Month: July 2015

DME Client Checklist: 5 Steps to Prepare for ICD-10

July 28, 2015 Posted on Categories ICD-10

Your Bonafide team has been working hard to prepare for the upcoming ICD-10 transition, which is scheduled to go into effect Oct. 1, 2015. ICD-10 will expand the number of diagnosis codes from 18,000 to 140, The Invisible Guest film online now


We will do everything we can on our end to help ease the transition for our customers. Here is a checklist of what you should be doing to prepare your business for this change. Click here for a visual infographic of this Fifty Shades Darker 2017 movie


1. Assess Your Current Situation
Each DME provider will have a different level of complexity in transitioning to ICD-10. Conduct a charge summary by primary diagnosis code. This will allow you to see how challenging ICD-10 will be for your particular business.

Next, identify all systems and work processes that will be affected by ICD-10. This will likely include documentation, encounter forms, superbills, contracts, and more.

Finally, consider your referring physicians. Remember that the largest challenge you may face as a DME provider is poor coding on their behalf. If they fail to use the correct ICD-10 code, it will be up to your team to find the correct code, which will require additional time.


2. Make a Plan
Once you know how seriously ICD-10 will impact your business, you should create an implementation plan. The countdown starts now, with full implementation going live Oct. 1.

Your plan should map out exactly how you are going to train your staff, prepare your providers, and conduct billing under the new system. Your plan should also evaluate the costs involved in the ICD-10 transition. In addition to training and implementation costs, you should also create a financial cushion to cover cash flow shortages that you may experience during the transition.


3. Communicate
Your implementation plan should include communication strategies for all of the parties with which you interact. In addition to referring physicians, customers and payors, you will also want to consider how you will communicate with your staff, delivery service, billing service, and wholesale suppliers.

Remember that the biggest challenge for DME providers during the transition will be cash flow shortages. This will not always be under your control, and thus you should expect significant hiccups along the way. By preparing communication strategies in advance, you can avoid major problems.


4. Get Started
Your plan should outline how to get started, but definitely don’t wait to begin training your staff. Another key action is to start becoming familiar with the most commonly used code or codes in ICD-10 in your business. You can also start obtaining ICD-10 codes from referring providers.

Depending on how you manage your billing, you will want to talk to Bonafide about how and when we are conducting any system tests. You should also familiarize your staff with the ICD-10 crosswalk mapping.


5. Get Help if You Need it
At Bonafide, we know how stressful ICD-10 is for our customers. We are developing training materials and programs for everyone. If you would like us to conduct a complimentary assessment of your frequently-used codes to let you know how seriously ICD-10 will impact you, then contact us right away. We will also be providing custom consulting, training and crosswalk mapping for a small fee. Please contact us if you have questions!

5 Things Physicians Need to Know About ICD-10

July 20, 2015 Posted on Categories ICD-10

The new ICD-10 requirements will be updated as of October 1, 2015, which will bring the current number of diagnostic codes from 14,500 to 69,700, an increase of 55,200 new codes.

This change will greatly impact your practice efficiency and billing revenue for several months. To minimize the impact, you should educate yourself and your staff today to make the transition smoother in October.

Check out this infographic about ICD-10, and feel free to call Bonafide for a customized ICD-10 analysis, plan and support.


5 Things Physicians Need to Know About ICD-10


1. More Codes

ICD-10 will bring the number of diagnostic codes from 14,500 to 69,700, an increase of 55,200 new codes. This massive increase is mainly due to individual codes being multiplied to increase the detail The Shack movie


2. Laterality Codes

Laterality is a major theme in the expansion of codes under ICD-10. For example, instead of simply coding for a cyst on the eyelid, under ICD-10 providers need to specify the location of the cyst: left, right or bilateral.


3. Anatomical Location Codes

In addition to laterality, providers will be required to specify detail in terms of location of an injury or condition. For example, an arm fracture will now need specific details such as which arm (left or right), precisely where on the arm, and additional anatomical location details.


