In Getting to Yes, his classic book on negotiating, Roger Fisher writes: “Like it or not, you are a negotiator. Negotiation is a fact of life. You discuss a raise with your boss. You try to agree with a stranger on a price for his house. . . . Everyone negotiates something every day.”

Fisher, who founded the Harvard Negotiation Project, was right. When you stop and think about it, you realize that you are probably negotiating for something every day . . .

-     Can you work on a flextime basis, instead of logging in and logging out at regular hours?

-     Would your company consider setting up an in-house daycare center for employees’ children?

-     Will your husband or wife cook dinner for your family tonight, so you can go to the gym on the way home?

-     Can you take on a bigger job – the one that a departing colleague just vacated?

When you are about to discuss questions like those, it is tempting to think that you are about to enter into conflict, not into conversation. According to Fisher, that is a mistake. He writes that it is better to practice something that he calls Principled Negotiation – an approach in which both parties look for areas of mutual gain.

Here are the four principles of Fisher’s approach . . .

-     Separate the people from the problem. For example, set aside the fact that you don’t like your office manager and that you want to score a win against her. Remember that when you negotiate, you will come to a better agreement if you focus on issues, not personalities.

-     Focus on interests, not positions. Instead of saying, “I need flextime, period,” discuss your underlying reasons for needing it and invite the other side to express its interests too. When you strive to make a situation better for both sides, you are more likely to make progress toward your goals. Read the rest of this entry »

You have to get down to work. You have to sit down to study. But instead, you make another a cup of tea, chat with a friend, or shop online.

We all do it, because procrastination is one of life’s guilty little pleasures. But if procrastination becomes a habitual pattern, it can add a lot of stress to our lives.

So, do you procrastinate? According to the book Good Stress, Bad Stress, these could be the underlying reasons:

Cumulative procrastination – If you’ve let your work pile up, it becomes harder and harder to attack it.

Perfectionism – If you’re worried that you cannot handle certain tasks well, you tend to avoid them.

Conflict avoidance – If you fear that tacking a certain project will trigger disagreement with your boss or a colleague, you tend to avoid it.

Here are some procrastination-fighting techniques for medical billers and coders recommended by Barry Lenson, author of Good Stress, Bad Stress:

Tackle unpleasant tasks first thing in the morning. If you’ve been delaying a touchy conversation with your boss or a colleague, have it as soon as you arrive at work. Tackling dreaded tasks first gives you energy that can boost your productivity through the day.

Say, “I’ll work on it for just five minutes.” This tactic works especially well if you have let work pile up. When you make just a small commitment to start on a backlog of work, you break the logjam and get going.

Work with a partner. Take a batch of coding work, divide it up with a colleague, and get started. (And offer to share his or her work in the same way.) When you cooperate on a body of work, you stand a better chance of whittling a pile of work down to size. Cooperation is fun and energizing.

Have you found strategies for fighting procrastination? If so, why not take a moment and share them here with other readers of Medical Billing and Coding Blog?

What’s the best way to project a completely professional image in job interviews? According to Debra Benton, one of America’s leading executive coaches, you need to pay close attention to all the small things that add up to create your image.

“Little things mean a lot when it comes to making important impressions,” Benton tells Medical Billing and Coding Blog. “A traditionally professional bearing shows respect to people in the company and the organization as a whole.”

Debra Benton’s advice for interviewing women . . .

-     Dress in a dress, slacks or a jacketed skirt.

-     Don’t wear jeans, even designer ones.

-     Wear close-toed, low-heeled shoes or flats, not today’s sexy, popular platforms.

-     Pull your hair off your face and out of your eyes, and don’t play with it during the interview.

-     Show no cleavage or upper thighs, because your clothes shouldn’t be more interesting than you are.

-     Don’t wear noisy bracelets or distractingly dangly earrings, despite today’s fashions.

