a much better job now, too.

> I think the business was just getting too busy for

one part timer,

> and I am not willing to hire someone full time for this; I refuse to

> become anything but a low overhead practice.

>

> Thinking about a second way increase income. I have been

here in

> Drain long enough that I seem reliable to the local businesses for

> on-the-job injuries. Workman's comp pays like a trooper, if you keep

> good documentation. I am starting to become the one they send these

> folks to, and I have started to visit the local factories/businesses to

> offer my services. Businesses tend to have habits of behavior for

> injuries, and if you are their first choice, you can get some good

> cases, with great followup coverage. Here, these businesses are

mills

> and machinist shops, with some logging companies, which have rather

> specific types of injury.

>

>

Joanne

> _____

>

> Love cheap thrills? Enjoy PC-to-Phone calls

> <http://us.rd.yahoo.com/mail_us/taglines/postman9/*http:/us.rd.yahoo.com

> /evt=39666/*http:/beta.messenger.yahoo.com/> to 30+ countries for

just

> 2¢/min with Yahoo! Messenger with Voice.

>

[Guest guest]

Just as a clarification, BCBS in my area

does pay for home visits for nonhomebound children (I

checked this with the local rep prior to billing). I guess they figure it’s

still cheaper than an urgent care or ER. Medicare, of course, requires the

patient be homebound.

Re: various issues: learning billing,

> EOB grooming, and income

>

> From Dr Joanne in Drain, Oregon,

>

> The reason you haven't heard much from me recently

is that I am now

> starting to do my own billing. I had a billing expert who came in 10

> hours a week to bill for me, but I was seeing more patients, documenting

> the way she told me to, and not getting more money. So I decided to

> bite the bullet and learn Lytec well enough to bill for myself and find

> out why.

> As of two weeks ago, I have been billing the

day's patients the end

> of every day, and am starting to cream through my old EOBs and do all

> the challanges, rebills, charging to secondary billing, etc,etc that one

> must do to actually collect what you are allowed to get from these

> folks. It is irritating and time consuming, but it certainly is

making

> me a better coder as well as collecting a reasonable amount of money.

> What was happening with my (everyone says

including the MD she is

> working full time for) skilled billing person, is that she was skipping

> the tough ones: For example, Blue Cross Blue Shield 65 Plus is

supposed

> to have a primary care provider that they have to access first. Some

of

> them can come here for very acute problems if they can't get into their

> primary provider. They may be rejected for payment:

however; if so,

> one can rebill straight to Medicare and get them (mostly) covered,

> except for 15 or 16 dollars. I found 25 or 30 of those that never

got

> rebilled to Medicare.

> No, I didn't fire the part time worker. I

have a rule that " you can

> never hire anyone to do anything you don't all ready know how to do

> yourself, better. " I think it was my fault for not learning the

system

> myself first. And the worker is doing a much better job now, too.

> I think the business was just getting too busy for

one part timer,

> and I am not willing to hire someone full time for this; I refuse to

> become anything but a low overhead practice.

>

> Thinking about a second way increase income. I have been

here in

> Drain long enough that I seem reliable to the local businesses for

> on-the-job injuries. Workman's comp pays like a trooper, if you keep

> good documentation. I am starting to become the one they send these

> folks to, and I have started to visit the local factories/businesses to

> offer my services. Businesses tend to have habits of behavior for

> injuries, and if you are their first choice, you can get some good

> cases, with great followup coverage. Here, these businesses are

mills

> and machinist shops, with some logging companies, which have rather

> specific types of injury.

>

>

Joanne

> _____

>

> Love cheap thrills? Enjoy PC-to-Phone calls

> <http://us.rd.yahoo.com/mail_us/taglines/postman9/*http:/us.rd.yahoo.com

> /evt=39666/*http:/beta.messenger.yahoo.com/> to 30+ countries for

just

> 2¢/min with Yahoo! Messenger with Voice.

>

[Guest guest]

Just as a clarification, BCBS in my area

does pay for home visits for nonhomebound children (I

checked this with the local rep prior to billing). I guess they figure it’s

still cheaper than an urgent care or ER. Medicare, of course, requires the

patient be homebound.

