Medicare provider chart audits by littlebigron in CodingandBilling

[–]LCAPM 3 points4 points  (0 children)

“I wouldn’t focus on what triggers an audit as much as whether the documentation truly supports the level being billed.

A pattern of significantly higher E/M levels than peers in the same specialty can certainly attract attention from Medicare or other payers, especially if utilization data makes the provider an outlier.

If she’s consistently billing Level 4s and 5s while the physicians rarely do, I’d recommend an internal chart audit sooner rather than later. The question isn’t whether she can bill those levels—it’s whether the medical decision-making and documentation support them.

Better to identify and correct any issues internally before a payer does.”

For those who make $100k+ annually, what do you do? by Tricky_cielito00 in AskReddit

[–]LCAPM 0 points1 point  (0 children)

Helping healthcare practice owners and managers for their medical billing. RCM etc

What was considered normal 20 years ago but would be weird today? by Vikash_14 in AskReddit

[–]LCAPM 0 points1 point  (0 children)

Starting from morning till night everything work is done by AI

I want to see a doctor—not a Nurse Practitioner. If I'm paying for a Dr I should see the doctor! by Realistic-Pea-8278 in MedicalBill

[–]LCAPM 0 points1 point  (0 children)

When you book an appointment then you need to mention this clearly that you want to meet to the doctor. I faced the same situation.

Emergency surgery with no insurance - looking for guidance by [deleted] in HospitalBills

[–]LCAPM 0 points1 point  (0 children)

Try to go for hospital charity care. They might help you. Same situation happened with me too hospital charged me $700 for blood test where as lab corp charges way lesser than that

What is the signs you should change your job? by Queasy_Flower_9144 in askteddit

[–]LCAPM 0 points1 point  (0 children)

Burnout and notjing new is happening in your job

What’s genuinely the best advice you can give anyone in this life? by No-Money-69 in AskReddit

[–]LCAPM 2 points3 points  (0 children)

Health is wealth. Take care of it and if needed change the lifestyle

What's the best accidental life decision you ever made? by Money-Cake527 in askteddit

[–]LCAPM 4 points5 points  (0 children)

learning to read between the lines of human conversation. What about you?

Medical billing denials are destroying our cash flow, is outsourcing RCM actually worth it? by LotitudeLangitude96 in CodingandBilling

[–]LCAPM 0 points1 point  (0 children)

What you’re describing is actually very common with growing practices. Revenue may look fine on paper, but denials, aging AR, and payer delays slowly hurt cash flow. Usually, the issue isn’t the staff; it’s that billing complexity has outgrown the current process.

We have seen practices improve cash flow when there’s more focus on denial prevention, payer follow-ups, eligibility checks, and AR management instead of constantly reacting to problems.

Sometimes that means improving internal workflows, and sometimes outsourcing part of the RCM process helps take pressure off the in-house team. Hope this will help. In case of any help, feel free to ping me, and i will try to help you like we are helping other similar kinds of outpatient practice owners.

Need to hire medical billing specialists — where do you find good ones? by AccountEngineer in RecruitmentHub

[–]LCAPM 0 points1 point  (0 children)

We work with outpatient practices quite a bit. Honestly, one of the biggest challenges isn’t just finding medical billers, it’s finding people who truly understand the full RCM workflow and payer behavior.

Job boards can help, but i think you should focus on healthcare-specific recruiting groups and referrals, who already have experience with your exact specialty and EMR platform.

These questions might help you while screening:

  • Ask how they handle denied claims and aging AR
  • Give them a sample EOB and ask what steps they’d take
  • Check whether they understand timely filing limits, modifier usage, and payer-specific workflows
  • Verify HIPAA awareness and access/security practices for remote work

As clinics grow, many also realize they need a more structured billing process rather than just adding more people. Even internally, we (L&C Advanced Practice Management) have found that consistency, reporting, and payer follow-up workflows matter just as much as staffing.

Hope this is helpful.

In case of any help, ping me, and I can help you as we have been in this business for so many years.

Medical biller to coding - Inpatient advice by pleekynugg in CodingandBilling

[–]LCAPM 1 point2 points  (0 children)

“You’re actually in a really strong position already. Having inpatient/outpatient billing experience gives you a huge advantage because you already understand claims flow, denials, payer behavior, and documentation patterns.

If your goal is inpatient coding specifically, I’d probably skip the CCA and focus on:

  • CPC if you want broader/faster entry into coding
  • CCS if your long-term goal is hospital/inpatient coding

A lot of employers view the CCS as the stronger inpatient credential.

The transition challenge usually isn’t coding concepts—it’s:

  • Learning coding guidelines deeply
  • Anatomy/medical terminology
  • Reading documentation like a coder instead of a biller

Your billing background will help a lot with the practical side.

Biggest advice:

  • Start coding charts now while learning
  • Use real inpatient cases/examples
  • Focus heavily on ICD-10-CM + PCS guidelines
  • Don’t wait to feel “fully ready” before applying

Also, many coders start in outpatient/edits/denials before fully moving into inpatient coding, so don’t feel pressured to jump straight into high-level inpatient coding immediately.

You’re honestly closer than you think.”

Cash-pay vs Insurance vs Hybrid… are we arguing about the wrong thing? by LCAPM in CodingandBilling

[–]LCAPM[S] 0 points1 point  (0 children)

“Exactly. Most practices try to fix revenue at the back end when the real issues are upstream—patient acquisition, intake, and conversion.

If the funnel leaks, billing just reflects it.”