-     Cross your legs at the ankle rather than at your knee to avoid a nervous or a flirty-looking swinging of the leg.

-     Laugh, but don’t girlishly giggle.

Debra Benton’s advice for interviewing men . . .

-     Wear a collared sport jacket, suit jacket, or suit.

-     Wear a collared shirt.

-     Don’t wear jeans, even designer ones.

-     Wear close-toed shoes, not sandals or sneakers.

-     Your shoes and belt color should match.

-     Have a reasonable hair cut.

-     Be well groomed, which means checking out your fingernails, nose and ear hair too.

Debra Benton’s advice for both men and women . . .

-     Arrive with an attitude that says, “I really want to be here!”

-     Sport no tattoos – unless you’re part of the Maori tribe.

-     Show no visible body piercing – your ear lobe is okay, but pass on nose, lip, and eyebrow.

-     Stand up straight and carry yourself with control.

-     Firmly shake hands.

-     Slow down your walk, talk, and gestures, so that you will look more confident. Read the rest of this entry »

Not too many years ago, workers who needed an energy boost at work would reach for coffee, tea or maybe a can of cola. With the arrival of energy drinks, all that has changed. Now many workers with sagging energy are popping open cans of these new beverages.

How safe are these beverages? Opinions vary, but according to Edward R. Laskowski, M.D., a physical medicine and rehabilitation specialist at the Mayo Clinic, overconsumption of caffeinated energy drinks can have negative effects. Here are some that he cites in a post on the Mayo Clinic’s Fitness blog:

-     Restlessness and irritability.

-     Headaches, tremors, nausea and insomnia.

-     Increased blood pressure.

-     Quickened heart rate, especially if the consumer also drinks alcoholic beverages.

-     Weight gain, especially if the energy drink contains sugar. (Some energy drinks boast that they contain very little sugar.)

Suppose you want to boost your energy using natural foods? According to nutritionist Jennifer Newell who writes on the HealthNews blog, there are ways to boost energy without relying on energy drinks. Ms. Newell writes . . .

“The most consistent energy booster is regular exercise, proper sleep, a healthy diet that includes plenty of fruits and vegetables, and the consumption of a minimum of eight glasses of water per day. This type of regimen will allow for sufficient energy to face each day, and when that extra burst of energy is required, an all-natural fruit drink or glass of tea might be enough to do the job.”

If you really like energy drinks and intend to keep drinking them, how can you find out what’s in yours? Of course, you can read the contents that are listed on the label. But we also found a blog, Energy Drink Ratings, that you might want to check out. Some of its reviews cover low-calorie energy drinks that contain little more than vitamins, fruit juice and tea.

A whole blog that does nothing but rate drinks with names like Speed Stack and BooKoo Citrus Shot? Well, it’s a brave new world out there. And apparently, it’s an energized one too.

Medical Billing and Coding Blog is sponsored by Ultimate Medical Academy (UMA), a leading healthcare career school. UMA has campus locations in Tampa and Clearwater, Florida, as well as a national online program.  For more information about UMA please visit our website at www.ultimatemedical.edu

“I’ve learned that you shouldn’t go through life with a catcher’s mitt on both hands; you need to be able to throw some things back…”

- Maya Angelou, in an interview with Oprah Winfrey.

Is it possible to manage workflow that comes to you from two, three or more bosses?

It can be done, but it can also be a challenge. Consider these words from a medical biller and coder who works for a small group of physicians:

“Each doctor thinks that his or her work is priority one,” she states. “And since I am not really in a position to say no to any of them, I feel like I am being pulled in all directions while my in-basket piles higher and higher.”

So, how can you manage workflow from multiple bosses? Here are some suggestions from a variety of experts.

Suggestion One: Let Your Bosses Decide what Comes First

Get conflicting bosses into one room and let them help set your priorities. But don’t use this tactic if both bosses are already fighting aggressively for your time – you could end up with an even bigger pile of work and no resolution.

