Medical Billing ToolsTM
Office/Outpatient Version
Provided by: Clyde P. Sanchez, CFNP, PhD

NP Central is pleased to announce our partnership with Doorstep Medical Consultants. We have become an official on-line seller of Doorstep Medical Consultant's Medical Billing ToolsTM. Due to occasional changes in the policies of our suppliers, the information, products, names, prices, and availability contained in this web site are subject to change without notice.

Doorstep Medical Consultants announced in June, 2000 the release of a series of hand-held pull-tab tools that simplify the determination of proper evaluation and management (E&M) service codes. HCFA and most insurance companies now require these E&M codes when submitting medical billing. Until now, physicians, nurse practitioners, physician assistants, and other health care providers had to memorize long and complicated rules and regulations in order to determine the proper code to bill. Many seminars and books are available to train individuals on these rules and regulations, but prior to the Medical Billing ToolTM, no simple means was available to help providers determine the correct codes. HCFA has begun an initiative to enforce proper bill coding, including fines of $10,000 per violation plus three times the billed amount. "These tools could not have come at a better time," has been the declaration of many providers.

Why is it important to complete the E&M billing codes correctly?

1. Reimbursement can be denied if documentation does not accurately reflect the guidelines’ requirements.

2. If documentation does not reflect the E&M code selected, this can be interpreted by HCFA as non-compliance with the rules concerning limiting charges. Section 1848(g) of the Social Security Act describes limiting charges, and section 1842(j)(2) prescribes civil money penalties of up to $10,000 per violation, plus three times the amount of applicable excess charges. For example, if one submitted 10 claims for $100 and these were billed at a higher E&M code than the documentation justified, a fine of $103,000 could be assessed. Is HCFA enforcing these rules? Yes!

These ingenious hand-held cards utilize pull-tabs. One merely has to look at one’s note, pull the tabs out to what has been recorded on the note, and the Medical Billing ToolsTM will automatically determine the proper billing code. What was taking a frustrating amount of time, and usually amounted to no more than an "educated guess", can now be accomplished accurately and in a matter of seconds utilizing the Medical Billing ToolsTM.

There are a number of different Medical Billing ToolsTM, which will aid in billing for a wide variety of practices. These various tools include:

To see a brief demonstration, click here!

Doorstep Medical Consultants is a company dedicated towards making tools for health care providers to assist them in making their jobs easier and more efficient.

The president of the company is Clyde P. Sanchez, CFNP, Ph.D., who has been practicing as a family nurse practitioner for over 22 years, having earned degrees from Cornell University, Yale University, and the University of New Mexico.

Updated June 22, 2000