Outpatient billing

I suddenly have a project that involves hospital billing (outpatient specialty clinic which would include both the professional and facility charges). Does anyone have any good resources or recommendations on how I can learn quickly the "ins and outs" for this? Websites, books, courses??

Thank you!

Outpatiernt billing

The rules for hospital outpatient billing & professional fee billing are very different. It is not uncommon for the biller to submit both claims, depending upon the agreement with the provider for billing of professional fees. If you have no background in hospital billing, I'm afraid it is not something that you can likely learn in a day. Your will also need to know your payer requirements in this area.
Example: Medicare does not want volume 3 procedure codes on outpatient claims, while some managed care payers require both CPT & volume 3 codes on the claims. I have done training in this area for quite a while. If you need additional information, you can contact me at dsteed9667@aol.com.

Dorothy Steed
CPC-H, CHCC, CPUM, CPUR, CPHM, CPMA, RCC, CCS-P, ACS-OP, CPC-I, CEMC, CFPC, FCS, PCS, RMC, CPAR

Re: Out Pt billing

I'm wondering if anyone has any insight on outpatient billing when it comes to casts/orthopedics. The doc charged a cast application on the professional side. The hospital charged a "procedure fee", the cast, and several small pieces I feel are part of the cast. I know bundling rules are different when it comes to professional vs hospital charges...is this ok?