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referential matching

Referential Matching: Fixing the Problem of Duplicate Patients

Seeing Double An article by Bruce Pegg of AAPC.com highlights a very real problem in the medical billing industry and one way we may be able to avoid it. Many doctor’s offices and medical billing companies deal with the issue of a patient being entered into the system twice. This can arise from a variety […]

Beware of medicare scams

Beware of Medicare Scams

Every day, scam artists are inventing new ways to steal personal data and commit fraud. To make matters worse, these scammers routinely target the elderly. Senior citizens who may not be as familiar or comfortable with online or electronic systems are the most vulnerable when it comes to identity theft. Unsurprisingly, there has been an […]

rheumatoid arthritis, obesity, and women

Obesity, Rheumatoid Arthritis, and Women

Rheumatoid Arthritis and The Obesity Paradox Through our interactions with medical practices of varying specialties, AMPM Billing has seen that the epidemic of obesity is a contributing factor in many common diseases and ailments. It has been well documented in recent years that patients who qualify as obese or morbidly obese are at a greater […]

Capturing liability insurance revenue

Don’t Lose Out on Liability Revenue

Liability insurance can become a medical billing nightmare if not handled correctly. Often when a patient comes in as a result of an accident, the patient’s liability insurance is not accurately captured or recorded. Many times, the patient may not have the information available when they come in. In other instances, this info may not […]

DNA Fingerprints

DNA Fingerprints: Catching up to Cancer

In honor of World Cancer Day, AMPM Billing takes a look into the new strides being made in the fight against cancer. What are DNA Fingerprints? A report on Science Daily spotlights a new collaborative effort spearheaded by over 1300 scientists from 36 countries. This pan-cancer study aims to use DNA fingerprints to trace each cancer’s root […]

Carpal tunnel syndrome

Are You at Risk for Carpal Tunnel Syndrome?

What is carpal tunnel syndrome? Carpal Tunnel Syndrome is when the median nerve in the wrist becomes irritated or inflamed.  This nerve is connected to the wrist within what is known as the carpal tunnel.  When the nerve becomes irritated, hand strength may diminish. As carpal tunnel syndrome worsens, you may feel tingling or burning […]

February is American Heart Month

February is American Heart Month

When February rolls around it’s not unusual to see pink and red hearts decorating storefronts. However, Valentine’s Day isn’t the only reason to celebrate the heart this month. Keep that iconic muscle pumping by raising awareness this American Heart Month! The Heartbreak of Cardiovascular Disease According to the Centers for Disease Control (CDC) over 600,000 […]

The history of the ICD

Medical Billing Basics: What is ICD?

The history of medicine across the world is a long and complicated one. It is only within the last couple centuries that we have fine-tuned how we treat, diagnose and categorize illness. Disease is a shared human experience that does not abide by borders. Therefore, it became necessary to develop a standardized system of classifying […]

Sleep studies to diagnose sleep disorders

Sleep Studies: What’s Happening While You Snooze?

Sleep is vital. The amount of sleep we get is responsible for everything from re-energizing us for the new day to regulating our moods to even how much weight we gain. Unfortunately, far too many people do not get enough sleep. Often this is due to poor sleep hygiene. However, there are many who have […]

Glaucoma awareness month

January is Glaucoma Awareness Month

Known as the “sneak thief of sight,” glaucoma can strike without warning and is the leading cause of permanent blindness. It is estimated that approximately half of people with glaucoma are unaware they have the disease. Each January, Glaucoma.org and other eye organizations are promoting education and awareness in hopes of prevention. As a member […]

Coordination of Benefits

Coordination of Benefits: How Does COB Impact Claim Processing?

Whether you are a patient, doctor’s office or medical billing company, you are sure to run into a coordination of benefits issue at some point. CMS.org defines coordination of benefits, or COB, as the process which “allows plans that provide health and/or prescription coverage for a person with Medicare to determine their respective payment responsibilities”. […]

Getting the most out of your GI visit

Top 5 Ways to Prepare for your GI Visit

A visit to your gastroenterologist is an important part of staying healthy, especially as we grow older. Nevertheless, many people are unsure what to expect during their first visit. As a medical billing company that services multiple GI practices, we understand the importance of coming prepared to your visit. Here are 5 important things you […]

What is COPD?

Learn About COPD and Breathe Easy

Approximately 6 million people in the United States are living with Chronic Obstructive Pulmonary Disorder (COPD). Unfortunately, many more may have the disease and not even know it. According to the National Heart, Blood and Lung Institute, COPD is one of the leading causes of illness-related deaths in the country. Here are a few facts […]

The difference between new and established patients

Coding Conundrums: Distinguishing New and Established Patients

In medical billing, determining whether a patient is new or established can be more complicated than it seems. When billing to an insurance carrier, specifying this difference can greatly impact how a claim is reimbursed. Here is a breakdown to help you distinguish between the two: What makes a patient new? Distinguishing a new patient […]

