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Chiropractic billing and coding has undergone significant overhauling in the previous years given changes in insurance practices, automation of data recording and compliance regulations. However, chiropractors across the nation continue to lose money in claim denials, bad debts and audit issues due to inefficient coding and billing procedures. To improve financial feasibility of your chiropractic clinic and eliminate risk of expensive medical audits or claim denials, as a medical practitioner, you must strive to adopt best in industry billing and coding practices.
In the next 5 years, General insurance providers, PPOs (Preferred Provider Organization) and HMOs (Health Maintenance Organization) will continue to cover chiropractor services in healthcare setup. Therefore, your chiropractic coding and billing process must be designed to optimize claim settlement out of these carriers. Following industry best practices can exponentially improve your clinic’s profitability both over short term and long term –
- Identify coding errors by reviewing coding manuals periodically: The switching from ICD9 to ICD10 codes have necessitated reviewing of coding process in your existing chiropractic billing. In addition CPT coding and HCPCS coding manuals are also important to be referred to at the time of identifying most frequently used codes by your medical practice.
- Adopt effective EMR to facilitate billing processes: Automation of patient record updating and patient data transfer within the practice as well as at the time of claim filing enhances the overall efficiency and productivity of your billing process. With EMR billing practices, you can minimize human errors, standardize coding and billing formats and record as well as access large amount of patient data more effectively.
- Establish medical document necessity: Billing process effectively begins from the point when the patient walks in and ends at the point of complete claim settlement. At each stage of medical billing, specific documentation and patient record can improve your claim settlement ratio.
- Ensure HIPAA compliance at the time of claim filing: HIPAA compliance and Electronic Data Interchange regulations not only ensure patient data security but also protect your practice from potential audits. Therefore, you must ensure complete compliance at the time of claim filing and any other data sharing.
- Calculate accurate fees for one time and continued care: Chiropractic services are subject to questionable fee structure and giving justification of continued care at the time of billing is a tedious task. Hence, your fees matrix must be accurately calculated to avoid any confusion in patients at the time of payments.
- Install RCM: Revenue cycle management is a scientific way of monitoring your finances thoroughly while delivering quality patient care. Daily, weekly and monthly revenue reports can improve your overall profitability as well as reduce risk of accounts receivables aging due to lack of follow up.
Medicalbillersandcoders.com is a complete billing and coding solutions provider that offer services of specialty experts for your practice. In order to internalize industry best practices for billing and coding in your chiropractic clinic without losing focus on patient care, you can partner with medicalbillersandcoders.com for effective billing and enhanced profitability.
Medical audit is without doubt the most difficult time that any medical practice may have to survive. It involves scrutiny of medical records, critical analysis of billing and collection processes and worst of all, unearthing old claim settlements and payment records which inevitably prove you in debt of Medicare or Medicaid! In fact, surviving audit is not the only test; the real challenge is to come out of a medical audit without any significant financial or technical loss. Medical audit not only hampers the efficiency and productivity of your GE practice but also wastes quite a few man hours. Therefore, eliminating medical audit risk for your Gastroenterology practice is the best way to improve existing processes and address problematic areas in your medical practice.
Browse All : Gastroenterology Medical Billing Services
Audit risk can be effectively minimized by way of installing regular system checks for quality improvement and quality assurance. Following steps can eliminate the audit risk for your GE practice as well as prepare it for the worst case scenario –
- Undergo regular practice medical audits – Practice audits are conducted by peer groups and medical associations typically having medical experts that have experience in the same specialty field as your practice. These practice audits expose possible problem areas in your GE practice and help you plan out improvement strategies.
- Conduct regular compliance sessions – Quality assurance and improvement is derived predominantly from compliance of your services to HIPAA guidelines and other healthcare regulations. Most medical practices fall prey to heavy financial penalty due to insufficient patient data security and missed compliance. By conducting regular compliance sessions for your medical and billing staff you can ensure that no process is left with an exception to compliance guidelines which can result in audit red flags.
- Update your billing software to EHR/EMR– Automation of billing process can streamline majority of your processes in a manner that minimizes human errors and reduce audit risk exponentially. Gastroenterology practices attract a lot of audit calls due to patient complains and claim denials, both of which are results of incorrect medical records and faulty billing. EHR/EMR can effectively reduce patient record errors and billing discrepancies, resulting in reduced audit risk.
- Revise coding changes in your system periodically – With the inclusion of many new medical procedures under the purview of gastroenterology, ICD10 coding changes have become of utmost importance for GE practitioners. Revising coding changes in your system can ensure correct coding and billing practice and lesser claim denials as well as audit risk.
