Outpatient Facility Coding Alert - 2012 Issue 44
Part B Revenue Booster: These 5 Errors Could Be Causing You to Bleed Money
Subscribe or sign in to view the full article.
Article Overview
This article is a revenue-cycle and medical coding overview for Part B practices. It explains five common billing problems that can lead to lost reimbursement, including patient balance collection, delayed follow-up on outstanding amounts, undercoding, modifier use with procedures and diagnosis linkage, and billing a sick visit with an annual wellness visit when appropriate. It is relevant to coders, billers, practice managers, and clinicians who want to reduce avoidable claim denials and missed payment opportunities.
Why This Topic Matters
These issues can directly affect cash flow, claim acceptance, and compliance in everyday office billing. The article is useful for practices that want to identify preventable revenue leakage and improve documentation, charge capture, and claim submission processes.
Article Sections
-
Collecting patient cost-sharing amounts
Discusses patient balances, coinsurance, and copay collection timing in a practice setting. It focuses on revenue-cycle process concerns and patient payment handling.
-
Timing and follow-up on outstanding balances
Covers billing follow-up after a balance is identified and the general progression of reminder and collection efforts. It addresses office workflow for overdue patient accounts.
-
Undercoding and lost reimbursement
Explains the revenue impact of reporting lower-level services than documentation supports. It references compliance concerns and audit risk in professional coding.
-
Using modifiers with bundled procedures
Reviews a procedure-bundling scenario involving Medicare-related edit concerns, diagnosis linkage, and modifier use. It also notes special caution around evaluation and management services.
-
Billing a sick visit with an annual wellness visit
Addresses when an evaluation and management service may be reported along with an annual wellness visit. It highlights documentation and separation of services under Medicare-related guidance.
What You Will Learn
- Common causes of avoidable reimbursement loss in Part B billing
- General strategies for collecting patient responsibility amounts
- How overdue balances can affect practice revenue
- Why reporting below-supported services can reduce income
- How modifier use and documentation affect claim processing
- How annual wellness visit encounters may intersect with separate evaluation and management services
Who Should Read This
- Medical coders
- Medical billers
- Practice managers
- Revenue cycle staff
- Physicians and other qualified healthcare professionals
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
Subscribe or sign in to view the full article.


Quick, Current, Complete - www.findacode.com