Important health screenings for men and women

Top Health Screenings for Men and Women

As the new year approaches, make a resolution to be proactive about your health. Many of today’s severe diseases are most easily treated if caught early. For this reason, a number of screening procedures and tests have been developed to help prevent more serious illnesses. In fact, many insurance companies are required to pay in […]

handwashing awareness week

National Handwashing Awareness Week

For a significant portion of the United States, December marks the beginning of the coldest months of the year. As we all know, when the cold weather rolls in, so do the sniffles. The first week of December is dedicated to one of the best and simplest ways to avoid getting sick — washing your […]

Keeping seniors healthy during the holidays

Helping Seniors Have a Healthy Holiday Season

A happy holiday meal is made complete when our senior family members join us at the table. However, sometimes the festivities and sudden change in diet can be a shock to the system for older adults. As an article on Generationsathome.com describes, “studies illustrate that emergency room visits for older adults jump an astounding 10% […]

The use of modifiers in medical billing and coding

The Use of Modifiers in Medical Billing

In medical billing and coding, CPT codes were designed to describe medical procedures and services in detail. However, a CPT code on its own does not always provide a complete picture. Modifiers were introduced to better explain what services took place and also how those services should be reimbursed. That said, applying modifiers correctly can […]

How much sleep do we need as we age?

How Much Sleep Do We Need as We Age?

Sleep is one of the most important activities of our day. Not getting enough sleep can affect everything from productivity and alertness, to body weight and mental health. As a medical billing company for sleep and pulmonary doctors, AMPM is aware of how sleeping disorders are a growing concern in our society. Incidentally, how much […]

5 Tips for a Healthy Digestive System

5 Tips for a Healthy Digestive System

AMPM services multiple GI practices — so we see on a daily basis the importance of keeping your digestive system healthy and preventing diseases. Here are just a few tips for your digestive wellness: Tip #1: Fiber, fiber, fiber. According to the Mayo Clinic, dietary fiber is best known for its ability to prevent constipation. […]

UB-04 and CMS-1500 forms

Know Your Claim Forms: UB-04 and CMS-1500

As a medical billing company for various doctors and facilities, we understand that knowing which form to use is the first step to filing a successful claim. UB-40 and CMS-1500 are the two most common claim forms for submitting to insurance companies. These acronyms may not appear to say much about which is appropriate to […]

Government programs medicare and medicaid

Medicare and Medicaid — How Government Programs impact Medical Billing

While similar in name, these two government established forms of healthcare coverage differ greatly. As of July 2019, an estimated 60 million people were enrolled in Medicare, while over 75 million people were enrolled in Medicaid (CMS.gov). At AMPM, we understand that many patients seen by our doctors will be enrolled in these programs. Because […]

How to keep claims clean

How to Submit Clean Medical Claims for Your Practice

Nothing is more frustrating in medical billing than a claim that is denied for a clerical error. Mistakes such as these add unnecessary time to the process and can delay reimbursement, longer than one might expect. Improving the percentage of clean claims (claims without errors) will increase the timeliness of your revenue flow, and decrease […]

November is pancreatic cancer awareness month

November – Pancreatic Cancer Awareness Month

November is National Pancreatic Cancer Awareness month. According to the Pancreatic Cancer Action Network, 2019 is estimated to see upwards of 56,600 cases diagnosed. That is more than 150 people per day who will find themselves navigating the difficult waters of treatment – and how to afford it. As a medical billing company, AMPM recognizes […]

Approval from Insurance companies for medical procedures

Referral or Prior Authorization: Knowing the Difference Matters!

From the doctor’s office to the medical billing department, it is important to understand the difference between a prior authorization and a referral. A common assumption is that these terms are interchangeable. However, for medical billing purposes, this is not the case. Individually, authorizations and referrals can have a major impact on reimbursement from an […]

Filing a successful appeal

How to File a Successful Appeal

In a perfect world, all claims would be processed correctly the first time. In the world of medical billing, however, we know this is not always the case. Situations may arise where it becomes necessary to file an appeal. Knowing when and how can save time and frustration. Here are a few key steps to […]

The safe exchange of data

Medical Billing and New Medicare Identification Numbers

What are the new Medicare ID Numbers? Growing concern over fraud and identity theft has prompted the Centers for Medicare & Medicaid Services (CMS) to change how Medicare ID numbers are formatted. According to the CMS website (www.cms.gov), The Medicare Access and CHIP Re-authorization Act (MACRA) of 2015 stipulates that Social Security Numbers will no […]

What is timely filing?

What is a Timely Filing Limit and How Can it be Contested?

Denials for “Timely Filing” In medical billing, a timely filing limit is the timeframe within which a claim must be submitted to a payer.  Different payers will have different timely filing limits; some payers allow 90 days for a claim to be filed, while others will allow as much as a year.  This time frame […]

Video Capsule

Capsule Endoscopy Medicare

Guidelines for billing the Capsule to Medicare will vary between jurisdictions and as a medical biller, you need to look up the LCD that governs your state…

Colon Cancer Risk

Colon Cancer Risk

As a medical billing company, we see the benefits of colorectal screenings and the fact that they can save lives. According to Centers for Disease Control and Prevention, colorectal cancer is the…