Wednesday, September 17, 2014

Physician Billing Services - Out-Of-Date Codes Can Cost Your Practice Money and Time



CPT and ICD-9, now ICD-10 codes are updated yearly. This means that each year codes are added, changed and deleted. When codes are deleted, but are used continuously on claim forms, they will be denied by the insurance company, or the claim will go into adjudication and payment can be delayed for up to 120 days. When a claim goes into adjudication, it essentially goes to a department where an experienced claims representative, will review your claim to figure out why it is being deemed "a problem claim". The insurance company that receives the claim will determine through its in house policies, if they will change your out of date code to the correct code, or if they will flat out deny the claim. But, any of these things happening are bad, because it will either deny you money you have rightfully earned, or you will be reimbursed months later.

A great way to make sure, that you are not still using out of date codes are to have a consulting or medical billing firm come in and review your superbill. If your practice does not have a superbill, then you should list all of the procedure and diagnosis codes that your office uses regularly. Another way to thoroughly vet each code, is to call each insurance company and ask whether the codes on your superbill are still being accepted by that insurance company. Many representatives will tell you the correct, or more up to date code they accept on their claim forms. However, the latter option can be very, very time consuming. The former option is quicker, but you will need to outsource that task, in order to receive the most accurate, and expert advice.

Healthcare Providers, should also be aware that sometimes insurance companies will prefer you to use a different code, than one that is already widely accepted by insurance companies. For instance, United Healthcare does not accept the widely used physical therapy code 97014. Instead UHC prefers a G code. If you put 97014 on the claim, UHC will pay it, but the claim will go into adjudication, and reimbursement can be delayed for up to 90 days. When you receive the EOB, back from UHC, you will notice that they will change the 97014 to G0283. However, if you put G0283 on the original claim, you will receive prompt payment. If you are billing electronically, you will be reimbursed within weeks of UHC receiving your claim.

If you are unsure if your practice is using out of date codes on claim forms, give us a call, we would love to help you. When you contact us about our Physician Billing Services, we will offer to review your codes for Free. We will also review your A/R and perform a cost analysis all for free, so that we can begin to identify any claims that may have denied because of out-of-date codes. Accurate billing is timely billing, and here at Montebello Medical Billing and Consulting, we make sure that our Physician Billing Services, represents both.

2 Reasons Why Chiropractors and Pain Management Clinics Need Medical Billing Services



Chiropractic and pain management clinics are gaining momentum and popularity in America. More people are interested in non-invasive medicine. Pain management clinics, usually include many doctors from many different specialties. However, most pain clinics will at least have a medical doctor, a chiropractor, and a physical therapist. Sometimes they will have an acupuncturist on staff, as well. A patient may come in, and receive services from all 4 doctors. The patient will go in for an office visit with the medical doctor (99213), then a manipulation with the chiropractor (98940), then go receive a hot/cold pack from the physical therapist, and end the day by getting some much needed acupuncture. This encounter form will look very confusing, and will be a challenge to bill. However, reputable physician billing companies will have the knowledge you need, to bill this patient's insurance correctly, and receive prompt reimbursement. Check out these 2 reasons why Chiropractors and pain management clinics should consider using medical billing services.

Tailor Made Medical Billing Solutions

If you have any problems in your office, in regards to physician billing, or practice management, a billing service can help. If you have a great billing department, but your A/R needs some sprucing up, a this service can help. If you want to keep your in-house physician billing department, but you would like to increase your reimbursement percentage, this service can help you. If you are unsure that your codes are up to date, they have you covered. If your not sure if a physician billing company is the best for you, give them a call, email or shout because they would love to hear from you. If you need help getting credentialed with Insurance companies, so that you can begin billing in network, this service can help you. If you need a medical transcriptionist, they can help. If your Chiropractic office or pain management clinic is in need of any physician billing company, including consultation, contact a reputable medical billing service.

Medical Billing Services Guarantees Great Benefits

Billing services can customize their medical billing services to fit your needs. The most important benefit we can offer is timely, and accurate billing. My mantra is "Let us scrub your claims clean". A clean claim, is a claim that will be reimbursed. This is because we have strictly adhered to the guidelines set forth by the federal government and insurance companies. When claims go out clean, you don't run the risk of being audited by Insurance companies. Audits are triggered when fraud or unethical billing practices are suspected by the Insurance company. And unfortunately, when one Insurance company audits you, it sends a red flag to all of the other Insurance companies you send claims to. An experienced physician billing service can help you greatly reduce the odds of claim rejections and denials, all while optimizing reimbursement for all outgoing claims and A/R.

As you can see, outsourcing medical billing services can be a great advantage to a physician's practice, large or small. The greatest thing that will determine your success is the efficiency of your medical billing department. Outsourcing your medical billing services can increase your revenue from 5% - 30%. If you would like to know if outsourcing your physicians billing and practice management services can benefit your practice, visit our website, and we will tell you how to receive a free practice cost analysis. This way you can see in real numbers, just how advantageous outsourcing your medical billing services can be.