How Well Do You Know Medicare Billing?

The biggest request we get for interim billing staff concerns Medicare hospital billing. It makes sense because nationally, 60 to 65% of all inpatient claims concern Medicare patients, and Medicare outpatients can be voluminous as well. That, plus if things are going well Medicare pays fast, and hospitals love any payer that pays their bills fast.

If you’re an interim Medicare biller, your job actually starts at home rather than at a work site. That’s because interim people are often expected to know things and know how to fix claims that every day hospital billers don’t know how to do. That might seem strange, but that’s how it always seems to go. So, a first main step is for interim Medicare billers to check in on at least their local fiscal intermediaries websites and take a look at two things. One pertains to newer Local Medicare Review Policies (LMRPs) to see what types of things might be in them to help hospital bills get paid. The second is going through Medicare bulletins, which come in different ways depending on the intermediary. If you’re going to be traveling to different states, a good thing to do is to subscribe to news bulletins from those intermediaries so you’ll get them in your email.

After that, it’s all about standard Medicare billing rules that, once again, existing billing personnel sometimes don’t know about. Denials is probably the biggest problem a hospital or physician’s office has if they’re having problems with their Medicare billing, so staying on top of those rules will keep you ahead of the game. Understanding the relationship between what codes Medicare wants to see with what also helps a great deal. And of course knowing how to verify MSP issues helps a great deal.

Make yourself valuable by keeping up on Medicare regulations. It can only benefit you long term.

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One Response

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