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unhappy with book

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Pay_My_Claims:

--- Quote from: Michele on June 14, 2009, 12:45:08 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


--- End quote ---

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:

--- Quote ---WHY and HOW diagnoses are put in a particular order and WHEN to use the modifiers.
--- End quote ---

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?   ??? ???

advance11:
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:

--- Quote from: PMRNC on June 14, 2009, 11:23:39 AM ---
--- Quote ---WHY and HOW diagnoses are put in a particular order and WHEN to use the modifiers.
--- End quote ---

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?   ??? ???



--- End quote ---

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:

--- Quote from: advance11 on June 14, 2009, 12:39:55 PM ---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. 

--- End quote ---

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!! 

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