DON SELF'S FREE DOCUMENTS PAGE,

Please help yourself to whatever on this page that you want and please also feel free to donate things to us to share with others, as long as it's not copyrighted. On 6/21, we added a PDF file of all CLIA Waived lab tests. On 5/31, we added the 2007 Medicare Bell-Curve & Utilization numbers and a book of Terminology for Medical-Billing from Steve Verno. We added a Red Flag Policy on 5/21/09 to help you prepare for the Red Flag Laws that went into effect January 1st of this year but will not be enforced until August 1st.


PLEASE NOTE:
I have had problems getting INTERNET EXPLORER to work properly with my webpage. It works great with FIREFOX & SAFARI, but not with Internet Explorer. I had to change the HTML code so that the buttons on the left shows up twice on Firefox & Safari - or it doesn't show up on Internet Explorer if I do not. Please bear with us as we're working on it. If you have a suggestion to improve this appearance - PLEASE let me know. Keith & I can increase almost any primary care doc's income by hundreds of thousands per year - but I am having trouble making this page look great.

NEW WEBSITE REVEALED! CHECK OUT WWW.MEDICALSOURCE.BIZ BY CLICKING ON THE LINK TO THE LEFT. IT'S GREAT!



NOTE - PLEASE READ THIS



Much too often, I hear from people that they "NEED HELP FROM DON & KEITH - BUT THEY CAN'T AFFORD US". That tells me that I'm NOT doing a good job of explaining how we work! 75% of what we do for primary care physician offices that results in them increasing their income by $100,000 to $300,000 a year does NOT cost that practice anything for our consulting. 75%! I can understand that most people reading this at this moment are confused by this because NO ONE ELSE in the country does what Keith and I do. No one! Yet - what can we do to get people to understand that they do not HAVE to continue having trouble paying their bills or struggling to increase their income and that if they just pick up the phone and call us - we can help and we are NOT going to charge them for 3 of the 4 things we do? We use PQRI in a way that no one else does and we do that part of our consulting for doctors - at no charge.

Don Self is Working closely with Keith LaBonte and Medical Source, Inc (see the button on the left), so that we can almost always guarantee a Family Physician, Internal Medicine, Geriatric or Rural Health Clinic that our consulting will increase their annual profits by at least $50,000 or they do not owe us a penny. Most of the time, the guarantee will be over $100,000 - but we do not know this until we perform a FREE one hour analysis with the doctor and manager (see button on left) .

NO ONE ELSE IN THE COUNTRY DOES WHAT WE DO!!!
NO ONE!






Do you feel like the penguin on the left and the insurance carriers are the one on the right?

What-is-the-best-thing-that-has-happened-to-primary-care




Click here to visit MEDICAL SOURCE, INC - IF YOU ARE IN FAMILY, INTERNAL OR GERIATRICS AND YOU'RE NOT USING THE PQRI TO INCREASE YOUR PRACTICE INCOME BY $50,000 TO $400,000 PER YEAR - YOU'RE MISSING THE BOAT AND IT'S COSTING YOU.



Don has a BLOG with an update where he, Angie and Cookie are and where they are going as well as an idea of what is happening in their life on the road in an RV - including photos as well. Find out when they'll be near you by reading the blog




DON'S PAGE HAS BEEN VISITED BY
PEOPLE.







CODERS & MANAGERS, MAKE YOUR JOB EASIER AND QUIT GIVING YOUR DOCTOR AN ULCER OR HIGH BLOOD PRESSURE. E&M Coding is very simple, yet so many only know it to be confusing. Your doctor is trying to do a good job - so make it easier on them by using the E&M Sliderule. I have taught thousands of physicians in the last 9 years using this sliderule and doctors can usually learn all they need to know about E&M documentation within 20 minutes using this tool - and they LIKE it.


Order one for $12.50 plus $2.50 s/h and we'll send it to you with a statement. If you like it - pay the statement. If not, return it and owe nothing. You have nothing to lose. We have sold thousands of these so far.


*******************************************************************

HERE ARE THE FORMS YOU CAME HERE FOR, IN ALPHABETICAL ORDER


If the file is in a format that your browser will not read, you may need to RIGHT-CLICK your mouse on it and click on "SAVE AS" or "SAVE LINK AS" in order to save it to your computer in order to open it in the appropriate program.

***********************************




CHART QUOTE: "The baby was delivered, the cord clamped and cut and handed to the pediatrician, who breathed and cried immediately".



2009 HCPCS CODES in Excel format.

2009 HCPCS CODES in PDF format.


2009 MEDICARE FEE SCHEDULE in Excel format - added 12/6/2008. This will take you to a page listing all 59 files - sorted by state and locality




2009 MEDICARE Global Fee periods RVS in Excel format - 1.4mb

2009 MEDICARE Global Fee periods RVS in PDF format - 364kb




2009 MEDICARE RVS in Excel format. File is about 6.2 mb

2009 MEDICARE RVS in PDF format. File is 498KB




MEDICARE PQRI - see PQRI below -





CHART QUOTE: "Patient has two teenage children, but no other abnormalities. "




99211 PowerPoint Presentation on when it is appropriate and when it is not appropriate to use 99211, by Lori Hoyt - who did an EXCELLENT job on this and donated it to the site

ACRONYMS Used in FEDERAL REGISTER with the 2005 Medicare Fee Schedules

ABN - FOR EVERYONE This is required (since Sept 1, 2008) where Medicare payment is expected to be denied for medical necessity reasons. The revised ABN replaces the 2002 ABN-G (Form CMS-R-131G), ABN-L (Form CMS-R-131L), and NEMB (Form CMS-20007) - in Adobe (PDF) Format (47KB).

ABN Instructions - published by CMS on March 6, 2008 in Adobe (PDF) Format.


CHART QUOTE: Patient has left his white blood cells at another hospital.






ACCOUNTS RECEIVABLE SUMMARY in Excel, donated by Barbara Colburn on 12/29/06.



CHART QUOTE: He had a left-toe amputation one month ago. He also had a left-knee amputation last year.



ANCILLARY INCOME chart listing services that most practices can and should be performing in their office, with income potential and costs, donated by Miheer Shah, Director Strategic Medical Management, Inc./RapidCare on 1/29/07, and updated by Don Self on 1/30.

ASSIGNMENT OF BENEFITS & RELEASE OF INFORMATION STATEMENT CAN BE OBTAINED FROM THE ERISACLAIM.COM WEBSITE THROUGH THE ERISA PROGRAM, thanks to Dr. Jin at the ERISACLAIM.COM website


CHART QUOTE: The patient is tearful and crying constantly. She also appears to be depressed.




