f a procedure is done, or a device is prescribed for a patient by a doctor, shouldn't that be reason enough? Isn't the doctor's word law? Doesn't he know best? Well, maybe he does as far as medicine goes. As to medical billing, that is a different story. See, while the doctor may feel that a certain procedure or device is needed for theIt's a strange world we live in. We expect most things to be a simple matter of ABC. We don't want to have to think. We don't want to have to go outside the box to figure things out. We want it all laid out there for us in plain simple to follow steps. The medical billing world is no different. Medical billing persons don't want to have to think. Just give me the info that I need to get the bill out and move on to the next claim. Unfortunately, there are times when it isn't so nice and neat when it comes to submitting a claim to an insurance carrier, especially when you're sending claim to a heavily regulated carrier like Medicare. Sometimes, the carrier is going to want some narrative explanation as to why this claim is being sent. This is where notes come into play.

A note, in medical billing speak, is not something you play on your Yamaha keyboard, or a post-it you slip to the person in the cubical next to you to meet you at lunch time for a smoke. A note is just that, a short narrative explanation that is given to the insurance carrier to help explain why a certain procedure was done and why it is being billed. More importantly, it explains to the insurance carrier why the claim should be paid in the first place.

But why are they needed? Why should you have to explain to Medicare why a particular claim is being billed? If a procedure is done, or a device is prescribed for a patient by a doctor, shouldn't that be reason enough? Isn't the doctor's word law? Doesn't he know best? Well, maybe he does as far as medicine goes. As to medical billing, that is a different story. See, while the doctor may feel that a certain procedure or device is needed for the

e to think. Just give me the info that I need to get the bill out and move on to the next claim. Unfortunately, there are times when it isn't so nice and neat when it comes to submitting a claim to an insurance carrier, especially when you're sending claim to a heavily regulated carrier like Medicare. Sometimes, the carrier is going to want some narrative explanation as to why this claim is being sent. This is where notes come into play.

A note, in medical billing speak, is not something you play on your Yamaha keyboard, or a post-it you slip to the person in the cubical next to you to meet you at lunch time for a smoke. A note is just that, a short narrative explanation that is given to the insurance carrier to help explain why a certain procedure was done and why it is being billed. More importantly, it explains to the insurance carrier why the claim should be paid in the first place.

But why are they needed? Why should you have to explain to Medicare why a particular claim is being billed? If a procedure is done, or a device is prescribed for a patient by a doctor, shouldn't that be reason enough? Isn't the doctor's word law? Doesn't he know best? Well, maybe he does as far as medicine goes. As to medical billing, that is a different story. See, while the doctor may feel that a certain procedure or device is needed for the

nt some narrative explanation as to why this claim is being sent. This is where notes come into play.

A note, in medical billing speak, is not something you play on your Yamaha keyboard, or a post-it you slip to the person in the cubical next to you to meet you at lunch time for a smoke. A note is just that, a short narrative explanation that is given to the insurance carrier to help explain why a certain procedure was done and why it is being billed. More importantly, it explains to the insurance carrier why the claim should be paid in the first place.

But why are they needed? Why should you have to explain to Medicare why a particular claim is being billed? If a procedure is done, or a device is prescribed for a patient by a doctor, shouldn't that be reason enough? Isn't the doctor's word law? Doesn't he know best? Well, maybe he does as far as medicine goes. As to medical billing, that is a different story. See, while the doctor may feel that a certain procedure or device is needed for the

tion that is given to the insurance carrier to help explain why a certain procedure was done and why it is being billed. More importantly, it explains to the insurance carrier why the claim should be paid in the first place.

But why are they needed? Why should you have to explain to Medicare why a particular claim is being billed? If a procedure is done, or a device is prescribed for a patient by a doctor, shouldn't that be reason enough? Isn't the doctor's word law? Doesn't he know best? Well, maybe he does as far as medicine goes. As to medical billing, that is a different story. See, while the doctor may feel that a certain procedure or device is needed for the

f a procedure is done, or a device is prescribed for a patient by a doctor, shouldn't that be reason enough? Isn't the doctor's word law? Doesn't he know best? Well, maybe he does as far as medicine goes. As to medical billing, that is a different story. See, while the doctor may feel that a certain procedure or device is needed for the patient, the insurance carrier may not feel the procedure of device should be covered. This is very common with some elective types of surgery where the patient's immediate health is not an issue and the surgery is more for comfort or appearance. For example, in some cases, surgery for hemorrhoids is not covered under insurance, especially if it's a particularly new procedure like IRC. In this case, a narrative note must be sent to the carrier to explain why this surgery is required and why it should be covered by insurance.

In most cases, these claims will eventually be paid. But there are those cases where even with a narrative explanation, the insurance carrier will deny the claim, even with the narrative explanation. In this case, there is always an appeal and review process, but these things take forever to get through.

The point to all this, however, is when a medical biller sends a claim for a particular procedure that specifically states that a narrative explanation is required, that biller better have one from the doctor or get one. Otherwise, the chances of that claim being paid are slim to none.