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16 Most Absurd ICD-10 Codes

10/1/2015

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Which One Do You Use?

2/13/2015

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By Jennifer Albach RN CCM LNCC
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My work entails reviewing medical records all day, every day.  Next to “chicken scratch”,
my biggest pet peeve is… non-yellow highlighters.  Why?  Too often non-yellow highlighting
looks like this, when copied.*


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This is what those pretty pink, green and blue highlighters produce when scanned and printed. 
Why?  Most copy machines only print black and white. So every color on the page has to be
converted to either black or white. Yellow is very close to white, so it disappears
.


The next time you’re about to use one of those non-yellow highlighters, please think about the
ultimate use of the document.
 

* Staedtler claims to produce multi-colored highlighters, in which, the document writing can still be read after
copying with a non-yellow highlighter.  However, this brand is the exception to the norm. 





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How to Choose a Health Insurance Plan                                                    by Jennifer Albach RN, CCM, LNCC

2/3/2015

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Recover Overpayments to Providers

1/23/2015

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What is Balance Billing?

1/16/2015

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Jennifer Albach RN, CCM, LNCC
Balance billing occurs when providers or facilities bill you for the difference between the amount your health plan pays them and the amount the provider or facility believes to be adequate reimbursement.
 
Sometimes, providers will try to get a second slice of the pie by billing the patient not only for the portion he owes after the insurer has paid its part, but also the difference between the charge contracted with the insurer and its regular charge.  For example, a specialist charges $ 100.00 for an office visit.  However, your insurance company has contracted an $80.00 per visit charge for its customers.  A specialist billing the patient for the $20.00 difference would be considered “balance billing”.


Balance billing is illegal for all approved Medicare services you receive from a provider. Additionally, 47 states have laws that require contracted/preferred/in-network, health care providers to seek payment only from the health plan and not from their patients.  These laws vary from state to state and may include only some types of health plans.  Some state laws restrict balance billing from out of network providers, as well.

Balance billing does not include your doctor or other provider charging or collecting out-of-pocket expenses such as deductibles, copayments, or co-insurance that may be required by your health plan.  Your state’s ban on balance billing usually does not apply if you have an elective procedure, such as cosmetic surgery, which is not a covered benefit. Additionally, you may be liable for the complete bill or a balance if you get an out-of-network service that is not an emergency and has not been approved by your health plan.

If you cannot resolve the issue with your health plan or doctor’s office, file a complaint with your state’s insurance department or Attorney General.  

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Health Law Attorney Blog                                                                            Blog post: 'RAC Lawsuit Dismissed by Federal Judge'

1/14/2015

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    Jennifer Albach

    A board certified Legal Nurse Consultant, available to provide medical-legal support services.

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This site is provided as a public service by Medical Records Review Specialists. While the information on this site is about legal issues, it is not legal advice or legal representation.
Medical Records Review Specialists - Legal Medical Consulting Services
Friendswood, Texas - Services offered nationally
Phone: 281 686-1674
Website: www.MedicalRecordsReviewSpecialists.com
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