Audit Sheets - 4 in one file - in PDF Format. 936,161kb

Audit Tool - Used by Medicare - HGSA - Added 1/15/04 in PDF (Acrobat) Format. 503kb


Audit Tool - Page 1 - Added 5/1/00 in Excel Format, donated by ?.

Audit Tool - Page 2 - Added 5/1/00 in Excel format, donated by ?.

Audit Forms/Instructions
Excellent chart auditing form in Word format, along with instructions, submitted by ?. This form will help you on cpt coding as well as medical documentation.

Audit Worksheet - Emergency Room
This is a very useful (48KB) worksheet (WORD FORMAT) to use, donated by Charlene Burgett, BS,CMA,CMM,CPC,CCP

Audit Worksheet - Establised Patient
(68KB) worksheet (WORD FORMAT), donated by Charlene Burgett, BS,CMA,CMM,CPC,CCP

Audit Worksheet - New Patient
(66KB) worksheet (WORD FORMAT), donated by Charlene Burgett, BS,CMA,CMM,CPC,CCP

Audit Worksheet For Neuro & Ortho
( worksheet (PDF FORMAT), donated by Bonnie Ribble, CPC in June 2008

BELL CURVE (Utilization) DATA FROM MEDICARE from 2005 for all specialties on this one link for all E&M codes CMS calls it utilization data. It is the data that shows by specialty, the E&M codes and volumes of services allowed by Medicare. You can use it to compare your own physicians billing profiles with the national data that cms is using.




BELL CURVE (Utilization) DATA FROM MEDICARE from 2007 for SOME specialties for all E&M codes in Excel file - per specialty:

  • Specialty 01 - General Practice 78kb

  • Specialty 02 - General Surgery 78kb

  • Specialty 06 - Cardiology 71kb

  • Specialty 08 - Family Practice 128kb

  • Specialty 11 - Internal Medicine 87kb

  • Specialty 16 - OB/GYN 57kb

  • Specialty 37 - Pediatrics 57kb

  • Specialty 46 - Endocrinology 78kb

  • Specialty 50 & 97 - Nurse Practitioners & Physician Assistants 112kb

    BC/BS LETTER
    Letters sent by Georgia State Board of Ins. & BC/BS about the automatic downcoding they did. This is the same one that was being faxed by Anne Robinson. It is in PDF format


    Appeal Solutions Advertisement












    Billing Productivity Log in WORD format, donated to this page by ?


    Body Mass Index Table in PDF format, with cross-index, donated to this page by Joey Hilario


    Cardiac Questionnaire for patients to complete. Best used when placed on back side of Symptoms Survey form (also found on this page) in Word by Jason Green.

    Cardiology EP Ticket in Excel

    Cardiology New patient Form in Excel by Jean Stoner.


    CHART QUOTE: On the second day the knee was better and on the third day it had completely disappeared.


  • Cardiology Est patient Form in Excel, also from Jean Stoner Jean did a great job on these forms! (35KB)


    American Medical Billing Association Advertisement The AMBA also help doctors in the following areas: medical coding information, cpt code usage, claim processing data, tips on electronic medical billing, links to billing services, hipaa compliance and HIPAA compliance, denial by carriers, executive healthcare information and more


    CARE PLAN OVERSIGHT FORM used by the physician to record care plan oversight services rendered each month in RTF format.


    CHART QUOTE: She is numb from her toes down.


    CARE PLAN OVERSIGHT FORM
    used by the physician to record total care plan oversight services rendered each month in WORD format, which is necessary for medical reimbursement and proper cpt coding.

    CHARITY POLICY & APPLICATION used by a Radiology practice in Washington that not only explains what the law is about charity write-offs, but also gives you the application and criteria for poverty levels - submitted by Michelle Juette



    CLAIM FORM INSTRUCTIONS FOR NEW CMS 1500 - previously called HCFA 1500 claim form in HTML format, for the new claim form.

    CLIA WAIVED LAB TESTS From CMS, effective for 2009 in PDF format.

    CMS REGIONAL OFFICE Listing in word format, added 3/22/07

    Code Of Conduct and example being used by some offices to show compliance with OSHA, HIPAA, privacy laws, etc. from Joyce Kyle (Indiana)in WORD format.
    Code Of Conduct For Employees in Word format from Daryl Ewing in Houston.

    YOUR DOCTOR IS CONFUSED ABOUT THE CODING DOCUMENTATION REQUIREMENTS - DOWNLOAD SOME OF THE FOLLOWING E&M CODING ASSISTS AND THEN CHECK OUT THE OFFER WE HAVE AT THE TOP OF THE PAGE ON E&M DOCUMENTATION SLIDERULES. YOU CAN ALSO CALL MSI (MEDICAL SOURCE, INC) WHO SPECIALIZES IN ASSISTING YOU IN MEDICAL CODING REVIEW, CPT CODING, CPT CODE USAGE, CLAIM PROCESSING DATA, ELECTRONIC MEDICAL BILLING, HIPAA COMPLIANCE AND MORE



    CODE (E&M) AUDITING FORM - CALLED CODEBUILDER This Word document donated by Michelle Green is excellent and easy to use.

    Coding Card
    & An Out-Of-Office Coding Card from Adel Miles in WORDPERFECT 5.0 format. This does not prevent the office manager from having to go out into the parking lot and checking the forgetfull doctor's car for charge tickets & billing notes left above the visor. Having the correct information is vital for proper claim processing and healthcare reimbursement.

    Coding Correction Card A coding correction card in PDF format, donated by Laura Caperton on 8/15/05

    RiteCode

    CODING, DOCUMENTATION & Healthcare Reimbursement & Committee Proposal regarding CPT CODING in RTF format, submitted by Stephen Myers, M.D.

    CODING, DOCUMENTATION & REIMBURSEMENT & Committee Proposal in WORD format, submitted by Stephen Myers, M.D.



    McVey Seminar Advertisement








    CODING, DOCUMENTATION & REIMBURSEMENT & Committee Proposal in WORDPERFECT format, submitted by Stephen Myers, M.D.





    CODING FLOWCHART FOR CPT CODING SIMPLIFIED in WORD format, comparing AAPC and AHIMA coding certifications, submitted by Jeff Rustucio, added Oct 16, 2002



    CHART QUOTE: Both breasts are equal and reactive to light and accommodation.

