+Medical Cost Containment Training Courses
Medical Billing Advocates of America, Inc. (MBAA) is offering a service needed by any organization that processes, pays, or investigates health care claims. Our goal is to increase staff knowledge and ability to identify billing errors and implement proven and effective techniques to correct errors and overcharges from providers and facilities.
Attendees will be provided cost effective solutions for controlling healthcare costs by offering “hands on and practical” exercises focused on critical analysis of provider claims which will utilize proven effective techniques to determine the accurate claims submitted by providers.
Medical Billing Advocates of America (MBAA) would like to assist your organization by enhancing your staff’s ability to identify as many errors and overcharges as possible on medical bills.
It is extremely important that employees understand the foundation and requirements of provider coding and reimbursement to maximize the errors identified and increase the advocacy efforts for its members.
MBAA highly recommends the following courses which will give valuable coding background information that is essential to understanding how billings are generated and how providers and facilities are compensated for services rendered.
The National Coding Systems and
Claims Submission (CMS-1500)
Medical coding drives health care billing, charges and reimbursement. Illness, medical conditions, and services that are provided, as well as the places where services are performed are identified through a combination of nationally recognized coding systems. These coding systems are the core to generating billings to federal programs, private insurance carriers and consumers.
This course will provide in-depth knowledge of the 3 national coding systems, ICD-9-CM, CPT and HCPCS (level 2) and how they drive and impact provider billing and reimbursement.
Evaluation & Management Codes and
Specialized Services (Medicine Codes)
Codes in this course primarily cover physician’s visits. Proper coding and reimbursement are based on a number of factors:
§ Location of physician’s services (physician’s office, in-patient hospital, out-patient hospital, emergency room, nursing facility, etc.)
§ Type of patient (new or established)
§ Type of service (consultation, critical care, intensive care, home visit, preventive care visit, etc.)
§ Level of service (determining the intensity or complexity of the service provided)
§ Specialized Services (psychiatric, ophthalmology, dermatology and therapy visits)
Radiology, Pathology and Laboratory Services
Learn the key elements for proper coding and reimbursement. Radiology, pathology and laboratory tests and treatments have risen dramatically in the last decade.
Anesthesia and Surgery Codes (CPTs)
Anesthesia codes are complex and confusing to say the least. Without thorough understanding of anesthesia coding the majority of payers are overpaying excessive amounts of money and sometimes paying two providers to perform the same services.
Anesthesia services can be performed by Anesthesiologists, Anesthesiologist Assistants or Certified Registered Nurse Anesthetists (CRNAs). On occasion, physicians perform ‘conscious sedation’, nerve blocks. Only one code can be billed per-operative session even though multiple surgeries are being performed.
Hospital Compliance Billing
MBAA’s comprehensive approach to hospital bill analysis typically identifies non-billable charges in addition to excessive, indefensible overcharges. Our hospital review methodology is an in-depth, line item by line item review that incorporates the traditional medical record and compliance audit approach.
Training is offered on-site or at our Virginia training center.