Source: Adapted from the book Managing Multiple Bosses: How to Juggle Priorities, Personalities & Projects – and Make It Look Easy by Pat Nickerson (AMACOM books, 1998).

Suggestion Two: Keep a Time Log

Simply keep a calendar for three or four days where you log exactly what you worked on, in 15-minute increments. If certain bosses are claiming an unbalanced share of your time, your time log should provide documentation that things are not being handled fairly.

Source: Adapted from the book How to Get Control of Your Time and Your Life by Alan Lakein (Signet, 1989).

Suggestion Three: Schedule Individual Meetings with Your Bosses

Schedule time with each one. Explain that you want to handle everyone’s work more effectively, explain the workload you are dealing with, and ask them to make suggestions. Asking for help in this way is more effective than saying no to new work.

Source: Management consultant Jennifer B. Kahnweiler writing on AMANET.com. Read the rest of this entry »

Medical Billing and Coding Blog interviewed a professional biller and coder with over 30 years of industry experience, and a current member of the National Advisory Board for the American Academy of Professional Coders. We got her take on the top 10 coding errors that she sees in medical billing and coding students. Here is her list of the top 10 coding mistakes:

1.  Unbundling of codes

a. Unbundling is breaking apart codes that are inclusive of other codes.  This not only affects reimbursement but it is illegal to do and will trigger an audit.

2.  Not coding the diagnosis code to the highest level

a. This is due to the fact that some ICD-9-CM codes need a 4th or 5th digit to be accurate and correct, something that many beginning coders will miss.

3.  Not understanding how to interpret the operative reports

a. For instance, if a laminectomy is performed, but the word laminectomy is not mentioned in the body of the operative report, the coder thinks that it has not been performed.  The physician has described the procedure in the report but not mentioned the term laminectomy; fully understanding how to interpret the operative reports will limit this error

4.  The physician not marking on the encounter form or superbill that they performed an x-ray gave an injection…etc

a. The coder has no idea that these were done unless it is mentioned in the documentation on the chart.  Usually by this time, the coder or biller has already sent the claim out. They then have to submit an amended claim which could result in lost time and money.

5.  Not having access to the provider, surgical tech or the documentation to be able to audit the claim.

a. In the situation where a coder is working off site from the provider’s office, they may not be able to contact the provider or see the documentation from the patient’s chart.  If they have a question about something, they have no way of getting that information unless they have a good relationship with the physician’s office.  Therefore, it takes a team of the physician, surgical tech, medical assistant, front desk staff and the medical records to sometimes get the information they need to code the claim correctly.

6.  Coders and Billers not having access to the Explanation of Benefits.

a. The coders and billers have no idea of any mistakes that have been made when the claim has been denied.  The bigger the practice the harder it is to track and correct these mistakes right away.  Usually, whoever is putting in the payments work the denials.  However, if the coder does not know what is wrong with the claim, they have no way of fixing the problem in the future.

7.  Collecting the patient’s co-pay up front.

a. The co-pay should be collected before the patient sees the physician.  The front desk coders should know in advance what the patient’s co-pay is and if they have met their deductible for the year so they can be ready to ask for it when the patient arrives.  This is an agreement between the patient and the insurance company.  If they continue to not pay their co-pay, the insurance company has a right to drop them.

8.  Undercoding.

a. This happens when the physician actually performs more than he charges for because he is afraid of an audit.  This is just as bad as upcoding; charging for services that were not performed.  This is also illegal and can trigger an audit as well by the OIG (Office of Inspector General).

9.  Physicians not documenting everything they did in the chart even though they may have done it.

a. A physician’s note should be able to stand alone – what the patient is being seen for, the physical examination, the doctor’s assessment and his treatment plan.  If it is not documented, it was never done and is not billable. Sometimes, this is where the coder needs to educate the physician on how to document.