- Maintaining RCM (Revenue Cycle Management) – Revenue cycle management can streamline your entire billing and coding process, thereby enabling better monitoring of your financials and accounts receivables.
Medicalbillersandcoders.com offers medical billing and coding solutions by a team of gastroenterology experts who not only have experience specific to gastroenterology but also understand how to prevent various failures of the system to avoid audit risk at all costs. With medicalbillersandcoders.com as your billing service provider, you can focus on patient care while your billing and coding process operates flawlessly without any audit risk.
One of the biggest financial burdens on any medical practice is that of medical audit. Even though it is a necessary evil in the healthcare industry, medical audits setback the financial growth of any practice and initiates change in an otherwise streamlined medical practice. The best way to prepare your chiropractic clinic for a medical audit is by eliminating any chances of audit altogether. Most medical audits originate due to billing failures, repeated claim denials and customer complains. All these issues can be effectively captured in the billing processes and can be easily fixed.
Commonly found chiropractic medical billing errors that lead to an increased audit risk are –
- Allocation of incorrect ICD9, ICD10 or CPT codes for services rendered
- Providing all services at one level and billing all services at a higher level
- Recording incorrect services in patient data
- Non compliance to HIPAA guidelines for patient record maintenance and transfer
Now these errors can be easily captured and fixed by taking the following steps –
- Install revenue cycle management or RCM in your chiropractic billing: RCM is a holistic approach towards streamlining your coding and billing processes. With the daily, weekly and monthly reports generated by RCM you can check the billing cycle, claim cycle and collections cycle effectively. RCM also facilitates your supervision by generating meaningful analysis of your billing processes that can in turn be referred to for making system improvements.
- Monitor billing procedures regularly to identify chronic and one-time errors: Most billing errors that can attract a medical audit are result of negligence or process inadequacy and can be avoided in long run. On the other hand, there are some very common coding related errors which remain unnoticed in the system until caught by an insurance carrier. Therefore, these chronic as well as one time errors must be addressed by way of medical staff training, regular coding revisions in the system and even monitoring automatic duplication of codes.
- Track causes of claim denials in your system: Claim denials and rejections on grounds of non compliance, coding or documentation are red flags for your chiropractic billing process and can attract audit at any time. Therefore, you must do a root cause analysis of each and every claim denial instead of simply getting your medical billing service provider to file an appeal or foregoing the revenue from that claim.
- Address causes of customer complaints: Repeated customer complaints on incorrect diagnosis or insufficient treatment yet excessive billing can also increase the audit risk for your chiropractic clinic. Thus you must install a proper system in you billing process that should capture as well as address gaps in the system.
Medicalbillersandcoders.com is specialty billing service provider that offers the service of hundreds of medical billers and coders from the field of chiropractic. We not only understand the underlying failures of a billing process that can attract an audit but can also help you reduce potential audit risk by streamlining your billing processes effectively.
Medical practices need to have a quality billing software that will not only automate error-prone billing tasks and code claims properly but also help in verifying patient insurance coverage and increase payment collection.
Since a medical billing software has a vital role in ensuring whether or not a practice gets paid on time, choosing the right one is the most important decision practices will ever make. Whether you choose the billing software or you rely on the software chosen by your medical billing company, it should add efficiency in the core components of your practice such as:
- Charge entry
- Payment posting
- Insurance and patient billing
Challenges in choosing software of your choice:
Irrespective of the benefits, researching and choosing billing software appropriate to your practice needs can be a daunting task.
- The choices offered by medical billing software companies can be quite overwhelming, especially for providers who don’t have sufficient time
- The software needs to be according to the requirements of a practice as the patient workflow and billing is different for different specialties
- Not just the software but practices also need to be prepared with upfront costs for licenses, necessary hardware, servers, setup and training if they wish to buy an on-premise system. They will also have to pay for support fees and ongoing maintenance fee
- Decision will have to be made if you want to buy a standalone system, a system with fully-integrated billing scheduling or a system integrated with patient scheduling
- Providers will have to decide if they want an on-premise or web-based software. They will also have to ensure that data security is being taken care of since sensitive patient data is stored and transmitted through the software
- The software chosen by the provider should be HIPAA compliant as well
Software chosen by a medical billing service:
With so many concerns and requirements, practices find it difficult to choose software on their own due to time and money constraints. This is the reason why they prefer outsourcing their billing requirements to a billing company. This not only helps in maximizing their revenue and minimizing claim denials but also eliminates the headache of choosing and investing in billing software.
A reputed outsourced billing service has similar functional requirements to their respective provider clients; however, they require a broader more flexible system since they have to bill for clients from different specialties.
