This tutorial provides a quick overview of the charge entry process. It then explains the advantages of building a hybrid charge entry process that involves both paper and electronic data collection and entry. A clinic should evaluate their current system and then consider all the options presented in this tutorial. Sometimes a simple change can…

Charge Entry Processes Charge entry is a vital process in the financial system of your practice. It is often defined as “a process of entering important data and details to enable claims processing.” Most Charge Entry processes include: Creating an individual account for the patient; assigning an account number Entering demographics Assigning the account to…

Download Reference Documents The following resource is the instructional manual for interpretation of the code edit resources on CMS website. Do not overlook the need to locate similar resources on the payer provider portals. How to Use the Medicare National Correct Coding Initiative (NCCI) Tools

This quick tutorial provides an overview of what coding edits are and how a clinic can locate them online. We also take a peek at how payers adopt these edits and publish them in the reimbursement policies. There is no way to instruct a team member on everything there is to know about code edits…

What are Coding Edits? It all started with the Centers for Medicare & Medicaid Services (CMS). In an effort to prevent overpayments, control improper coding and promote national correct coding methodologies, CMS developed the National Correct Coding Initiative (NCCI) edits. It was a way to get everyone on the same page, streamline claim processing and…

Online Resources A Provider Manual is often made available to the provider once s/he is credentialed with a payer. After that, all updates to the Provider Manual are carried out electronically. It is up to the clinic to stay on top of Provider News and Updates regarding the contract agreement. Because carriers do make changes,…