10.  Coder’s not keeping up with their education of what has changed from the previous year or even daily with some insurance companies.

a. Physicians need to realize that a coder’s job has to include continuing education.  If the coders do not have the opportunity for continuing education, they will fall behind in their knowledge of the industry and therefore make mistakes.

If you are starting your own business as a medical biller and coder, what kind of insurance do you need?

It might be tempting to say “not much,” especially if you are setting up a computer in a home office and working part time. But then you start to think. What would happen if your computer was lost or stolen and you were not able to keep working for a period of time? What would happen if a client who stopped by to see you slipped on your front steps and got injured?

According to the U.S. government’s Small Business Matters resource for small businesses, here are some kinds of coverage that you would be wise to consider before starting a small business of your own:

-     Home-Based Business Insurance – According to Small Business Matters, homeowners’ insurance policies generally do not cover home-based business losses. While you may be able to add property damage riders to your policy, you may need to purchase additional policies to cover other risks, such as general and professional liability.

-     Commercial Property - This covers losses and damage of company property due to fire, smoke, severe weather, vandalism, and other events. It can cover lost income, business interruption, buildings, computers, company papers and even money that you have on hand.

-     General Liability - This insurance can provide protection against accidents, injuries and claims of negligence.

-     Professional Liability - If you provide a service, this insurance protects against malpractice, errors, and negligence in the services you provide to your customers. (Let’s say, for example, that a client incurs a loss because of errors you made.) Some state governments require certain professions to carry such a policy. To check your state’s requirements, click here.

Where can you find out more about the coverage you need? Speaking with an insurance agent in your area can be a good place to start, since local agents are likely to be aware of state and local laws and legal precedents. The Independent Insurance Agents & Brokers of America, a not-for-profit professional organization, offers a “find an agent” service that you can search online.

If you’re thinking about starting a business of your own as a medical biller and coder, should you structure it as a sole proprietorship, a general partnership, a limited liability company (LLC), or a corporation?

That’s a question you should discuss in depth with an attorney and tax advisor, because each structure can present different liability protection, tax liabilities, and reporting requirements. But according to “The Basics of Business Structure,” an article on Entrepeneur.com, here are some basic concepts you need to know:

• A sole proprietorship simply means that you are an individual doing business as yourself. (You can use your own name as the company’s name, or operate under a different company name you create.) Setting up a sole proprietorship is simple, though you might need to register your business with your municipality. The disadvantage is that there is no distinction between you and your company, and you could be personally liable for business debts.

• A partnership means that you and one other person are doing business together – it is essentially a sole proprietorship operated by two people. It’s easy to set up too, but both partners can be liable for debts. This is one reason that Entrepreneur.com advises potential partners to retain an attorney to draft a partnership agreement ahead of time.

• A Limited Liability Company (LLC) is a relatively new kind of business structure that offers the simplicity of a partnership with the liability protection of a corporation. To set one up, you may need to file legal forms with state agencies and pay registration fees.

• A corporation functions as a legal person in the eyes of the law. It can protect its owners from liabilities, and it can sell stock to raise funds. However, corporations are generally required to pay annual fees, hold stockholder and board meetings, and file reports.

So, what is the best structure for you? That’s a rather complex question. So if you’re going out on your own, meet with your attorney and tax advisor to weigh your options.

Note: This post was originally published on our Medical Administrative Assistant Blog. Check it out for more information on the allied healthcare field!

Social media is a big buzz word right now.  From blogs to Twitter to Facebook, social media is quickly becoming part of our daily lives.  Analysts are predicting where it will go, whether the bubble will burst, and what effects it will have on other industries.

But here is what we know right now: We know that social media is a powerful tool to connect and communicate with individuals that share your interests and goals.  In the next week, take these three steps to ensure that you are getting the most out of your billing and coding career.

Create a LinkedIn profile and begin connecting with colleagues.

