Being pregnant is the prerogative of a lady and you must think yourself privileged to the beautiful gift you are about to receive. If it is your first time, apprehensions prevail every moment, but if you have already delivered a baby then you must be at ease with yourself. However care taken is important before and after the baby is born.

Care taken during the pregnancy is known as prenatal care. As soon as you know you are pregnant, you should visit the doctor so that proper medication can begin. The doctor will make you see them at regular intervals.

During the first trimesters, your doctor will call you once every month. At the second trimester the visits increase to once every 2 weeks and then weekly right up to the delivery date. You must keep your appointments even though you are feeling fine as you do not know what is going on inside you.

The doctor basically checks for medical conditions like blood pressure. If there are any problems with the baby and of course the health of the mother. The main focus during prenatal care is to monitor the health of the baby and the mother.

Consuming the right quantity of vitamins, iron, collates and proteins is very important. If you are an absolute vegetarian make sure you are taking in proteins or protein milks. Request the doctor to draw out a chart for the dos and don’ts you are expected to follow with regard to food. Also there are few pointers to follow in everyday lifestyle like not picking up too much of weight, no cardio or heavy exercises. 8 hours of sleep is a must and a little exercise is necessary else you tend to get lethargic.

During pregnancy there are a few discomforts that you may experience as your body is getting adapted to a new life within you. Constipation, nausea, heartburn get a bit regular as your intake in food is not proportionate or they are just there. Whatever you do, will not chase them away. Eating in small quantities the entire day helps. Also avoid spicy, deep fried and tough food.

Fatigue is another regular discomfort. You feel extremely tired and exhausted. Headaches occur as you are not comfortable with some pains and anxiety leads to high blood pressure.

Life can be challenging, even overwhelming. Tornados strike. A debilitating illness weighs us down. Unexpectedly we lose someone we hold dear. Life has a way of stressing us to the limit of our ability to cope.

The National Institute of Health recently reported that each year over 60 Million Americans seek treatment for anxiety and depression as a result of the mental strain they experience. Women in particular seem to be particularly burdened as over 2/3 of the visits to doctors and hospitals were made by women.

May is National Women’s Health Month and it’s a good time to examine the powerful role that stress can have on our lives and health. What is clear is that the tension of daily living can do more than unnerve our hearts.

Sometimes hearts get broken. I don’t mean broken just in the usual sense, from a relationship that has gone sour. No hearts can become cracked like a piece of delicate china.

After being battered by emotional or psychological upheavals, our hearts can become broken on the inside. Overwhelming grief or sadness can fracture our hearts.

Know what I’m talking about? Most people do. Most people have had their hearts deeply hurt in one way or another. The pain, the anguish, or heartache can be so shocking that we may feel like giving up on life.

But did you know that a broken heart could literally kill you? It’s true. A broken heart can be lethal. And unfortunately, women may be at the greatest risk.

Medical researchers have recently identified a new illness called The Broken Heart Syndrome. First described in 1991 by Japanese physicians, The Broken Heart Syndrome is a medical condition that afflicts predominately middle-aged woman and leads to symptoms similar to a heart attack.

Women report chest pain, shortness of breath and feelings of severe fatigue. The symptoms are often so frightening that they seek medical help. When they present to the emergency room, they frequently have an abnormal EKG and may even be suffering with severe breathlessness and a buildup of fluid in the lungs-congestive heart failure.

A cardiac catheterization (a special x-ray test to examine the heart arteries) demonstrates that their symptoms are not a heart attack- no cholesterol deposits are present. Yet, their heart muscle is often severely weakened.

Research from Duke University published in the New England Journal of Medicine (2005) has demonstrated that excessive levels of stress hormones, particularly adrenaline like substances are circulating in the blood. Often the adrenaline levels will be 3-4 times the level commonly seen in a routine heart attack. Overwhelming stress is believed to be the culprit of this condition that can markedly reduce the heart’s ability to pump blood.

Fortunately, most patients make a full recovery from the illness, but it shouldn’t be taken lightly. Interestingly, The Broken Heart Syndrome is changing the way physicians view emotional health.

We used to think that feelings didn’t affect us physically. We thought that the notion of being scared to death was an old wives tale or folklore. Yet, scientific research in the last few years has shown this to be untrue. Our feelings, particularly negative feelings: fear, anger, grief, loneliness, anxiety, and depression to name a few- can have a harmful effect on our physical health. They can actually create illness. A broken heart can indeed kill you!