Re: various issues: learning billing,

> EOB grooming, and income

>

> From Dr Joanne in Drain, Oregon,

>

> The reason you haven't heard much from me recently

is that I am now

> starting to do my own billing. I had a billing expert who came in 10

> hours a week to bill for me, but I was seeing more patients, documenting

> the way she told me to, and not getting more money. So I decided to

> bite the bullet and learn Lytec well enough to bill for myself and find

> out why.

> As of two weeks ago, I have been billing the

day's patients the end

> of every day, and am starting to cream through my old EOBs and do all

> the challanges, rebills, charging to secondary billing, etc,etc that one

> must do to actually collect what you are allowed to get from these

> folks. It is irritating and time consuming, but it certainly is

making

> me a better coder as well as collecting a reasonable amount of money.

> What was happening with my (everyone says

including the MD she is

> working full time for) skilled billing person, is that she was skipping

> the tough ones: For example, Blue Cross Blue Shield 65 Plus is

supposed

> to have a primary care provider that they have to access first. Some

of

> them can come here for very acute problems if they can't get into their

> primary provider. They may be rejected for payment:

however; if so,

> one can rebill straight to Medicare and get them (mostly) covered,

> except for 15 or 16 dollars. I found 25 or 30 of those that never

got

> rebilled to Medicare.

> No, I didn't fire the part time worker. I

have a rule that " you can

> never hire anyone to do anything you don't all ready know how to do

> yourself, better. " I think it was my fault for not learning the

system

> myself first. And the worker is doing a much better job now, too.

> I think the business was just getting too busy for

one part timer,

> and I am not willing to hire someone full time for this; I refuse to

> become anything but a low overhead practice.

>

> Thinking about a second way increase income. I have been

here in

> Drain long enough that I seem reliable to the local businesses for

> on-the-job injuries. Workman's comp pays like a trooper, if you keep

> good documentation. I am starting to become the one they send these

> folks to, and I have started to visit the local factories/businesses to

> offer my services. Businesses tend to have habits of behavior for

> injuries, and if you are their first choice, you can get some good

> cases, with great followup coverage. Here, these businesses are

mills

> and machinist shops, with some logging companies, which have rather

> specific types of injury.

>

>

Joanne

> _____

>

> Love cheap thrills? Enjoy PC-to-Phone calls

> <http://us.rd.yahoo.com/mail_us/taglines/postman9/*http:/us.rd.yahoo.com

> /evt=39666/*http:/beta.messenger.yahoo.com/> to 30+ countries for

just

> 2¢/min with Yahoo! Messenger with Voice.

>

[Guest guest]

They may pay for them, but with which CPT

code?  If the usual 99212-99215 codes then it would be senseless to do a house

call for that kind of reimbursement, and if they pay for the better reimbursed

house call codes then what need is there for an office if all the kids could be

seen in their homes & the doc gets paid better anyways?

Re: various issues: learning billing,

> EOB grooming, and income

>

> From Dr Joanne in Drain, Oregon,

>

> The reason you haven't heard much from me recently

is that I am now

> starting to do my own billing. I had a billing expert who came in 10

> hours a week to bill for me, but I was seeing more patients, documenting

> the way she told me to, and not getting more money. So I decided to

> bite the bullet and learn Lytec well enough to bill for myself and find

> out why.

> As of two weeks ago, I have been billing the

day's patients the end

> of every day, and am starting to cream through my old EOBs and do all

> the challanges, rebills, charging to secondary billing, etc,etc that one

> must do to actually collect what you are allowed to get from these

> folks. It is irritating and time consuming, but it certainly is

making

> me a better coder as well as collecting a reasonable amount of money.

> What was happening with my (everyone says

including the MD she is

> working full time for) skilled billing person, is that she was skipping

> the tough ones: For example, Blue Cross Blue Shield 65 Plus is

supposed

> to have a primary care provider that they have to access first. Some

of

> them can come here for very acute problems if they can't get into their

> primary provider. They may be rejected for payment:

however; if so,

> one can rebill straight to Medicare and get them (mostly) covered,

> except for 15 or 16 dollars. I found 25 or 30 of those that never

got

> rebilled to Medicare.