Medicalbillersandcoders.com has been offering effective medical billing services to practices across 50 states in the US. Our team of expert billers and coders will not just help you in adoption of software driven billing practices but also customize services like data recording, coding changes and appointment scheduling as per the needs of your specialty.
MBC strives to help practices fight challenges related to selection and implementation of medical billing software. Our team makes use of the latest, HIPAA-compliant software to handle your revenue cycle management and enhance collections.
Family practices lose approximately 10-20% of revenue every year due to coding errors. Due to this, it becomes important to have a team of certified, well-trained coders who are capable of handling coding complexities and collecting revenue from different insurance carriers.
Browse All : Family Practice Medical Billing Service
With government and insurance rules changing constantly, family practices face coding changes every year. In order to manage these changes, family practitioners need to:
- Review the coding changes
- Study the CPT manual carefully
- Follow the documentation guidelines
- Assess the impact of coding changes on their practice
- Create a plan to handle the changes
Family practices will have to do a lot of planning before the implementation of ICD-10 this year. Since majority of revenue for a typical family practice is generated by submission of CPT and ICD-9 codes to third party payers, small coding errors can lead to disrupted cash flow.
Reduced revenue can lead to reduced number of support staff, shrinking compensations and limitation on equipment and supplies. When combined, these factors will not only affect the financial health of family practices but providers will also become unable to hire trained coders or buy the latest EHR.
Is your family practice making these coding mistakes?
If your family practice is missing revenue, there are certain mistakes your coders might be making. These mistakes need to be reviewed and corrected to prepare your practice for future coding challenges.
- As a family physician you must see if the encounter forms of your practice are up-to-date. If the forms have not been updated for more than five years, you may be losing various revenue opportunities. It is a time consuming yet vital task
- You will have to substantiate the medical necessity of the services being provided by your family practice. From selection of ICD-9 code or codes valid for a visit or other service to linking the codes to associated CPT code, the process should involve you along with your coders and billers
- Time will be required to select and document appropriate levels of E/M services which is another challenging task
- Data related to coding patterns will have to be gathered from your billing system to determine whether or not your practice is losing revenue due to under-coding
- As a provider you will have to learn the rules of using modifiers because modifiers can be the difference between denials, full reimbursement or reduced payments
- Make sure that charges are being captured for the services provided
Fulfilling these tasks can be a challenge for family physician due to lack of time, money and resources. Therefore, they seek assistance from a reputed billing company to ensure error-free coding for maximum reimbursements.
Medicalbillersandcoders.com is the largest consortium of trained coders and billers, offering effective billing solutions to family practices across the US. Our coders are certified, updated and they make use of the latest technology to ensure that your practice receives payments on time.
Due to variations in health plans, physician performance and rise in healthcare costs, a significant number of practices in the US are implementing pay-for-performance incentive program. P4P started in the private sector but due to growing popularity it crossed over to the public sector as well.
Browse All: Medical Billing Services
As a tool to improve quality of care, this program has the potential to benefit providers; however, there are certain challenges related to P4P that can cause trouble for practices.
- This medical billing companies model has increased pressure on the workforce, leading to healthcare attrition. Since the focus has shifted on provision of value and derivation of customer satisfaction, staff at medical practices is finding it difficult to understand and implement their KRAs and duties
- Providers will have to bring variation in their practice to become eligible for this program. Medical safety practice will have to be promoted to reduce errors and chronically-ill patients will have to be given best care to reap benefits of P4P
- Hospitals will have to ensure that there are no complaints in terms of patient stays and emergency room visits. Only when the care co-ordination between office, home and hospital for chronic disease patients is of good quality, a practice or hospital will become eligible for P4P
- Providers will have to spend money on buying the latest health IT for treatment of Medicare hostgator coupon code 2014 patients who are chronically-ill as this is also a criteria for getting rewards under P4P
- Time and money will have to spent to make sure that the patients coming to your clinic or hospital are well-informed and powered
All the above mentioned tasks will have to be performed by providers if they want to reap the benefits of pay-for-performance program. In case you are planning to stay out of P4P you will end up losing out on market share as well as patients.
There is no doubt that pay-for-performance has several advantages but in order to become eligible for P4P rewards, practices need to streamline medical billing and get paid on time. Fulfilling the requirements for P4P can become daunting if your practice is facing revenue loss and claim denial issues. Only when the cash flow is smooth, providers can focus on enhancing quality of care and other requirements to get paid under P4P.
Considering the lack of time, money and resources, an unorganized billing department can reduce your chances of implementing pay-for-performance in your practice. Therefore, seeking help from a medical billing company can work wonders for you in terms of minimizing claim denials and maximizing revenue collection.