    COMPLIANCE OFFICER DESCRIPTION This Word document has 4 different descriptions used and submitted by Cindy Wilkins for all to use and enjoy


    COLLECTION LETTERS



    Collection Letter - Balance Due & in RTF format - donated by Gwen Ousley (5 kb)

    Collections - Collection Agency Check List & in Word format - donated by Gwen Ousley (23kb)

    Collection Letter - Collection Agency Warning Letter & in RTF format - donated by Gwen Ousley (5 kb)

    Collection Letter - Collection Process & in Word format - donated by Gwen Ousley (27 kb)

    Collection Letter - No Response From Insurance & in RTF format - donated by Gwen Ousley (5 kb)

    Collection Letter - Payment Arrangment Letter & in RTF format - donated by Gwen Ousley (4 kb)

    Collections - Physician Notification Form & in RTF format - donated by Gwen Ousley (8 kb)


    Collections - Patient Account Flow Chart & in Powerpoint format - donated by Gwen Ousley (37 kb)

    Compliance Plan for CPT Coding & This text file is a good coding compliance plan by Leslie J, added to the site Jan. 17, 2003

    Compliance Plan & This 32K text file is a product of Sheila, Susan and Todd. Will it keep the HCFA Gestapo from nailing you in an audit? Who knows - but since they put so much work into it - I added it to the page

    Compliance Plan For Medical Billing Services & submitted by Todd on 12/19/98 in Word format.

    CO-PAY, DEDUCTIBLE ∓ WAIVER INSTRUCTIONS & FORM This is an excellent guide, reference and waiver to use on charity cases, submitted by Sherry Straub, in Word format (31K). See also - Charity form above for a different guide to waiving co-pay and deductibles


    CHART QUOTE: "When she fainted, her eyes rolled around the room."


    CONSENT FORM FOR TREATMENT used by the physician to record the patient's consent for treatment in Word format.

    CONSENT FORM (This one is a spoof created by Don) In WORD format.

    CONSENT FORM for TREATMENT OF MINORS(donated by Charlene Burgett) In WORD format.

    CONSULTATION GUIDELINES by Erica Schwalm, at ERICACODES.COM, donated 2/6/07. If you have not visited Erica's website yet, you really should. Her site is www.ericacodes.com

    CONSULTATION REQUEST FORM TO SUPPORT CPT CODING CONSULTS in Word format.

    CONSULTATION REQUEST FOR PAIN OR NEURO FORM in Word format, donated by Carol E. on 6/7/05

    CONTRACT NEGOTIATION EXCEL SPREADSHEET FORM for ANESTHESIA in Excel format, donated by Michele Howell in Feb 2003.


    CHART QUOTE: Whilst in Casualty she was examined, X-rated and sent home.

    CO-PAY-LETTER to send to insurance carriers notifying them that the policyholder has not paid the co-pay or co-insurance in Word format, donated by Laura Bassett, RMM in August of 2007 .





    C.P.O. (CARE PLAN OVERSIGHT) FORM used by the physician to record care plan oversight services rendered each month, in RTF format. This form is necessary if you intend to bill for G0179, G0180, etc...

    C.P.O. (CARE PLAN OVERSIGHT) FORM used by the physician to record total care plan oversight services rendered each month, in WORD format.

    Critical Care Template - CICU FORM used submitted by Diane Brooks in WORD format.

    Critical Care Template - MICU FORM used submitted by Diane Brooks in WORD format, which is needed for CPT code 99291.

    CLICK HERE TO SEE HOW DON HAS A BETTER THAN 86% SUCCESS RATE, WITH HUNDREDS OF PHYSICIANS IN GETTING RID OF MIGRAINE HEADACHES WHEN PATIENTS HAVE AT LEAST ONE A WEEK

    DEATH PRONOUNCEMENT and whether you can bill for it or not (In WORD format) thanks to Gregory L. Schnitzer, RN, CPC, CPC-H, CCS-P, RCC.

    DIAGNOSIS POINTER (block 24E) instructions from Medicare, (pdf format) thanks to Karen Hurley

    DIAGNOSTIC TEST INTERPRETATION rules of Medicare
    for ERs - telling Medicare to pay for the interp actually used in the treatment and not just an interp used as quality control. Radiologists will not like this rule that most people are not aware of. In PDF format - from CMS MCM 15023.

    DIAGNOTIC TEST SUPERVISION REQUIREMENTS BY Medicare in Program Memorandum B-01-28, dated 4/19/2001 (In Acrobat - PDF format)

    DISCHARGE FROM NURSING HOME LETTER from HCFA (In PDF format)

    DIVORCE LETTER FOR PATIENTS in Word format - from Don

    DIVORCE POEM FOR PATIENTS in Word format - from Don


    CHART QUOTE: "The patient states there is a burning pain in his penis which goes to his feet."

    Drug Codes (HCPCS) - Table of Drugs in Microsoft Word format - - Added 5/17/02 (213 kb)

    Drug Dispensing Guidelines for California in Microsoft Word format - - Added 3/10/03 - by George Ward

    Drug Pricing by NDC in Microsoft Excel format in a zipped file. This Excel file is 3.5 megs when unzipped and 957kb when zipped. It was donated to the site by Jacqueline C. Langlois, RN, MSN, CRNI with Mass Med Legal. - - Added 3/24/02

    E & M DOCUMENT TABLE This nifty table was submitted by Deb Martinez on 10/7/99 and many will find this easy to use.





    E & M AUDIT SHEET This form submitted by Mary Thomas in WORD format.


    CHART QUOTE: "Patient was released to outpatient department without dressing."

    E & M HISTORY This form submitted by Stephanie L. Fiedler, CPC, ASC-EM and it is in WORD format.


    E & M WORKSHOP HANDOUT - - - This is the 34 page seminar workbook Don drafted up (garnering info from everyone I could) in Word format (135kb) (106KB).



    E&M Utilization files - see UTILIZATION PER SPECIALTY for the link to a special page.

    Emergency Medicine Documentation Guide in Word for Office 95 format by Martin Gottlieb called 1998doc.doc. (141kb)

    Emergency Room Acuity worksheet in Excel format, donated by Mimi Tytko (19kb)
    Emergency ROOM Acuity worksheet in Word format, also donated by Mimi Tytko (63kb)

    Emergency ROOM Code Utilization listed by State on ERCODER.COM website run by Todd Thomas, whom I trust more than any other for ER coding answers, added 10/6/06.

    EMPLOYEE QUIZ - A quiz (in WORD format) to give to prospective employees or to use to test your existing employees donated to the list by Deb Lief in Fort Worth. Be careful though that some lane brane prospective employee with an IQ equal to their shoe size doesn't hire a liberal ACLU certified attorney (looking to save the world for people that refuse to accept personal responsibility) to sue you if they fail the test

    EMPLOYEE QUIZ - The same quiz described above in TEXT format

    EMPLOYEE REPRIMAND FORM - This form can be used when warning an employee about improper behavior or when you're not satisfied with their job performance in WORD format

    ENCOUNTER FORM - An EXCELLENT encounter form to use for documentation that prompts the doctor to document all healthcare reimbursement elements needed for the E&M encounter in Word Format called encountr.doc by Sandy Turpin.