> No, I didn't fire the part time worker. I

have a rule that " you can

> never hire anyone to do anything you don't all ready know how to do

> yourself, better. " I think it was my fault for not learning the

system

> myself first. And the worker is doing a much better job now, too.

> I think the business was just getting too busy for

one part timer,

> and I am not willing to hire someone full time for this; I refuse to

> become anything but a low overhead practice.

>

> Thinking about a second way increase income. I have been

here in

> Drain long enough that I seem reliable to the local businesses for

> on-the-job injuries. Workman's comp pays like a trooper, if you keep

> good documentation. I am starting to become the one they send these

> folks to, and I have started to visit the local factories/businesses to

> offer my services. Businesses tend to have habits of behavior for

> injuries, and if you are their first choice, you can get some good

> cases, with great followup coverage. Here, these businesses are

mills

> and machinist shops, with some logging companies, which have rather

> specific types of injury.

>

>

Joanne

> _____

>

> Love cheap thrills? Enjoy PC-to-Phone calls

> <http://us.rd.yahoo.com/mail_us/taglines/postman9/*http:/us.rd.yahoo.com

> /evt=39666/*http:/beta.messenger.yahoo.com/> to 30+ countries for

just

> 2¢/min with Yahoo! Messenger with Voice.

>

[Guest guest]

They may pay for them, but with which CPT

code?  If the usual 99212-99215 codes then it would be senseless to do a house

call for that kind of reimbursement, and if they pay for the better reimbursed

house call codes then what need is there for an office if all the kids could be

seen in their homes & the doc gets paid better anyways?

Re: various issues: learning billing,

> EOB grooming, and income

>

> From Dr Joanne in Drain, Oregon,

>

> The reason you haven't heard much from me recently

is that I am now

> starting to do my own billing. I had a billing expert who came in 10

> hours a week to bill for me, but I was seeing more patients, documenting

> the way she told me to, and not getting more money. So I decided to

> bite the bullet and learn Lytec well enough to bill for myself and find

> out why.

> As of two weeks ago, I have been billing the

day's patients the end

> of every day, and am starting to cream through my old EOBs and do all

> the challanges, rebills, charging to secondary billing, etc,etc that one

> must do to actually collect what you are allowed to get from these

> folks. It is irritating and time consuming, but it certainly is

making

> me a better coder as well as collecting a reasonable amount of money.

> What was happening with my (everyone says

including the MD she is

> working full time for) skilled billing person, is that she was skipping

> the tough ones: For example, Blue Cross Blue Shield 65 Plus is

supposed

> to have a primary care provider that they have to access first. Some

of

> them can come here for very acute problems if they can't get into their

> primary provider. They may be rejected for payment:

however; if so,

> one can rebill straight to Medicare and get them (mostly) covered,

> except for 15 or 16 dollars. I found 25 or 30 of those that never

got

> rebilled to Medicare.

> No, I didn't fire the part time worker. I

have a rule that " you can

> never hire anyone to do anything you don't all ready know how to do

> yourself, better. " I think it was my fault for not learning the

system

> myself first. And the worker is doing a much better job now, too.

> I think the business was just getting too busy for

one part timer,

> and I am not willing to hire someone full time for this; I refuse to

> become anything but a low overhead practice.

>

> Thinking about a second way increase income. I have been

here in

> Drain long enough that I seem reliable to the local businesses for

> on-the-job injuries. Workman's comp pays like a trooper, if you keep

> good documentation. I am starting to become the one they send these

> folks to, and I have started to visit the local factories/businesses to

> offer my services. Businesses tend to have habits of behavior for

> injuries, and if you are their first choice, you can get some good

> cases, with great followup coverage. Here, these businesses are

mills

> and machinist shops, with some logging companies, which have rather

> specific types of injury.

>

>

Joanne

> _____

>

> Love cheap thrills? Enjoy PC-to-Phone calls

> <http://us.rd.yahoo.com/mail_us/taglines/postman9/*http:/us.rd.yahoo.com

> /evt=39666/*http:/beta.messenger.yahoo.com/> to 30+ countries for

just

> 2¢/min with Yahoo! Messenger with Voice.

