Author Topic: unhappy with book  (Read 3188 times)

advance11

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unhappy with book
« on: June 12, 2009, 10:56:41 AM »
I talked the chiro that I work for into buying your billing book, and am very disappointed with it.  I thought you would have specific billing guidelines for Chiropractors, but the info is all general in nature, and I find myself having to plow through the message boards for specific answers, such as WHY and HOW diagnoses are put in a particular order and WHEN to use the modifiers.  What forms EXACTLY are required for Medicare, and ALL of the implications of being in and out of Network. 
I suppose a refund is out of the question, but can you address the above issues in one spot, please?

PMRNC

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Re: unhappy with book
« Reply #1 on: June 13, 2009, 09:37:41 AM »
Seems to me that's all anyone could offer with a book on Practice Management for any specialty. With each carrier and each state they are going to have various differences.
Also if you are buying a book and hoping it would answer all your questions or teach you how to bill for any specialty you will be very disappointed no matter how good the book is. Books are a general guideline as they should be. I have not seen the book you are referencing but I have some idea with how people perceive to expect a lot from a book or a reference.
In addition to the book you want to get some knowledge of your state's Medicare carrier and other state rules/regulations.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Pay_My_Claims

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Re: unhappy with book
« Reply #2 on: June 13, 2009, 08:08:18 PM »
Well Linda I can understand where the poster is coming from. I purchased my first book on medical billing, and it was for someone who NEVER did billing before. It was about insurance, what a supebill was etc. I do agree that you can't approach a specialty billing book to include all scenarios, but the one that will be equal in all instances as it relates to Medicare. If I wrote a book on DME billing I can include how to deal with a denial when a client is SNF. (when the client is no longer snf, you can extend the CMN to add the rental months). I don't want a book that basically list everything off the DMERC website. It appears that what he is complaining about is that its not specific to Chiropractic billing. It may be too general. I have never billed for a Chiropractic service, but being an experienced biller, I feel that I could pick it up. If I purchase a book to learn how to bill for a Chiropractic office, I want it to list the most common used codes, modifiers, the most common mistakes, talk about any codes that are bundled together. What the Medicare rules are for visits. What Medicare pays for and what it doesn't. What dx create red flags, what are the most common dx. What dx associated with what cpt will create a denial. If anyone has a book like that........email me, I'm ready to purchase!!

Michele

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Re: unhappy with book
« Reply #3 on: June 13, 2009, 09:39:30 PM »
I was holding off on answering this post for a lot of reasons.  First of all, the book she is referring to in mine.  I am completely open to criticism, but I guess I was a little put out at how she decided to express the criticism.  The book was written for someone who was new to chiropractic billing and wanted to understand the basics.  I think that one of the complaints is that we didn't explain why Medicare has certain diagnoses that have to be in a certain order

Quote "specific answers, such as WHY and HOW diagnoses are put in a particular order"

Well, if any of us understood why Medicare does any of what they do we would blow the lid of the billing industry.  In the book we explain WHAT (not WHY) diagnoses are accepted by Medicare as primary, what diagnoses are accepted by Medicare as secondary, and how many visits Medicare will allow with those diagnoses.  We also explain what modifiers would be appropriate for Medicare, and other commercial carriers.  We also address that Medicare requires providers to file claims electronically unless they apply for a waiver.  We also do explain that paper claims are filed on CMS 1500 forms, with the exception of workers' comp, which are filed on workers' comp forms that vary by each state.  We do not include a form for each state in the book.

What I really feel the poster needs based on the complaints is more of a course in billing, which I agree the book is NOT.  But I don't market it as such either. 

We sell many books, and this one in particular is one of our better sellers.  We have received many responses saying how helpful the book was.  We have not received any negatives until now.

I was going to delete the post, but decided I would prefer that everyone could see that we truly don't hide things, and we are just out to try to help everyone succeed. 

As far as a refund, that might not have been out of the question if the poster had contacted us to explain that the book was not what she expected or needed.

I would just like to note that this poster also had posted a thread on her employer that she asked me to remove shortly after, which I did.  I think that she may type before she thinks things through thoroughly. 