So how does a person know if they’re at risk of dying from a broken heart and what can they do to prevent it?

First, recognize that your emotion health is important. Don’t discount strong feelings of discontent or inner pain.

Second, seek medical help. Your physician can help decide if your emotional state is severe enough to require the care of a psychologist or psychiatrist.

Third, take the time to get more in touch with your own feelings. Simple things like spending 15 minutes each day for personal reflection has helped many people overcome troubling emotional states.

Finally, recognize that you can improve the way you feel. Research has shown that counseling, meditation, yoga, and other self-help practices can have a positive impact on your heart health.

A Broken Heart Can Kill You, but you don’t have to become a medical statistic.

You can change your life.

If you’re planning on doing medical billing and sending in claims for oxygen, you better make sure you’ve had plenty of sleep the night before. Oxygen billing is probably the most complex of all the medical billing procedures because of certain conversions and calculations that need to be done in regard to the oxygen itself. In this installment of our series on medical billing and the electronic transmission of claims using NSF 3.01 specifications, we’ll be covering the GX0 record, picking up with field number 14.

GX0 field 14, positions 125 - 127, is the oxygen flow rate. This tells the carrier how many liters per minute the patient is supposed to receive. The valid values are 001 - 999. If the patient is going to be getting less than one liter per minute than the software needs to enter 00X.

There are some notes that are important about this field, as it is one of the most important fields on this CMN.

If you’re billing for an oxygen concentrator, the concentrator being given to the patient must go along with the flow rate prescribed by the doctor. This is especially critical when billing for flows greater than 4 liters per minute and less than 1 liter per minute. Also, if you’re billing oxygen for a flow rate greater than 4 liters per minute, the date the test was performed must be filled in. Use field GX0-20 for this. Also, flows of greater than 2 liters per minute will usually require a review by the insurance companies medical staff.

GX0 field 15, positions 128 - 129, is the frequency of use. This field tells the carrier how many times per day the patient is to use the oxygen. Just a note. This field is usually only filled in if the doctor prescribed oxygen use during certain times, such as when the patient is exercising, sleeping, etc.

GX0 field 16, positions 130 - 131, is the duration of use. This field tells the carrier how long in hours the patient is to use the oxygen for each use. If the number of hours is less than 10, then the field needs to be left zero filled. So 4 hours would be transmitted as 04.

GX0 field 17, positions 132 - 134, is the arterial blood gas at 4 LPM. This field tells the carrier what the blood tests results were for arterial gas when the patient was given oxygen at a rate of 4 liters per minute.

GX0 field 18, positions 135 - 137, is the oxygen saturation at 4 LPM. This field tells the carrier what the blood test results were for oxygen saturation when the patient was given oxygen at a rate of 4 liters per minute.

GX0 field 19, positions 138 - 145, is the date the patient was tested on 4 LPM. This field tells the carrier the date that the patient was tested for the 4 LPM tests. This date can be transmitted as yyyymmdd or mmddyyyy, depending on the carrier requirements.

If you’re in the medical billing business, or plan to get into it, one of the most important things you’re going to have to do is hire a staff of billers. This may sound easy but it is far from it. In this installment, we’re going to cover some basic things that you’re going to want to look for when hiring a billing staff.

The first thing you want to look for, probably above all else is somebody who has knowledge of the industry. The reason for this is because the medical billing industry is filled with rules and regulations. Medicare regulations alone are enough to make your hair stand on end. The last thing you want is for a biller to have to look up every single regulation before sending out a bill. They need to have a solid command of the rules of the industry or productivity is going to suffer greatly.

The next thing you’re going to want is somebody who has excellent typing skills. Sad as it is, most of medical billing comes down to typing and a lot of it. The person will have to type up order pages, patient accounts and a number of other items. Plus, they will be doing this all day. It is critical that they are able to get a certain amount of claims out or the company will not be as profitable as it could be.

The next thing you want to look for in a medical billing person is somebody who is technical to some degree. The reason for this is that most billing today is done by computer and many claims are no longer printed on HCFA 1500 forms but instead sent electronically. If the person you hire is not familiar with modems and things of a technical nature, they are going to have a hard time doing their job in today’s environment.