    Encounter Form Maker Link Encounter Form Maker is one of the easiest programs we have seen for helping offices prepare, update and design superbills and encounter forms. I've created hundreds of different superbills in my earlier career as a Superbill salesman with Controlo-o-fax, and I only wish I had this program back then.

    DON BELIEVES YOU CAN HELP 75% OF YOUR PATIENTS WITH MIGRAINE HEADACHES REDUCE OR ELIMINATE THEIR HEADACHES WITHOUT PILLS, INJECTIONS OR PROCEDURES. CLICK ON THE MAN ABOVE TO READ ONE PAGE DON HAS AND THEN YOU CAN COME BACK TO THIS PAGE.


    ENCOUNTER FORM 2 - Another EXCELLENT encounter form to use for documentation that prompts the doctor to document all elements needed for the E&M encounter in Word Format donated by Deborah Hill in Georgia.

    ER ACUITY WORKSHEET submitted by Jennie, in Word Format. (63k)

    ER Audit Worksheet
    This is a very useful (48KB) worksheet (WORD FORMAT) to use, donated by Charlene Burgett, BS,CMA,CMM,CPC,CCP

    ER INTERPRETATION rules of Medicare
    for diagnostic tests - telling Medicare to pay for the interp actually used in the treatment and not just an interp used as quality control. Radiologists will not like this rule that most people are not aware of. In Word format - from CMS MCM 15023.


    CHART NOTE: "The patient has no past history of suicides."


    ER VISIT FORM , in Excel Format. (19k)

    ERISA - HOW TO APPEAL YOUR CLAIM AND MAKE THE CARRIERS PAY YOUR CLAIM IN FULL (NOT JUST ALLOWED OR UCR) USING THE 1974 LAWS IN PLACE THAT THEY HAVE TO OBEY. CLICK ON THE IMAGE BELOW, AND YOU WILL BE SURPRISED. YOU'LL PROBABLY WIN ON AT LEAST 80% OF YOUR APPEALS - REGARDLESS OF THE REASON FOR DENIAL OR REASON THEY REDUCED THE PAYMENT.
    BE HAPPY




    EVALUATION FORM FOR EMPLOYEES - A tongue-in-cheek employee evaluation form in WORD format by Don - feel free to add to, modify or alter this form. It's not copyrighted.

    FAMILY MEMBERS WHO MEDICARE DOESN'T ALLOW YOU TO BILL in WORD format



    < FLUOROSCOPY CODE APPEAL in WORD format, donated by Linda at Desert Pain Institute (with names changed by Don)



    GENERAL, MUSCULAR, NEUROLOG. & URINARY 4 separate EXCEL files designed with General , Muscular, Nuerological and Urology in mind by Maureen McGee.
    General Exam - (36kb)
    Muscular Exam - (38kb)
    Neurological Exam - (35kb)
    Urological Exam - (36kb)


    CHART QUOTE: "Patient was becoming more demented with urinary frequency."

    GLOBAL FEE PERIODS - 2007 in Excel format. File is about 1.5 mb




    HARDSHIP LETTER AND APPLICATION Form in Word format by Linda Sauls

    Hardship Waiver form for Medicare patients in Word Format. (21kb) added 4/23/02

    HCFA 855 Reassignment of Benefits Form in PDF (Acrobat) Format.

    HCFA Medicare Par Agreement Form in PDF (Acrobat) Format.

    HCFA Specialty Code Listing in PDF (Acrobat) Format.

    HCFA Medicare Request For Review (Appeal) Form in PDF (Acrobat) Format.

    HCFA Memo re. E&M documentation from Dr. Kanoff submitted by Linda Howrey in Word Format. If you prefer - you can have it in TEXT HCFA'S memo format. I have to say - in all of the time I've seen stuff from Linda - I've never seen it incorrect - she's one of the brightest bulbs on the Christmas tree





    HCFA's 2002 E&M PROPOSALS submitted by Charlene Allen in Word Format. (88k)

    HIPAA BUSINESS ASSOCIATE AGREEMENT (BAA-2008) in WORD format, donated by Robin at Physicians Choice Medical Billing

    HIPAA COMPLIANCE 101 FOR PROVIDERS FROM CMS in pdf format. This is supposed to be posted on CMS' website soon, but CMS sent it to us early.

    HIPAA COMPLIANCE BUSINESS ASSOCIATE AGREEMENT (BAA) in WORD format

    HIPAA COMPLIANCE B.A.A. (Business Associate Agreement) 4 PAGE in WORD format, donated by Dr. Herbert Schwarz - He does HIPAA consulting with HIPAA TODAY. This file was added March 13, 2003

    HIPAA CONFIDENTIALITY AGREEMENT (CA) & NON DISCLOSURE AGREEMENT in WORD format, (2 PAGE) donated by Dr. Herbert Schwarz - This file was added March 11, 2003

    HIPAA FAX COVER SHEET in WORD format, created by Don as humor.

    HIPAA FAX COVER SHEET in WORD format.

    HIPAA NPP (NOTICE OF PRIVACY PRACTICE ACKNOWLEDGEMENT form for the patient to sign in WORD format, donated by Terri Ristem - added Dec 3, 2008

    HIPAA NPP (NOTICE OF PRIVACY PRACTICES in WORD format, also donated by Terri Ristem December 3, 2008

    HIPAA NPP (NOTICE OF PRIVACY PRACTICE 2 PAGE final in WORD format, donated by Jennifer Humbert - added March 10, 2003, and required if practices intend to be HIPAA COMPLIANT.

    HIPAA NPP (NOTICE OF PRIVACY PRACTICE) 2 PAGE in WORD format, donated by Kathy Pfaff, R.N., B.S.N., M.B.A. - added March 11, 2003

    HIPAA NPP 2 PAGE - GEORGIA DEPT OF COMMUNITY HEALTH in WORD format, donated by Ruth Carr - added March 13, 2003

    HIPAA NPP 2 PAGE - GEORGIA SHBP in WORD format, donated by Ruth Carr - added March 13, 2003


    CHART QUOTE: "The patient's past medical history has been remarkably insignificant with only a 40 pound weight gain in the past three days."


