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The Basics of Medical Billing Book

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Lou:
I work for a teleradiology group and we are starting a new contract that we will be doing medicare/medicaid billing for, the volume will be very low. I will be doing the billing and have never done medical billing before.  Is medicare/medicaid straight forward?  Is this something I can do with no training?  I saw your book, (the basics of medical billing - would this book help with medicaid/medicare billing?  Thank you for any help you maybe.

Michele:
I honestly don't think the basics book would be that helpful for your situation.  It is a 'basic overview' of medical billing in the sense of explaining primary insurance, secondary insurance, importance of getting information from patient, authorizations, referrals, deductibles, copays, coinsurance, workers comp, no-fault, HIPAA, and much more, but it doesn't specifically cover how to bill claims to Medicare/Medicaid.  If you know nothing about medical billing then basics would give you a great overview.  The 'How to complete a CMS form completely & correctly' might be a good help though.  Do you have a practice management system you will be using to submit claims?

Michele

Lou:
Michelle

Thank you for the response.  At this point, I am just feeling my way through this. Also, at this time we do not have any software to help with the process.  I am not sure if that is an option because my boss says the volume will be low.  I am just worried that I will get over my head with this.  I have printed off things from the internet that looks like it would be helpful at least a little.  Two additional question, do you use the same form  (CMS1500) for medicare/medicaid claims? And what about the CPT codes? Please excuse my stupid questions, but, I am for sure drawing straws at this point.  I appreciate very much any help you maybe.  I think maybe I will go ahead and purchase the book.  My boss said to go ahead and get it, but, I wanted to check to see if it would be helpful in anyway.  Thanks again!!!

Michele:
Medicare uses the CMS form, Medicaid usually provides you with their specific form.  If you are already a Medicaid provider you can call them and ask them to send you some forms.  Also ask them if they can send you any info on the fields on the form.  (I know we received a cheat sheet a long time ago from our Medicaid office and it was quite helpful.) 

The book will probably be helpful since you really are starting from ground zero.  But feel free to ask questions on the forum too.  You might want to get a CPT book so you can look up the codes.  You can get one from Amazon at the following link:

http://www.amazon.com/CPT-2008-Standard-Procedural-Terminology/dp/1579479367/ref=sr_1_1?ie=UTF8&s=books&qid=1224855865&sr=1-1

Good luck
Michele

Lou:
Thank you very much for your help Michelle!!

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