The next think you want to look for in a medical billing person is somebody who is trustworthy. The medical billing world deals with a lot of information that is private. Your biller is going to be seeing information such as patient files that is for nobody’s eyes. They are going to have to be able to see all of these things on a daily basis and keep their mouth shut about it.

Finally, you want to find somebody with a great attention to detail. Medical billing is one of the most complex things you can do. Aside from all the regulations and forms, there are things like enteral billing and parental billing where they are going to have to understand feeding methods and conversions. For oxygen billing, they’re going to have to know how to calculate oxygen units. They will need to be able to tell when a claim just doesn’t look right. For example, if oxygen units shows some crazy amount, they are going to have to be able to recognize this.

There is so much hype out there about electronic medical claims billing. If you are not sending your claims electronically yet, you are probably too embarrassed to admit it. And if you are, you are probably wondering if the method you are using is the best. What is the real truth behind electronic billing?

Many of the larger insurance companies are really pushing providers to submit their claims electronically. Some are even calling the provider’s offices and telling them that they are mandating electronic submissions by a certain date and that they will no longer accept paper claims. Others offer incentives to submit electronically, such as faster payment, or even no authorization required for services if claims are submitted electronically.

Bottom line, the real question for a provider is “is electronic billing really necessary for my practice” and “what will it require of me.”

For the first question, I think that everyone must realize that with the changes in technology electronic submission of medical claims is inevitable. Today’s society is moving towards paperless transactions in many ways.

The second question will depend upon many things such as how large, or small, your office is, how much equipment you already have and how up-to-date it is.

One of the biggest misconceptions of electronic billing is that it makes the billing in your office a lot simpler. In some ways it does, but it presents you with a whole different set of tasks that you didn’t have before. I’m not implying that it makes anything harder. Just that there are things that go along with electronic billing that you did not have to do before such as reading and acting on reports and maintaining and updating the electronic software.

When you submit a claim on paper, the claim is both received and processed, or you never hear a thing. Hopefully in the latter case, your staff will call and check status on it after 30 days. Whether your paper claim has complete and accurate information on it or not, it will be handled the same way. You will either receive payment for the claim, or an explanation of benefits showing a reason for denial.

When you submit claims electronically, it is not quite so simple. First, you will receive a report letting you know if your batch of electronic claims was accepted or rejected. If a claim has incorrect data such as an incorrect date of birth, it will be rejected before it ever reaches the insurance companies claims processing system. You will receive a report, usually within 24 - 48 hours showing all rejected claims, and the reasons for the rejections. You will also receive a report showing the claims that were accepted with no errors.

It is very helpful to receive notice so quickly that your claim had incorrect information; however, you now have to make sure your staff is able to check on this report and take the time to find and correct the needed information.

What electronic billing is actually doing is letting you know sooner that you have problems with specific claims. When you are submitting them on paper, you generally don’t find out about the problem claims until you are doing a follow-up report and calling the insurance companies. So by submitting your claims electronically, you are not eliminating all the problem claims, you are finding out about them sooner.

Once you decide to take the plunge into electronic billing, there are still choices to be made. Is the practice management system you are currently using capable of submitting claims electronically? If not, you will need to update or change your software. You will need to determine how you will submit your claims to the insurance companies. A clearing house may be the best option, or if you are a larger practice, or billing service, you may want to consider software that allows you to act as your own clearing house.

In any case, if you are not already submitting your claims electronically, it probably would be wise to start researching your options. A good place to start is by contacting your practice management system support and asking them if they recommend any method in particular. Another way is to ask your colleagues. Electronic claims submission is a big step and it should not be taken lightly.

Medical billing complexity and massive volumes of daily claims render manual claims processes incapable of protecting both the provider and the payer from underpayments, overpayments, and billing compliance violations. Straight Through Billing addresses complexity and volume processing problems by automating the majority of the claim flow and focusing the billing follow-up specialists to exceptions only. A Straight Through Billing process flags problems, routes them for follow up, and enables online correction and resubmission. Straight Through Billing methodology implements billing service transparency and focuses management on strategic process improvement opportunities.

Straight Through Billing (STB) integrates billing process within the practice management workflow, automates vast majority of transactions, focuses manual labor on exceptions, and establishes a process for continuous improvement.