>

[Guest guest]

I use the home visit codes. As for what

need is there for an office, some patients don’t want docs coming to

their house. Also, the travel time will generally make the home visit less

profitable than seeing 2-3 kids in the office even with the higher

reimbursement (similar to the hospital reimbursement issue previously

discussed). But, for a mother who does not have to try and bring in 3 other

kids into the office in addition to the one with the problem, a home visit can

be a wonderful experience.

Re: various issues: learning billing,

> EOB grooming, and income

>

> From Dr Joanne in Drain, Oregon,

>

> The reason you haven't heard much from me recently

is that I am now

> starting to do my own billing. I had a billing expert who came in 10

> hours a week to bill for me, but I was seeing more patients, documenting

> the way she told me to, and not getting more money. So I decided to

> bite the bullet and learn Lytec well enough to bill for myself and find

> out why.

> As of two weeks ago, I have been billing the

day's patients the end

> of every day, and am starting to cream through my old EOBs and do all

> the challanges, rebills, charging to secondary billing, etc,etc that one

> must do to actually collect what you are allowed to get from these

> folks. It is irritating and time consuming, but it certainly is

making

> me a better coder as well as collecting a reasonable amount of money.

> What was happening with my (everyone says

including the MD she is

> working full time for) skilled billing person, is that she was skipping

> the tough ones: For example, Blue Cross Blue Shield 65 Plus is

supposed

> to have a primary care provider that they have to access first. Some

of

> them can come here for very acute problems if they can't get into their

> primary provider. They may be rejected for payment:

however; if so,

> one can rebill straight to Medicare and get them (mostly) covered,

> except for 15 or 16 dollars. I found 25 or 30 of those that never

got

> rebilled to Medicare.

> No, I didn't fire the part time worker. I

have a rule that " you can

> never hire anyone to do anything you don't all ready know how to do

> yourself, better. " I think it was my fault for not learning the

system

> myself first. And the worker is doing a much better job now, too.

> I think the business was just getting too busy for

one part timer,

> and I am not willing to hire someone full time for this; I refuse to

> become anything but a low overhead practice.

>

> Thinking about a second way increase income. I have been

here in

> Drain long enough that I seem reliable to the local businesses for

> on-the-job injuries. Workman's comp pays like a trooper, if you keep

> good documentation. I am starting to become the one they send these

> folks to, and I have started to visit the local factories/businesses to

> offer my services. Businesses tend to have habits of behavior for

> injuries, and if you are their first choice, you can get some good

> cases, with great followup coverage. Here, these businesses are

mills

> and machinist shops, with some logging companies, which have rather

> specific types of injury.

>

>

Joanne

> _____

>

> Love cheap thrills? Enjoy PC-to-Phone calls

> <http://us.rd.yahoo.com/mail_us/taglines/postman9/*http:/us.rd.yahoo.com

> /evt=39666/*http:/beta.messenger.yahoo.com/> to 30+ countries for

just

> 2¢/min with Yahoo! Messenger with Voice.

>

[Guest guest]

I use the home visit codes. As for what

need is there for an office, some patients don’t want docs coming to

their house. Also, the travel time will generally make the home visit less

profitable than seeing 2-3 kids in the office even with the higher

reimbursement (similar to the hospital reimbursement issue previously

discussed). But, for a mother who does not have to try and bring in 3 other

kids into the office in addition to the one with the problem, a home visit can

be a wonderful experience.

Re: various issues: learning billing,

> EOB grooming, and income

>

> From Dr Joanne in Drain, Oregon,

>

> The reason you haven't heard much from me recently

is that I am now

> starting to do my own billing. I had a billing expert who came in 10

> hours a week to bill for me, but I was seeing more patients, documenting

> the way she told me to, and not getting more money. So I decided to

> bite the bullet and learn Lytec well enough to bill for myself and find

> out why.

> As of two weeks ago, I have been billing the

day's patients the end

> of every day, and am starting to cream through my old EOBs and do all

> the challanges, rebills, charging to secondary billing, etc,etc that one

> must do to actually collect what you are allowed to get from these

> folks. It is irritating and time consuming, but it certainly is

making

> me a better coder as well as collecting a reasonable amount of money.