4. Combination Codes

ICD-10 includes hundreds of combination codes that link symptoms, manifestations and/or complications with a diagnosis. For example, rheumatologists may document the relationship between two conditions using language such as “due to,” exacerbated by,” “with,” or “in” to demonstrate condition severity.


5. Encounter Type Codes

Providers will need to specify whether the encounter is initial (patient receives initial active treatment), subsequent (patient receives routine care during the healing or recovery phase) or sequela (patient receives treatment for complications or conditions that arise as a direct result of a condition).



Q&A with Bonafide: Electronic Submission for Medicare Audits

July 8, 2015 Posted on Categories Billing Service, Documentation

Q: Can I electronically submit my Medicare audits using Bonafide?

A: Yes!

Bonafide has an Electronic Submission of Medical Documentation (esMD) electronic submission of Medicare audits module.

Many of our clients are spending time with Medicare audits. Because of this, we created an esMD solution. This allows you to submit Medicare audits electronically through your Bonafide system. This process shaves off quite a bit of time and shortens your reimbursement time, and the cost is only 5 cents per page! There are no other start up, sign up or maintenance fees.

Using Bonafide’s esMD to electronically submit your Medicare audits is easy:

1. Go to your Claim Filing screen and select the Medicare claim for which you would like to submit the audit.

2. You will see a new tab labeled esMD. Click on this tab.

3. The ordering physician information on the claim is automatically populated, but you may need to enter the Order Physicians License Number.

4. Enter the Case # from Medicare (this is the 30-digit Documentation Case ID Number from the audit letter).

5. Enter the ICN (the 17-digit Medicare claim number from the letter, including the “-“ separator).

6. Attach all supporting compliance documents in a single PDF file (this is something you will need to create ahead of time).

7. Select the appropriate “Audit Recipient/Payor type. Example: RAC, MAC, ZPIC, streaming

8. Once all of this has been entered, simply click “Submit,” and your audit information for that claim will be sent electronically to Medicare/CMS.

Billing Made Better

July 7, 2015 Posted on Categories Billing Service

by Michelle Tohill


Millions of dollars go uncollected every year by physician practices. How much money does your practice leave on the table?


If it’s as much as most doctors, then you have a serious problem. The worst part is that the money is there for the taking – you just need the right billing structure in place to claim it, and that’s where most physician practices lose out.


The fact is that medical practice billing is both science and art, but most medical practices treat it more as a chore. The people who are responsible for your billing are human, which means they will tend to seek out the easiest activities rather than chase down harder tasks. In billing, this means that the easy claims are adequately handled, while the harder claims are often left to die on the vine.


This is why Bonafide focuses on software as the core science of our business. Because the easy claims are automatically handled by our software, our billing team is tasked with the harder activity of chasing down the more difficult claims. This results in consistently higher reimbursement rates. Our software also maintains accountability for every single claim, so our billers are highly motivated to achieve high reimbursement rates.


How is your billing system structured? Do you feel that claims remain under-reimbursed because the easy claims eat up all the time and energy of your billing team? Here are some questions to ask yourself:

1.  Is my billing team/service focusing on just the easy-to-file claims and leaving harder claims un-adressed?

2.  Is my billing team/service accountable? Can they provide me with the information I need to determine their success rate?

3.  Is my billing team/service complaining of being overworked? Do they say they don’t have the time to chase down difficult claims?


If you answered yes to any of those questions, then give us a call so that we can do an A/R analysis of your billing system. We can identify just how much more money you could be making with an integrated software/service solution like ours.

Michelle Tohill is Director of Revenue Cycle Management of Bonafide Management Systems and oversees all billing programs and processes. Her specialty is conducting AR audits to expose inefficient billing practices that fail to fully reimburse physicians for their work. She conducts AR audits and provides Bonafide customers with training and consulting on how to improve every aspect of billing and practice management to maximize revenue.

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Bonafide Management Systems 241 Lombard St.
Thousand Oaks, CA 91360

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