Nov 23, 2010 | Medical billing basics
Initial Health Assessment As a Medicare Advantage Organization, BCBSF must make a reasonable effort to complete an initial health assessment for each BlueMedicare HMO, BlueMedicare PPO and BlueMedicare PFFS member within 90 days of enrollment to identify members with...
Nov 23, 2010 | Medical billing basics
There is nothing worse than finding different coding mistakes. One of the things that you can do in order to keep certain mistakes from showing up is keep your observation coding in check. Although you may think that you know all of the general rules in terms of...
Nov 22, 2010 | Medical billing basics
Medical Records System HMO providers must maintain a medical records system that is consistent with professional standards and that: Permits prompt retrieval of information and provides legible and timely information, accurately documented, and readily available to...
Nov 22, 2010 | Medical billing basics
Outsourcing is the process where a company uses a third party to perform work that is normally performed in-house. Outsourcing can be used for many different types of activities such as payroll, accounting, sales, distribution or computer programming. In recent...
Nov 18, 2010 | Medical billing basics
Documentation of Care Review The objective of performing periodic documentation of care reviews is to evaluate the quality and appropriateness of PCPs’ office medical records documentation and to promote continuous improvements. Documentation is an important element...
Nov 18, 2010 | Medical billing basics
Incident Reporting Florida law requires all HMOs in the state to report serious or adverse incidents to the HMO and the Agency for Health Care Administration (AHCA) within 15 days of the occurrence. These incidents are also to be analyzed internally to minimize the...