LinkedIn is a social network for professionals.  There is no “poking” or tagging of pictures, just a simple, personal business network.  You want to have a presence on LinkedIn because 75% of hiring managers use LinkedIn to research job candidates before making an offer.   Spend some time to create a real profile.  Having a profile with only your name and nothing else sends the message that you don’t care about your professional connections.

Once you have your profile, feel free to join the Ultimate Medical Academy LinkedIn group to connect with other professionals.

Start following colleagues on Twitter.

Twitter is a powerful tool for personally connecting with individuals in your industry.  Create an account and start following your colleagues, coworkers, and fellow students.  Begin sharing links that you find thought-provoking or relevant to medical billing and coding.  Mashable has a very comprehensive guide on Twitter.  Once you have an account, follow us on Twitter.

Start a blog.

Blogging requires determination, dedication, and a love for a specific topic.  If you have those qualities, then a blog is a great way to get your name out there and establish yourself as a responsible individual.  Your blog does not necessarily have to be about your career, but that doesn’t hurt.  David Spinks writes about the 14 Ways a Blog Will Help You Get a Job.  If you are nervous or don’t know where to begin, ProBlogger is a great resource.

Important: Keep in mind that these are opportunities to build your professional network, which means your profiles and conduct on these platforms should be professional in nature.  Get rid of “cutesy” names, inappropriate pictures, and highly personal information.

Is California a good place to build a career as a medical biller and coder?

If you have been following the news, you already know about the state’s budgetary problems, which have led to cutbacks in state funding for healthcare services, education, and a variety of essential services.

According to the Anderson Forecast, an independent trend-monitoring report issued by UCLA, here’s how things look for California’s overall employment picture in the coming year:

“Writing about California, UCLA Anderson Senior Economist Jerry Nickelsburg notes that despite the recession having officially ended, California’s unemployment rate continues to rise, while local governments continue to shed jobs. The outlook for the balance of 2010 is for little or no growth in the state, with the economy picking up speed slightly by the beginning of next year . . . The unemployment rate – currently at 12.5% – will fall slowly through the balance of this year and should average 11.8% for 2010. Though the state’s economy will be growing, it won’t be generating enough jobs to push the unemployment rate below double-digits until 2012.”

Double-digit unemployment is no laughing matter. Yet high unemployment does not necessarily translate to fewer jobs for medical billers and coders. Here are some factors to consider if you are thinking about working in the state:

• Hiring is happening. When we visited CareerBuilder.com a few days ago and searched for medical billing and coding jobs in California, we found a total of 445 jobs listed. Employers included Healthport, Hoag Memorial Hospital, La Clinica, Maxim Healthcare, Scan Healthplan, Sutter Health, and the UCI Medical Center.

• California has Medi-Cal, it’s own state-funded healthcare insurance program. Claims for medical service must be submitted not only to insurers and Medicare, but (if patients are participants) to Medi-Cal too. The process of billing claims to Medi-Cal can be complex, which can create a need in the state for medical billers and coders with applicable training.

• California is seeing an increase in the number of urgent care centers and other non-hospital healthcare service providers. One example: According to The Urgent Care Association of America, “the number of urgent care centers in the U.S. grew from approximately 8,000 in February 2009 to 8,700 in February 2010.” Urgent care centers are now dispersed widely through the state of California, as are California chiropractors and other healthcare providers that can hire medical billers and coders.

• The need for healthcare services in California remains strong. Even though the California Hospital Association points to a reduction in state funding for hospitals, there are many positive signs. One is that Kaiser Permanente, one of America’s leading not-for-profit healthcare plan providers, has just announced plans to equip 15 California hospitals with 15 megawatts of solar-generated electrical power by the summer of 2011. That’s a significant investment in the state’s hospital infrastructure.

So, is there a future for you in California? It could well be. To keep aware of hiring in the state, we’d recommend visiting CareerBuilder.com’s page of California job listings for medical billers and coders. It’s a convenient way to monitor some of the available jobs in the state.