    HIPAA NPP 2 PAGE - GEORGIA PEACHCARE FOR KIDS in WORD format, donated by Ruth Carr - added March 13, 2003

    HIPAA NPP ANOTHER 2 PAGE - for PHYSICIAN OFFICE in WORD format, donated by Merry Schiff - added March 12, 2003

    HIPAA NPP 2 PAGE - WOMEN'S HEALTH CLINIC in WORD format, donated by John Carrico, CMC - added March 12, 2003

    HIPAA NPP 2 PAGE - 3 Column in WORD format, - donated by Melissa Cornwell - added March 11, 2003

    HIPAA NPP 3 PAGE draft in WORDPERFECT format, donated by Sharyne Harper - added March 2003

    HIPAA NPP 4 PAGE in WORD format, donated by Malinda Butson - added March 11, 2003

    HIPAA NPP 6 PAGE in WORD format, geared towards Oncology, donated by Eileen Peterson. - added March 11, 2003

    HIPAA NPP 7 PAGE in WORD format, donated by Dr. Herbert Schwarz - He does HIPAA consulting with HIPAA TODAY and his phone is 714-838-4259 (O). This file was added March 11, 2003


    CHART QUOTE: "The patient experienced sudden onset of severe shortness of breath with a picture of acute pulmonary oedema at home while having sex which gradually deteriorated in the emergency room. "


    HIPAA NPP in SPANISH using WORD format, donated by Cindy Weston with The American Medical Billing Associaton (AMBA)- Their site is http://www.ambanet.net.

    HIPAA PRIVACY TRAINING requirements in WORD format, donated by Eric Sandham, CPC - added October 2002

    HIPAA SECURITY POLICIES & PROCEDURE in WORD format, donated by Gene Teglovic, at Healthcare Office Automaters

    HIPAA SUMMARY - 4 pages in MS Works format, donated by Pam Mauerhan - added October 2002

    HIPAA TRACKING FORM - donated by Valeta Barger

    HIPAA SUMMARY - 4 pages in WORD format

    HISTORY form for getting the health history from patients. This form is easy to use and modify and was donated by Debbie Foren in June 2000

    HOMEBOUND PATIENT RULES BY MEDICARE in WORD format. Medicare IOM 100-02, 15, 60.1A

    HOSPITAL CUTBACKS MEMO - humorous in WORD format



    CHART QUOTE: "By the time he was admitted, his rapid heart had stopped, and he was feeling much better. "



    HOSPITAL DISCHARGE MANAGEMENT CODING MEMO PER CMS, donated by Diane Brooks. This letter in pdf format is dated in 1991 from CMS

    HOSPITAL HCFA'S RULES RE. CLASSIFYING ENTITY AS HOSPITAL OUT-PATIENT OR PHYSICIAN CLINIC

    HPI Letters discussion whether it is allowed to count one item notated in the documentation under both, the HPI and the ROS. One of these letters is from Bart McCann, who used to be with HCFA. It is in PDF format, so you will need Adobe Acrobat or Acrobat Reader. This is vital to know for proper claims processing and Healthcare Reimbursement



    CHART QUOTE: "Many years ago the patient had frostbite of the right shoe. "





    If you know someone suffering from IBS - check out LEAP on the top left menu on this page - We have a better than 81% success rate!

    ICD9 CODING Pocketbook in Word format by Jaime Darling, CPC (444kb)









    IM - FP New Patient Form in Excel format by Jean Stoner (32 KB)



    IM - FP Established Patient Encounter Form in Excel format by Jean Stoner (29KB) - -



    INCIDENT TO LETTER FROM MGMA in Acrobat format, donated by Dianne Wilkinson (39kb) - -



    INCIDENT TO - SHARED VISIT GRID in Word format, donated by Wanda Woman (107kb) - -



    INFLUENZA COVERAGE RULES - BY MEDICARE in Word format - - -


    INJECTION CODES - 2003 HCPCS LEVEL 2 INJECTION CODES with AWP AMOUNTS (Medicare-allowed) in Excel format - - -


    INSURANCE ONLY - WHY YOU SHOULD NOT ROUTINELY WAIVE CO-PAYS AND/OR DEDUCTIBLES- quoting the Kennedy vs Connecticut General case and others in Word format - - added 11/27/03 -



    INSURANCE WITHDRAWL LETTER TO PATIENTS - notifying the patients that you're withdrawing from their HMO or insurance plan in Word format

    LAB ICD9 DIAGNOSIS CHEAT SHEET - THIS IS THE FORM - IN WORD 97 FORMAT - THAT ADEL MILES HAS BEEN FAXING TO PART B LISTSERV MEMBERS ALL OVER THE COUNTRY. IT IS CALLED LABDX.DOC - - -


    LISTSERV INFORMATION


    click here to sign up for the

    PROFESSIONAL MEDICAL OFFICE MANAGEMENT listserv

    that Don Self manages. It's free and it is a great way to network with other offices about Healthcare Reimbursement, medical billing and claim processing as well as executive healthcare issues. We discuss medical coding information, cpt code usage, claim processing data, tips on electronic medical billing, links to billing services, hipaa compliance and HIPAA compliance, denial by carriers, executive healthcare information and more.



    One of the ways that Don stays on top of changes is through Internet Listservs. This link will take you to a site that not only has a listserv for just about any specialty, and they also deal with medical coding information, cpt code usage, claim processing data, tips on electronic medical billing, links to billing services, hipaa compliance and HIPAA compliance, denial by carriers, executive healthcare information and more



    but also they publish some excellent newsletters, publications and consulting.

    For the very best in Podiatry coding, medical billing, claim processing and healthcare reimbursement business matters, you have to be a member of the Codingline community, run and managed by one of the very best in the business - Harry Goldsmith, DPM



    LOCALITIES - MEDICARE in Excel format, listing the different carriers, carrier numbers, localities, states, etc.


    MANAGED CARE CONTRACTING TIPS & the top 10 reasons why you should tell Mangled care companies NO, in WORD format, donated by Patricia Nelson


    MEDICAL RECORDS COPYING CHARGES BY STATE listing all of the state laws/recommendations by state on attorney Thomas Lamb's website


    MEDICAL RECORDS TRANSFER policy and fees


    MEDICARE CARRIER LISTED BY ZIP CODES in EXCEL format, updated 5/13/2008.




    MEDICARE CLIA WAIVED CODES & GRID in EXCEL format, added to site 7/25/05, thanks to Donna Beaulieu.




    MEDICARE CONVERSION FACTORS - 1996 - 2005 in WORD format



    MEDICARE COVERED PREVENTIVE SERVICE CHECKLIST in Excel format, dated 1/7/05 from Charlene Burgett,BS,CMA,CMM,CPC,CCP




    DON'S PAGES HAVE BEEN VISITED
    TIMES

    MEDICARE COVERED PREVENTIVE SERVICE MATRIX in Excel format, dated 12/31/04 from Charlene Burgett,BS,CMA,CMM,CPC,CCP




    MEDICARE CROSSOVER LISTING - TEXAS in WORD format, dated 11/03 from CMS




    MEDICARE DOCUMENTATION POINTER in txt format, from Medicare's site


    MEDICARE EOB REMITTANCE CODES in PDF format, dated 11/03 from CMS

    MEDICARE ENROLLMENT FORMS (CMS 855 FORMS) UPDATED 4/30/2006 (EARLIER VERSIONS NOT ACCEPTED AFTER 6/1/06)






    CMS uses five different provider and supplier enrollment applications. In general, Part A providers that bill fiscal intermediaries (see list below) are required to use the CMS-855A to enroll or update their enrollment information; physicians and non-physician practitioners (see list below) are required to use the CMS-855I to enroll or change their enrollment information; other Part B suppliers (see list below), except suppliers of Durable Medical Equipment, and Prosthetics, Orthotics, and Supplies (DMEPOS), are required to use the CMS-855B to enroll or update their enrollment information; and DMEPOS suppliers are required to use the CMS-855S to enroll or update their enrollment information.