First, integrated practice management and billing workflow connects patient scheduling, medical record management, and billing into a single flow. Every participant of the practice management workflow receives a unified and coherent picture of practice workload, patient and provider location, resource availability, and cash flow.

Next, transaction automation streamlines and expedites billing process by automating claim validation, payer message reconciliation, and billing workflow management:

* Automated claim validation eliminates errors downstream and reduces processing time because it flags errors before submitting the claim to payer.
* Automated claim-message reconciliation eliminates costly search for the original claim and standardizes message communication, further eliminating the need to decipher the (often cryptic) payer’s message.
* Billing workflow management drives the followup discipline required for resolution of claim denial and underpayment incidents and establishes high degree of process transparency for all billing process participants, resulting in full and timely payments.

Third, focusing manual labor to exceptions requires timely exception identification, routing to followup personnel, online error correction, and rigorous followup tracking. Again, process transparency, as implemented in vericle-like systems, enables tracking exception followup.

Finally, a process for continuous improvement requires continuous observability of every process attribute and a modification methodology for both automated claim processing and manual exception followup tracking.

STB implements billing transparency by design because billing transparency is an integral attribute of every component of STB process.

Straight Through Billing Architecture

Straight Through Billing systems architecture mirrors the architecture of general Straight Through Processing (STP) systems developed for the financial services industry. Such systems require effective workflow management, knowledge base validation system, connectivity to all process participants, including on-line data reconciliation, and tracking of problem resolution. Therefore, a typical vericle-like STB system has a three-tier architecture:

* Back-end processing engine designed for high-volume transaction processing environment
* Middle-tier uses Java Servlet technology
* Front-end is an HTML-JavaScript zero-footprint client

An STB system (e.g., Vericle) following the methodology outlined above implements rich functionality, which allows automated

* Computer aided preferential patient scheduling
* Integrated electronic medical records
* On-line computer aided coding
* Real-time claim validation and patient eligibility testing
* Electronic claim submission
* Payment posting, reconciliation, and verification of meeting contractual obligations
* Monitoring of audit risk and billing compliance
* Tracking of denial appeal process

Quantitative STB Management

STB methodology allows for quantitative management as the likelihood of failure of the entire process can be estimated as the product of such items for each individual workflow steps. A vericle-like STB system tracks the percent of clean claims (claims paid without any manual intervention in full and within the allocated timeframe) and focuses the management on those process aspects that yield the greatest potential improvement. Thus STB methodology focuses on exceptions both at tactical and strategic management levels.

Medical billing services are companies that take the pain of collecting money out of the doctor’s office. A good service will maximize a doctor’s receivables, while keeping their cash flow consistent. The key is choosing the right medical billing service.

A great service will submit insurance claims timely (preferably electronically), track the payments, follow up on unpaid claims and deal with all denials. They will not let any claim go unpaid.

Representatives of the service will attend insurance company seminars, advise the doctor of changes in their field and provide them with regular financial reports. They should not only handle the billing needs, but should act as consultants for the doctor, advising of fee structure, coding practices, and other ways to improve the office.

An obvious way a doctor can save money by outsourcing his billing is in the savings he will generate thru payroll, equipment, software support, updates, postage, forms, etc.

Outsourcing medical billing produces more than cash savings. A good service can maximize what the doctor actually brings in by collecting more money than an in-house staff can. In most offices, the in-house staff does not have the time, or the knowledge to handle the problem claims and the doctor ends up not getting reimbursed anything for those services.

By outsourcing, a doctor is hiring a professional. Medical billing services have the expertise to submit claims accurately, collect on all claims, even those that have been denied by the insurance carrier. This helps the doctor’s patients by avoiding billing the patient for a claim that should have been paid by the insurance carrier.

A doctor should avoid choosing the wrong service by carefully checking references. A doctor should call several other doctors who might be using a particular medical billing service.

When a doctor interviews a potential service, what is his overall impression of the people who will be handling his income? During the interview, he should pay attention to how they answer his questions. Are they confident in their answers? Are they correct in their answers? Does what they offer make sense?

Like many other fields, there are good and bad billing services. But medical billing services can be a great resource for a doctor if they are careful to choose the right one.

For today’s practicing physician, there is so much to do. Instituting, upgrading and perfecting electronic billing processes. Keeping abreast of all the new medical coding requirements. Billing and collecting enough to stay profitable, but not so much as to incur an audit by the federal government. Finding ways to stay compliant with the new HIPAA privacy and security standards without completely disrupting your office and re-designing most of your processes. Not to mention completing paperwork on each patient that is now estimated to take an average of 30 minutes per patient.