> What was happening with my (everyone says

including the MD she is

> working full time for) skilled billing person, is that she was skipping

> the tough ones: For example, Blue Cross Blue Shield 65 Plus is

supposed

> to have a primary care provider that they have to access first. Some

of

> them can come here for very acute problems if they can't get into their

> primary provider. They may be rejected for payment:

however; if so,

> one can rebill straight to Medicare and get them (mostly) covered,

> except for 15 or 16 dollars. I found 25 or 30 of those that never

got

> rebilled to Medicare.

> No, I didn't fire the part time worker. I

have a rule that " you can

> never hire anyone to do anything you don't all ready know how to do

> yourself, better. " I think it was my fault for not learning the

system

> myself first. And the worker is doing a much better job now, too.

> I think the business was just getting too busy for

one part timer,

> and I am not willing to hire someone full time for this; I refuse to

> become anything but a low overhead practice.

>

> Thinking about a second way increase income. I have been

here in

> Drain long enough that I seem reliable to the local businesses for

> on-the-job injuries. Workman's comp pays like a trooper, if you keep

> good documentation. I am starting to become the one they send these

> folks to, and I have started to visit the local factories/businesses to

> offer my services. Businesses tend to have habits of behavior for

> injuries, and if you are their first choice, you can get some good

> cases, with great followup coverage. Here, these businesses are

mills

> and machinist shops, with some logging companies, which have rather

> specific types of injury.

>

>

Joanne

> _____

>

> Love cheap thrills? Enjoy PC-to-Phone calls

> <http://us.rd.yahoo.com/mail_us/taglines/postman9/*http:/us.rd.yahoo.com

> /evt=39666/*http:/beta.messenger.yahoo.com/> to 30+ countries for

just

> 2¢/min with Yahoo! Messenger with Voice.

>

[Guest guest]

These kids are not homebound. It was about 9pm when the dad called me and one of the children was sleeping already. They live in my town 5 minutes away, which is closer than my office. I offered to open up the office, but the dad was resistant. I will bill the insurance. If they don't pay, I will bill the parents. This is a dad who set up an appt and flew to the mayo clinic and back in one day to get his "executive physical." n Brock DO wrote: Why were they seen in the home rather than office? It can not just be for convenience. Also, you can not code both a house call code (99349) and an office code (99213). If these patients are “homebound” that should be documented in the note & why/how they are homebound. Unless these peds patients are ventilator kids or something like that I doubt very much if the claim will get paid & you did not see them in the office so you can’t fall back on the 99213/99214 code either. Re: various issues: learning billing,> EOB grooming, and income>> From Dr Joanne in Drain, Oregon,>> The reason you haven't heard much from me recently is that I am now> starting to do my own billing. I had a billing expert who came in 10> hours a week to bill for me, but I was seeing more patients, documenting> the way she told me to, and not getting more money. So I decided to> bite the bullet and learn

Lytec well enough to bill for myself and find> out why.> As of two weeks ago, I have been billing the day's patients the end> of every day, and am starting to cream through my old EOBs and do all> the challanges, rebills, charging to secondary billing, etc,etc that one> must do to actually collect what you are allowed to get from these> folks. It is irritating and time consuming, but it certainly is making> me a better coder as well as collecting a reasonable amount of money.> What was happening with my (everyone says including the MD she is> working full time for) skilled billing person, is that she was skipping> the tough ones: For example, Blue Cross Blue Shield 65 Plus is supposed> to have a primary care provider that they have to access first. Some of> them can come here for very acute problems if they can't get

into their> primary provider. They may be rejected for payment: however; if so,> one can rebill straight to Medicare and get them (mostly) covered,> except for 15 or 16 dollars. I found 25 or 30 of those that never got> rebilled to Medicare.> No, I didn't fire the part time worker. I have a rule that "you can> never hire anyone to do anything you don't all ready know how to do> yourself, better." I think it was my fault for not learning the system> myself first. And the worker is doing a much better job now, too.> I think the business was just getting too busy for one part timer,> and I am not willing to hire someone full time for this; I refuse to> become anything but a low overhead practice.>> Thinking about a second way increase income. I have been here in> Drain long