    In addition to the enrollment applications described above, individual practitioners who would like to reassign their benefits to an eligible provider or supplier or terminate an existing reassignment agreement would use the CMS-855R.

    You should file a CMS-855A with the designated CMS fee-for-service contractor (i.e., fiscal intermediary) if you would like to enroll your organization in the Medicare program as one of the following types of providers.

  • • Community Mental Health Center
  • . Comprehensive Outpatient Rehabilitation Facility
  • • End-Stage Renal Disease Facility
  • • Federally Qualified Health Center
  • • Histocompatibility Laboratory
  • • Home Health Agency
  • • Hospital
  • • Hospice
  • • Indian Health Services Facility
  • • Organ Procurement Organization
  • • Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services
  • • Religious Non-Medical Health Care Institution
  • • Rural Health Clinic
  • • Skilled Nursing Facility

    You should file a CMS-855I with the designated fee-for-service contractor (i.e., carrier) if you would like to enroll in the Medicare program as one of the following types of suppliers.
  • • Physicians (all specialties)
  • • Non-Physicians
  • o Anesthesiology Assistant
  • o Audiologist
  • o Certified Nurse Midwife
  • o Certified Nurse Specialist
  • o Certified Register Nurse Anesthetist
  • o Clinical Social Worker
  • o Mass immunization, roster biller (individual only)
  • o Nurse Practitioner
  • o Occupational Therapist in private practice
  • o Physical Therapist in private practice
  • o Physician Assistant
  • o Psychologist, Clinical
  • o Psychologist, billing independently
  • o Registered Dietitian or Nutrition Professional

    You should file a CMS-855B with the designated fee-for-service contractor (i.e., carrier) if you would like to enroll in the Medicare program as one of the following types of suppliers.

  • • Ambulance Service Supplier
  • • Ambulatory Surgical Center *
  • • Clinic and Group Practices
  • Hospital Departments
  • Multi-Specialty Clinic
  • Public Health/Welfare Agency
  • Physical/Occupational Therapy Group in Private Practice
  • Single Specialty
  • • Independent Clinical Laboratory
  • • Independent Diagnostic Testing Facility *
  • • Mammography Center
  • • Mass Immunization - roster biller only
  • • Portable X-ray Facility *
  • • Radiation Therapy Center
  • • Slide Preparation Facility
  • • Voluntary Healthy/Charitable Agency

    * denotes that a site visit or state survey is typically required.

    You should file a CMS-855S with the National Supplier Clearinghouse if you would like to enroll as a supplier of durable medical equipment, and prosthetics, orthotics, and supplies

    Medicare Enrollment - 855A - HealthCare Providers that will bill Medicare fiscal intermediaries (cms855a.pdf) in PDF.


    Medicare Enrollment - 855B - HealthCare Providers that will bill Medicare carriers (cms855b.pdf) in PDF

    Medicare Enrollment - 855I - Individual Health Care Practitioners (cms855i.pdf) in PDF .

    Medicare Enrollment - 855R - (cms855r.pdf) in PDF .


    Medicare Enrollment - 855S - (cms855s.pdf) in PDF .



    Medicare Enrollment - Individual Reassignment of Benefits (cms855r.pdf) (314 kb) in PDF (Acrobat) Format.

    Medicare Enrollment - DMEPOS Suppliers (cms855s.pdf)(911 kb) in PDF (Acrobat) Format.

    Medicare Enrollment - 855 Change of Information Form in PDF (Acrobat) Format.
    MEDICARE FEE SCHEDULE for 2009in Excel format - added 12/6/2008. This will take you to a page listing all 59 files - sorted by state and locality




    (a href="http://www.medicarenhic.com/providers/pubs/mentalhlth_apr07.pdf">

    Medicare Mental Health Services Billing Guide from NHIC Medicare in pdf format

    Medicare National Coverage Determinations (NCD) Coding Policy Manual & Change Report (April 2006) Suffix descriptions in PDF format.

    Medicare Patient HIN (Healthcare Identifier Number) Suffix descriptions in WORD format.

    Medicare Remittance Remark Codes dated Aug. 5, 2004 in Word format.


    MEDICARE Secondary Authorization form in Word format donated by George Ward.

    MEDICARE Secondary Payer Resource Guide in PDF format donated by Joel Shaffer.

    Medicare Status Codes - as found on Medicare's Global Fee and RVU pages in Word format - - -

    MISSOURI HPSA LOCALITIES Non-Metropolitan & Metropolitan HPSA areas in Missouri as of March 1, 2004.







    MODIFIER 25 - LETTERS from Kathleen Buto of HCFA in text format submitted by Jan Rasmussen- - -

    MODIFIER 25 (CPT CODING) NOT REQUIRED IF PROCEDURE HAS NO GLOBAL - Instruction from CMS to Medicare carriers in WORD format

    MODIFIER 25 (CPT) APPEAL LETTER - NEW PATIENT - Appeal Letter in WORD format. - Added 7/27/99 -

    MODIFIER 25 APPEAL LETTER - ESTABLISHED PATIENT - Appeal Letter in WORD format. - Added 7/27/99 -

    MODIFIER 57 APPEAL LETTER - Another letter in WORD format to appeal CPT modifier 57 denials.

    MODIFIER 57 CHART - To help you decide whether you want modifier 57 or modifier 25 on the claim in RTF format, donated by Linda Weiss.

    MODIFIER REFERENCE LISTING - IN WORD FORMAT submitted by Vinod Gopal on 12/31/04



    Multiple E&M Services in One Day - How to Code & Bill This is a link to the Code-Ryte website to an article written by one of the sharpest consultants in our country, Greg Schnitzer


    Multi-Specialty Exam Form in Microsoft Word/Wordpad format in a self-extracting file by Bill Cox (21KB) This is not a test you give physicians to see if they can name all the specialties



    YOU GOTTA LAUGH


    New York, NY
    During a police lineup, a detective told each man to step forward and repeat the threat delivered at the robbery: "Give me all your money or I'll shoot." One man stepped forward and yelled, "That's not what I said!"