Quote:  "I suppose a refund is out of the question, but can you address the above issues in one spot, please?"


I think that what the poster is truly looking for doesn't exist.  If there were one spot that we could go to and get answers to all of our questions, we certainly wouldn't be doing this.

Michele
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Michele

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Re: unhappy with book
« Reply #4 on: June 13, 2009, 09:45:08 PM »
Actually, Charlene, that is one of the main reasons we started writing books.  Many of the ones we encountered were also written by people not in (and never been in) the medical billing field.  It was very frustrating.

Michele
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Pay_My_Claims

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Re: unhappy with book
« Reply #5 on: June 14, 2009, 01:20:35 AM »
Actually, Charlene, that is one of the main reasons we started writing books.  Many of the ones we encountered were also written by people not in (and never been in) the medical billing field.  It was very frustrating.

Michele


I can believe that from what I have seen. The first book I got, I ended up letting my sister read it. For her she gained a lot because it was a basic 101 (Starting your own Medical billing book). There wasn't very much in it that I didn't know. I also agree with you that the poster could have emailed you directly, but your reply was very good. One advantage that he/she had over me is that they knew the author and could ask specific questions to you regarding your book prior to purchase. I had what I could review on Ebay and that was it.

PMRNC

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Re: unhappy with book
« Reply #6 on: June 14, 2009, 08:23:39 AM »
Quote
WHY and HOW diagnoses are put in a particular order and WHEN to use the modifiers.

This is just my opinion, but we are talking about "coding issues" here. While some books will address "general" recognition of codes/modifiers.. if someone wants more on "coding" I would think they should look for books/courses on coding, otherwise the provider is ultimately responsible for that if the biller is not fully educated, experienced or certified.

Am I missing something.. I'm thinking if you don't know what order dx codes go or general idea of modifier use, you are inexperienced and uneducated in coding.. right?   ??? ???

Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

advance11

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Re: unhappy with book
« Reply #7 on: June 14, 2009, 09:39:55 AM »
I did work in DME, and know some DME billing facts.  But I'm new to chiro billing.  On the board, there was a post about the second diagonsis code is the one that indicates how many visits should be necessary...I was hoping that would be explained in the book.  Ok, so that's a coding issue, and I need to learn that.  Where do I go to learn that?  Listing the ICD-9 codes for chiro is great for the chiropractor, but knowing how to use them is important for the biller.  I was hoping that the book would also explain how to properly bill for in and out of network Medicare Replacements, and the implications of accepting assignment or not.  And what forms need to be on file for that.  In the forum, I read about accepting assignment for insurances, when you are out of network.  Ok, then you can only accept what the insurance company says is allowable?  These are the type of issues that I had hoped that the book would address.  When can you balance bill the patient?  What do you do when the copay is higher than charge?  The sliding fee for insurance and cash patients...when you use the GW modifier... 
Workman's comp and Personal Injury--what are the standard practices, and where do you go to find your states' specific laws?  Where do you go to find what is legal with Insurance billing in your state after learning what the standard practices are.  For the ABN, how do you specify a length of time it is valid for, as Chiro is an on-going treatment and not a one time purchase or rental agreement...do you have to specify every procedure code, or can you blanket the ABN for all potential procedure codes?
This is how the book is marketed:
You Can Expect to Learn About;

Participating & Credentialing with insurance carriers
Authorizations and referrals
Co-pays, coinsurance and deductibles
Patient charts and notes
No fault, workers comp, & Medicare claims
CPT and ICD9 codes
Using modifiers
Orthodics
Billing Modalities
Practice management systems
Handling insurance denials
How to institute insurance appeals
NPI numbers – when you need 2 NPI #s
Where to find other provider’s NPI #s
Where to include NPI # on claim forms

 I found the book to be more of a dictionary of terms rather than a how-to book. 


Pay_My_Claims

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Re: unhappy with book
« Reply #8 on: June 14, 2009, 11:11:37 AM »
Quote
WHY and HOW diagnoses are put in a particular order and WHEN to use the modifiers.