enough that I seem reliable to the local businesses for> on-the-job injuries. Workman's comp pays like a trooper, if you keep> good documentation. I am starting to become the one they send these> folks to, and I have started to visit the local factories/businesses to> offer my services. Businesses tend to have habits of behavior for> injuries, and if you are their first choice, you can get some good> cases, with great followup coverage. Here, these businesses are mills> and machinist shops, with some logging companies, which have rather> specific types of injury.>> Joanne> _____>> Love cheap thrills? Enjoy PC-to-Phone calls> <http://us.rd.yahoo.com/mail_us/taglines/postman9/*http:/us.rd.yahoo.com> /evt=39666/*http:/beta.messenger.yahoo.com/> to 30+ countries for just> 2¢/min with Yahoo! Messenger with Voice.>

[Guest guest]

These kids are not homebound. It was about 9pm when the dad called me and one of the children was sleeping already. They live in my town 5 minutes away, which is closer than my office. I offered to open up the office, but the dad was resistant. I will bill the insurance. If they don't pay, I will bill the parents. This is a dad who set up an appt and flew to the mayo clinic and back in one day to get his "executive physical." n Brock DO wrote: Why were they seen in the home rather than office? It can not just be for convenience. Also, you can not code both a house call code (99349) and an office code (99213). If these patients are “homebound” that should be documented in the note & why/how they are homebound. Unless these peds patients are ventilator kids or something like that I doubt very much if the claim will get paid & you did not see them in the office so you can’t fall back on the 99213/99214 code either. Re: various issues: learning billing,> EOB grooming, and income>> From Dr Joanne in Drain, Oregon,>> The reason you haven't heard much from me recently is that I am now> starting to do my own billing. I had a billing expert who came in 10> hours a week to bill for me, but I was seeing more patients, documenting> the way she told me to, and not getting more money. So I decided to> bite the bullet and learn

Lytec well enough to bill for myself and find> out why.> As of two weeks ago, I have been billing the day's patients the end> of every day, and am starting to cream through my old EOBs and do all> the challanges, rebills, charging to secondary billing, etc,etc that one> must do to actually collect what you are allowed to get from these> folks. It is irritating and time consuming, but it certainly is making> me a better coder as well as collecting a reasonable amount of money.> What was happening with my (everyone says including the MD she is> working full time for) skilled billing person, is that she was skipping> the tough ones: For example, Blue Cross Blue Shield 65 Plus is supposed> to have a primary care provider that they have to access first. Some of> them can come here for very acute problems if they can't get

into their> primary provider. They may be rejected for payment: however; if so,> one can rebill straight to Medicare and get them (mostly) covered,> except for 15 or 16 dollars. I found 25 or 30 of those that never got> rebilled to Medicare.> No, I didn't fire the part time worker. I have a rule that "you can> never hire anyone to do anything you don't all ready know how to do> yourself, better." I think it was my fault for not learning the system> myself first. And the worker is doing a much better job now, too.> I think the business was just getting too busy for one part timer,> and I am not willing to hire someone full time for this; I refuse to> become anything but a low overhead practice.>> Thinking about a second way increase income. I have been here in> Drain long

enough that I seem reliable to the local businesses for> on-the-job injuries. Workman's comp pays like a trooper, if you keep> good documentation. I am starting to become the one they send these> folks to, and I have started to visit the local factories/businesses to> offer my services. Businesses tend to have habits of behavior for> injuries, and if you are their first choice, you can get some good> cases, with great followup coverage. Here, these businesses are mills> and machinist shops, with some logging companies, which have rather> specific types of injury.>> Joanne> _____>> Love cheap thrills? Enjoy PC-to-Phone calls> <http://us.rd.yahoo.com/mail_us/taglines/postman9/*http:/us.rd.yahoo.com> /evt=39666/*http:/beta.messenger.yahoo.com/> to 30+ countries for just> 2¢/min with Yahoo! Messenger with Voice.>