    National Drug Pricing by NDC in Microsoft Excel format in a zipped file. This Excel file is 3.5 megs when unzipped and 957kb when zipped. It was donated to the site by Jacqueline C. Langlois, RN, MSN, CRNI with Mass Med Legal.

    Nerve Conduction Studies & Office Visits instructions from Medicare in Word format.


    New Patient Definition by a Medicare carrier in Kansas/Nebraska/NW Missouri. This document file contains an excerpt from their September 1999 Special Bulletin - submitted to this site by Savannah Seins, CPC in August 2000.

    New Patient History Form in WORD DOCUMENT format (41KB) It has the standard questions such as "Were you born? Did you have a mother? Have you made out a will?"

    New Patient Form in WORD DOCUMENT format in a self-extracting file (21KB)

    NonCovered Procedure List from Medicare Florida submitted to this site by Murugesh in May 2000.

    NO-SHOW Information regarding Medicare and CMS, added 4/15/08, thanks to Cyndee Weston with the American Medical Billers Association


    NO-SHOW Divorce Letter to patients to explain why you're divorcing them in WORD DOCUMENT format (20KB) Added 4/23/02

    NO-SHOW Referral Letter to other physicians that requested you perform a consult, informing them that their patient never showed up for the appointment in WORD DOCUMENT format (20KB) Added 4/23/02

    OB/GYN Guide in WORD 97 format by Judy Harris. (39KB) - -

    OB/GYN Guide in TEXT format by Judy Harris. (8KB) - OK - one bit of advice to the guys .... If you're wife's expecting and you're going to be in the room with her when she gives birth - remove your wedding ring before you put the scrubs on - It will save you some pain - BELIEVE ME!!!


    OP NOTES TEST in WORD format by Chris Felthauser

    OP NOTES TEST ANSWERS in WORD format by Chris Felthauser

    OUT-PATIENT BILLING GUIDELINES in TIF format , donated by Karen Craig


    Patient Financial Responsibility form in WORD format, shared with others by Barbara Colburn 1/12/07

    Patient Registration Form in WORD format, shared with others by Anne Hillmann, and modified by Don on 9/6 - -

    Patient Registration Form in WORD format, in English, modified by Don- -

    Patient Survey in EXCEL format from Heidi Joseph - -

    Patient Survey - Humorous in EXCEL format from Don Self - -

    Payment Plan & Promissory Note in PDF format from Lisa Scott, CPC with Carolina Bone & Joint - Sept 2006 - -

    Pediatric Attending Form in TEXT format by Belinda Dixon (3kB) -


    Phone Form for recording the information you take on a new patient when they call in for the appointment. This form was donated by Lori Wyvill. You have your choice of downloading it in Word or Wordperfect format.

    Physician Family Rules of Medicare listing which family members that physicians are not allowed to bill Medicare for, added 2/4/04

    Physician Request Form for hospital services, submitted by Tammie Lewis

  • Word Format (14kb)
  • Wordperfect format (19kb)
  • Excel format



    Physician Retirement Letter to patients, informing the patients of the retirement, added 4/24/02



    Physician Supervision of Diagnostic tests rules added 11/24/05, in pdf format



    PLACE OF SERVICE (POS)codes in PDF format from Don Self - updated with Oct 1, 2003 codes from CMS-

    PODIATRY GLOBAL FEE PERIODS submitted by Ayshea Kumar, CPC ON 3/3/05 in Excel format

    PODIATRY LISTSERV - FREE TRIAL OFFER CodingLine has more than a dozen coding experts (most of which are Podiatrists, Seminar Leaders and Consultants). By clicking on this link, you will be taken to a site where you can sign up for a free trial of this Podiatry Listserv. Since it's free - you have nothing to lose by checking it out.

    PODIATRY DIAGNOSIS CODING LIST submitted by Jennifer Hila - - (28kb)






    PODIATRY PROCEDURE CODING LIST submitted by Jennifer Hila (29kb)

    PODIATRY PROCEDURE COVERAGE LIST submitted by Danielle Taimuty, CPC

    PODIATRY INITIAL PROGRESS SHEET in WORD format by Alan ? - This looks like an easy to use form for Podiatrists.

    PODIATRY FOLLOW-UP PROGRESS SHEET in WORD format by Alan. - -

    PQRI List 2008 & Instructions from CMS in PDF. This has 131 PQRI measures- -

    PQRI List 2009 & Instructions from CMS in PDF. This has 153 PQRI measures - -

    PRACTICE MOVING/RELOCATING CHECKLIST in an Excel file, donated by Laura Carbonaro in December 2003

    PRACTICE STARTUP CHECKLIST in a word file, donated by Mike Farley Dec 2003

    PRACTICE STARTUP CHECKLIST - in an Excel file, donated by Patricia McKinnon

    PRACTICE STARTUP CHECKLIST - ANOTHER ONEin a Word file, donated by Andy Arnold in Dec 2003

    PRE & POST OPERATIVE PERCENTAGES FOR 2000 MEDICARE in an Excel file, which also includes the 2000 global fee periods.

    PREVENTIVE MEDICINE Guidelines from Medicare - created in October 1999 and submitted to this site by Sharon Smith.

    PRIVACY LAWS BY STATE giving Minor Consent and Parental Disclosure laws per sate. This is at healthinfolaw.org

    PROGRESS NOTE FORM from Deb Martinez - submitted 12/30/99.

    PROMPT PAY LAWS BY STATE in Word format, submitted to the site by Donna Ryan in October 2003. -

    QUICK PAY DISCOUNT policy in an RTF file, FROM R. Lacy in Tampa Bay, FL.

    RECORDS RETENTION REQUIREMENTS in WORD format by Henry Hawthorne II(14kB) - -

    Records Review Checklist for a Managed Care Review donated by Jean Bowman - -

    RED FLAG LAW POLICY & PROGRAM Form in PDF format. The new 2009 Red Flag - Identify Theft laws went into effect January 1st, to help ensure that patient identify theft is guarded against and it does apply to medical offices - including the 1 doctor practices. The enforcement date changed from May 1st to August 1st - but you need to establish some kind of policy in your office before August 1st and this is an example you're welcome to use and change to suit your needs - for free - from Don - -

    REFERRAL TRACKING Form in WORD format (14kB) - -

    Refund Laws state-by-state, with references - This is a link to a site by Leslie Johnson, CCS-P, CPC

    REFUNDING PATIENT LAWS link & Unclaimed Property laws in each state. This link was submitted by Cyndee Weston with the American Medical Billing Association and gives you laws in each state that require you to refund patients promptly, and what to do if there are unclaimed amounts (NO! You don't get to keep the money)

    Refund Request Response letter Excellent Letter - in WORD format- -(10kb) - This one really kicks the insurance carriers in the butt! If you like it - you should check out www.appealsolutions.com as they have these specific to each state!

