Medical Coding Services

Delivering quality healthcare depends on capturing accurate and timely medical data. Physicians can depend on our well trained and reliable medical coders. Our medical coding professionals possess a thorough understanding of the health record’s content and can find information to support or provide specificity for coding. MHS medical coding professionals work in a variety of healthcare settings, including inpatient and outpatient healthcare settings.

• Knowledge of insurance claim and regulatory considerations: New patient interview and check-in procedures; established patient return visits; post-clinical check-out; computerized practice procedure methods.
• Completing cms-1500 and commercial claims: Billing guidelines for inpatient medical, in/outpatient global surgery, minor surgery, and maintenance of a provider's claim files; setting up a filing system for completed claims; determining primary and secondary status; completing common types of claims.
• Knowledge of blue cross and blue shield plans: Features of BCBS plans; correct filing procedure; completing a BCBS claim form.
• Knowledge of medicare: Parts of the Medicare program; eligibility criteria; fee schedule; supplemental plans and managed care; filling out an HCFA 1500 claim form.
• Knowledge of medicaid: Services covered under the federal portion of Medicaid; eligibility; services provided and paid for by state coverage; obtaining preauthorization for services.
• Tricare and workers' compensation: Health care for the military; deductibles, cost sharing and eligibility requirements for TRICARE; filing TRICARE claim forms; workers' compensation programs; classifying on-the-job injuries; preparing a First Report of Injury form; qualifying for workers¹ compensation benefits.
• Icd-9-cm coding: Using the ICD-9-CM coding system; primary vs. Principal diagnosis; ICD-9-CM terms, marks, abbreviations and symbols; index tables.
• Cpt coding: Basic format of CPT Service and procedure codes on the CMS-1500 claim; comparing CPT with ICD-9-CM coding; modifiers; new vs. Established patient; assigning emergency department and critical care codes; consultation vs. Confirmatory visit; preventive medicine visits.
• Hcpcs coding and cms reimbursement: The HCPCS system for reporting professional services, procedures, supplies and equipment; HCPCS level II coding system; CMS reimbursement; rules of the Medicare physician fee schedule payment system.
• Coding for medical necessity: Assessment and coding from patient medical records; securing the correct physician documentation; coding an operative report; selecting and coding diagnoses and procedures from case studies and sample records.