This is just my opinion, but we are talking about "coding issues" here. While some books will address "general" recognition of codes/modifiers.. if someone wants more on "coding" I would think they should look for books/courses on coding, otherwise the provider is ultimately responsible for that if the biller is not fully educated, experienced or certified.

Am I missing something.. I'm thinking if you don't know what order dx codes go or general idea of modifier use, you are inexperienced and uneducated in coding.. right?   ??? ???



No, you are 100% incorrect in that. I am a very qualified Medical biller, but I have never done chiropractic billing. Does that mean I can jump into a Chiropractic office and do the job as biller?? Maybe so, but there are things specific to a Chiropractics office that I need to learn. If being a medical biller was all you needed, then there would be no need for books. Its like a contradiction of information. You need to be qualified, but you can buy this book and be a biller. When I see people ask questions on the boar related to Chiropractic offices, Mental Health, Substance abuse, Home care, Hospice, I don't know diddly squat about what they are speaking about. Does this make me a bad biller?? No this just makes me inexperienced in that area of billing. Because I know insurance, what to ask, understanding of modifers, how they work, cpt coding (can't code from a chart since I am not a coder) Medicare/NC Medicaid rules & regulations, a billing book on either of the mentioned would be something I can use to help me do my job.  You do not need to be a certified coder in order to bill,

Pay_My_Claims

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Re: unhappy with book
« Reply #9 on: June 14, 2009, 11:23:47 AM »
I was hoping that the book would also explain how to properly bill for in and out of network Medicare Replacements, and the implications of accepting assignment or not.  And what forms need to be on file for that. 

I understand your frustration, but having not read the book I can't defend it or slam it. I can tell you just personally that what you said the book was about, should have been enough for you to determine if you wanted to purchase it. You needed a book that basically tells you how to bill for a chiropractic office. One that deals only with coding issues, common errors, Medicare requirement. There is no way that any book can cover every aspect of every payor. I have to stand firm on that ground right there, because it is the billers responsibility to verify the insurance. If you know how Medicare works, Medicare replacements, and in -out of network plans operate, then you can know how to proceed when you get benefits. Again. Accepting assignment is something that should be covered in an insurance 101 book. I personally don't want to pay for a book that focuses on that, I feel thats something I should know as a biller. It doesn't matter if I go from DME to Pediatrics, insurance is insurance is insurance. If I change specialties, I know as an already experienced biller that I have to obtain benefits specific to what I am dealing with. When I call on DME clients, I don't just get basic office benifits, I ask "Does the client have DME benefits" therefore if I call for Chiro, I will ask what the benefits are, how many visits do they have and does it cover CPT XXXXX!! 

PMRNC

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Re: unhappy with book
« Reply #10 on: June 14, 2009, 10:05:09 PM »
Quote
I was hoping that the book would also explain how to properly bill for in and out of network Medicare Replacements, and the implications of accepting assignment or not.  And what forms need to be on file for that.  In the forum, I read about accepting assignment for insurances, when you are out of network.  Ok, then you can only accept what the insurance company says is allowable?  These are the type of issues that I had hoped that the book would address.  When can you balance bill the patient?  What do you do when the copay is higher than charge?  The sliding fee for insurance and cash patients...when you use the GW modifier...

I have not read it either.. however.. the above is all relative to "general" medical billing, not specifically to chiropractic. If you have not done any medical billing than picking up a book on chiropractic billing is really not going to help. I don't know your level of experience so I can't comment on that either, only speculate.
You mentioned also you bought it for the chiro you work for.. does he do his own billing?

Again, all the things you mentioned above really are not specific to chiropractic, so perhaps a book in regards to general medical billing/practice management is needed.

I can make two great suggestions for books that sit on my book shelf and I am always pulling them out (get latest editions, they are updated frequently)

1. Understanding Health Insurance
2. Insurance Handbook for the Medical Office

Both also have workbooks and practice disks with them too. Both cover everything you mentioned, it does not go much into coding, but like I mentioned before, it might be beneficial to take a coding course and for that I would recommend the AAPC which offers the CPC certification.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

advance11

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Re: unhappy with book
« Reply #11 on: June 15, 2009, 10:47:20 AM »
Thank you for those suggested books.  I'll definitely look into them!