    Release of Information Request Authorization in Word format to have patients sign -(32kb) - added 4/23/02

    Review Of System form that you have each patient complete on every visit and place into the patient's chart. Not only will you meet every requirement for ROS, but also the PFSH on each visit, as well as serve as a reminder of certain items for the doctor when they are tired and forgot to ask or document by Don Self - in WORD format- -(34kb) -

    SCRIBES CAN BE USED on Medicare patients, per this letter from HCFA in RTF format, called scribes.rtf - donated to the site by Deena Wojtkowski, CMA, CCP

    Signature Form - - Adapted from Medicare's official EXTENDED PATIENT SIGNATURE AUTHORIZATION by Don Self in TEXT format. (2KB)

    Signature Requirements per Medicare carrier HGSA in Word format.

    Signature Regulations - - Per State. This RTF file from Linda Howrey lists the different physician signature requirements. BTW - the letters RTF stands for rich text format

    Site Review Checklist for a Managed Care Site Review donated by Jean Bowman - -

    SMOKING CESSATION CHART giving you coverage by Medicare, coding and recommendations, in Word format, donated by Ronda Scalise in Oct 2005 - -

    SPECIAL HANDLING Instructions, from Wayne Clark, in text format,(3Kb) called ISHL.txt - -

    SPECIAL HANDLING NOTICE , from Wayne Clark, in text format,(1Kb) called SHN.txt - -

    SPECIALTY CODES , for Medicare, in Word format, called SPECIALTY-CODES.DOC- -

    McVey Seminar Advertisement

    SURGICAL CODING FORM - A form for organizing surgical coding for the billing staff (and for the supervising coder to review from).


    SYMPTOMS SURVEY - A form used by Don for all patients, but developed originally for the LEAP program in WORD format


    TAXONOMY CODES FOR HIPAA in WORD format.

    TAXONOMY CODES FOR HIPAA in PDF format.

    TEACHING PHYSICIAN RULES PER CMS in WORD format.

    TEACHING TEMPLATE in an RTF format submitted by Maryann Palmeter on Jan. 26, 99.





    TEACHING TEMPLATE in TEXT format submitted by Maryann Palmeter on Jan. 26, 99.

    Telephone Billing document explaining the codes, by Brenda Beaboutin WORD format.

    TERMINOLOGY - MEDICAL BILLING by Steve Verno, in Acrobat pdf format.

    TIME BASED CODING Presentation in Powerpoint format.

    TYPE OF SERVICE (TOS) Codes for all CPT/HCPCS codes in PDF format, updated 9/14/03 with CMS's list dated October 11, 2002.

    UTILIZATION (BELL CURVE) DATA FROM MEDICARE from 2005 for all specialties on this one link for all E&M codes CMS calls it utilization data. It is the data that shows by specialty, the E&M codes and volumes of services allowed by Medicare. You can use it to compare your own physicians billing profiles with the national data that cms is using.



    UTILIZATION (BELL CURVE) DATA FROM MEDICARE from 2007 for SOME specialties for all E&M codes in Excel file - per specialty:

  • Specialty 01 - General Practice 78kb

  • Specialty 02 - General Surgery 78kb

  • Specialty 06 - Cardiology 71kb

  • Specialty 08 - Family Practice 128kb

  • Specialty 11 - Internal Medicine 87kb

  • Specialty 16 - OB/GYN 57kb

  • Specialty 37 - Pediatrics 57kb

  • Specialty 46 - Endocrinology 78kb

  • Specialty 50 & 97 - Nurse Practitioners & Physician Assistants 112kb



  • Medicare 2005 data showing the top 25 used codes per specialty from MIT Solutions, in zip format.

    LINK TO UPIN WEBSITE www.upin.us/

    WAIVED CLIA LAB TESTS From CMS, effective for 2009
    in PDF format.

    WELCOME TO MEDICARE EXAM SYNAPSIS in Word format, updated 1/4/05, donated by Charlene Burgett, BS, CMA, CMM, CPC, CCP.

    WELCOME TO MEDICARE PATIENT INFORMATION & CONSENT FORM in Word format, updated 3/3/05, donated by Charlene Burgett, BS, CMA, CMM, CPC, CCP, who credits it to Steve Cooper at Towncrest Internal Medicine in Iowa City, Iowa. Thank you Steve!

    WELCOME TO MEDICARE PATIENT QUESTIONNAIRE in Word format, updated 3/7/05, donated by Charlene Burgett, BS, CMA, CMM, CPC, CCP

    WELCOME TO MEDICARE PROGRESS NOTE in Word format, updated 4/26/05, donated by Charlene Burgett, BS, CMA, CMM, CPC, CCP

    WINZIP DOWNLOAD LINK - FREE WINZIP PROGRAM

    WORKERS COMP AGENCIES IN ALL 50 STATES This is a link to another website that lists all of the current agencies, shared to us by Charlene Munt.


    APPEAL SOLUTIONS

    Appeal Solutions has spent hundreds (if not thousands) of hours researching the legal issues concerning Healthcare Reimbursement, medical billing, claim processing, insurance claim collections, insurance appeals and laws to protect the patient and provider. They offer sample letters on their website, copies of letters and software to assist you in winning the fight against carriers


     

    INTELICODE

    is another company that produces an excellent Healthcare Reimbursement coding product. Some prefer this program over others. They are definitely worth checking out.





     

    EMAIL DON

    DON SELF & ASSOCIATES, INC.

    305 Senter Avenue, Whitehouse, TX 75791
    903 372-7529 - fax 480 247-5650



    Legal Disclaimer
    The publication or information on this Website is designed to provide accurate and authoritative information in regard to the subject matter covered. It is presented and published with the understanding that the author and publisher are not engaged in rendering legal, accounting or other professional service or advice. If legal advice or other expert assistance is required, the services of a competent professional person should be sought.

    We're not employees of, or in affiliation with any governmental or regulatory agencies.

    DON SELF & ASSOCIATES, INC is not a law firm. We do not practice law. We are not actors on a law show. If legal action or advice is required to successfully resolve a claim or a claim/business decision, we will refer out our client to an outside legal counsel chosen by our client.

    We do not teach, advise or participate in illegal, unethical or immoral coding & billing practices of your health care claims and practice. We advocate proper coding, billing and reimbursement techniques applicable to federal and state laws.

    We have assisted the OIG and CMS in identifying fraudulent billing activities and will continue to assist law enforcement to curtail illegal, immoral and unethical billing practices. Accordingly, we are also aware of the OIG: Special Advisory Bulletin: Practices of Business Consultants [PDF]

    [http://oig.hhs.gov/fraud/docs/alertsandbulletins/consultants.pdf]

    The Office of Inspector General (OIG), Department of Health and Human Services, June, 2001

    END OF DISCLAIMER