These factors, especially federal and state regulations, have greatly increased the need for experienced and certified coding and billing professionals. Private practices, clinics, emergency department physician groups, and hospitals simply cannot afford coding mistakes, yet most do not have the time or staff to properly and accurately bill those patients, in turn creating a demand for outsourced medical billing companies.

Naturally, as the expectations and standards for proper coding and billing procedures become more stringent, medical billing and coding companies are rapidly becoming a vital segment of the national health care industry. So much so, that traditional medical staffing firms have taken note, as they have expanded their suite of services to include physician coding and billing. Furthermore, publicly traded companies are quickly consolidating the medical billing and coding segment through the acquisition of smaller players.

Most medical billing systems are user friendly with many customizable tools. Modern systems also provide analysis reports on procedures performed, payments received, and accounts adjusted for any period. They can include additional medical functionalities in bills such as trip reporting for ambulance companies, transaction details for anesthesia billing etc. Electronic claim submission aids automated cash flow. Online systems help to streamline the activities from any Internet source.

Medical billing is an increasingly popular office or home-based small business opportunity that involves using skills and knowledge in medical terminology, insurance claims, and customer service to ensure that physicians and clinics receive payment from patients and insurance companies.

Whether working from home based small-businesses or at large hospitals, every medical biller utilizes medical billing software. Though still referred to as medical billing software, today’s electronic medical billing software is also more accurately called medical practice management software and covers many functions. Up-to-date medical billing software will generate a variety of reports based on data, manage appointments, as well as collect, transmit, and track billing information and payments. Current medical billing software will also make sure that records are kept in compliance with the Health Insurance Portability and Accountability Act security standards. When deciding on software to buy, compliance with this act is an important consideration and will help you steer clear of some of the software scam artists out there.

When considering software for a medical billing business, here are some things to ask yourself or potential suppliers:

• Does the software include the ability to manage several different accounts?
• Can the software handle multiple doctors or multiple offices?
• Does the software recognize current procedure and diagnosis codes and it is updatable for the future (very important!)

Many vendors will allow a trial use of their program to see if it fits your needs. You will also be able to address whether the supplier answers questions in a timely fashion and if the are helpful in a trouble-shooting situation. Remember that a good medical billing software suite will cost at least $500 so don’t be fooled by people trying to sell $50 products that don’t even function.

Though electronic billing is still mainstream, there is a movement towards online billing where a subscription is setup on the web allowing a paperless entry of patient information, claims, and more. This service will cost more than $200 per month so you have to research and weigh the benefits of a one time investment for electronic medical billing software that is local or the online web-based software that can be used from any web-connected computer or device.

Medical billing software is easier to use today than ever before. Innovations in the technology of medical billing software have created a new touchstone of digital accuracy. Once a complicated text-based interface filled with awkward textual fragments, today’s electronic medical billing suites are slick, undemanding, and intuitive, finally generating documents your patients can easily understand.

No more complicated invoices in the mail. Now easy medical billing software offers complete billing summaries. All you need to get there is the aid of a medical billing program that includes software that tracks claims management, patient billing, insurance, and scheduling in a single package. Easy medical billing software can create a seamless workspace in which everything from electronic medical records to healthcare forms is integrated and simple to use. Now you can find opportunities that allow you to effortlessly configure software yourself. Some other important features worth noting are; easy access to the latest forms and guidelines, a step-by-step process that will prompt you through the programs many functions, and an automatic bill printing feature, that will reliably generate the correct documents.

Many easy medical billing software packages are now designed like the paper scheduling and hard copy claims processing with which you are familiar. This software model makes learning fast and easy, even for first-time users. When investigating the different possibilities of medical billing software, it is a good idea to verify that the system was designed for the safe and secure back up of data and is HIPAA compliant, and whether the software is easy enough for a computer novice and will, at the same time, meet the needs of a busy medical practice.

Easy medical billing software has now evolved to a place where any staff member of your practice can use it. The simpler programs are usually available in most places where medical billing software is sold. When your office works efficiently, it always translates into better care for your patients. So get on board with the right easy medical billing program and see how simple that paperwork can be.