Medicalbillersandcoders.com is helping physicians across 50 states in the US with effective AR management and billing services to help them reap benefits of P4P program. Our team of well-trained coders and billers make use of the latest technology to ensure your practice gets paid on time for all the services offered. We can also assist you in training your employee for P4P and help you improve your in-house practices.
Dental practices need to streamline their billing tasks in order to enhance revenue collection. Accuracy needs to be exercised in coding, billing, timely claim submission and follow-ups to get paid for the services offered.
Challenges faced by dental practitioners:
With an increase in work pressure due to healthcare reforms, daunting back office tasks and rise in number of patients, dental practices are facing various billing challenges and it has reduced their reimbursement to a great extent. If your practice revenue has also hit a plateau, there are corrections you need to make in your business processes.
There are various categories and subheads under which dental services have been classified. Payment settlement can take place successfully only when the services are depicted appropriately in the billing system. In case of inaccurate details, the claim processing time can get delayed. It can lead to denied claims, affecting cash flow of a dental practice.
How can streamlining dental medical billing help your practice?
Compared to medical reimbursement rates, dental reimbursement rates are generally poor. A huge amount of complex execution and planning is required to maintain a certain level of profitability which can only be possible when you are streamlining dental medical billing tasks. Following areas will have to be taken care of when streamlining dental billing:
- Medical coding audits
- Patient enrollment
- Patient reminders and scheduling
- Payment posting
- Insurance verification
- Accounts receivable management
- Insurance authorizations
- Financial management reporting
Do you have the time to handle these tasks?
It becomes challenging for dentists to strike a balance between offering quality dental services and handling the daunting task of dental medical billing and coding. Busy schedule of dental practitioners does not allow them to handle both tasks simultaneously and this affects the entire process of claim submission.
At times dental practices have sufficient time but they lack skilled staff to carry out dental billing tasks with accuracy. In such cases, seeking help from a billing company makes sense as they have a team of experts who pay great attention to details and are trained in quick processing of dental claims. They carry out all the tasks in adherence to relevant norms so that dentists can maximize their reimbursements and minimize claim denials.
Billing partner such as Medicalbillersandcoders.com have been helping dental practices across the US enhance their revenue collection. We have the largest consortium of coders and billers who are well-trained to handle challenging dental billing requirements. Our main aim is to ensure that dental practitioners get rid of the strenuous optimization exercises that prove problematic to core medical efficiencies.
The team of experts at MBC will analyze your payer mix and offer you assistance in attaining sustainable profitability by enhancing processes. While a well-trained team is taking care of your dental billing and coding tasks, you can focus on providing qualitative care to your patients. MBC strives to improve the financial health of your practice under careful and effective administration.
A large number of healthcare providers are not worried about their practice’s billing procedures as long as the revenue is coming. Some choose to ignore whereas some lack the time to concentrate on the insurance billing processes. If you are facing the same problem at your dental practice, you might land up in serious trouble in the long run.
In case your billers are not performing error-free dental medical billing, your practice might be held responsible for dishonest billing practices. Such allegations can be costly to deal with and it can also damage your practice reputation.
Some of the dental medical billing services mistakes that can create problems:
- Failing to collect full co-payment or deductibles on a routine basis
- Offering to waive deductibles or co-payments
- Not showing other insurance coverage
- Not mentioning the correct treatment date
- Submitting claims for covered services, when a non-covered service was conducted
Browse All : Medical Billing Companies
What you need to do?
Dentists should have involvement in the billing processes at their practice. Any type of billing issue can be prevented by being proactive and through careful monitoring of billing patterns. From auditing insurance claim history for inconsistencies and reviewing third party payer contracts to cross-training staff and ensuring that the work performed matches the work billed are extremely important tasks for a dentist.
Dental practitioners should also be involved in reviewing financial charts of patients from time to time. This needs to be done to ensure that all treatments have been billed. If there is a batch of claims for which the insurance carriers haven’t made a payment yet, they need to take the required measures to get it solved. It is important to find the reason behind suspended claims waiting to be processed and also focus on eliminating documentation errors.
Don’t rely completely on your billing staff in handling the above mentioned tasks. It is good to concentrate on provision of quality care but to avoid facing fraudulent billing practices or insurance frauds, dentists need to devote some time towards the billing procedures as well. Remember, your dental license might be seized; you will end up paying huge fines or even go to jail if you are found guilty of insurance fraud; therefore, hire a team of skilled billers and coders and keep a constant track of what activities your billing department is performing.
Is lack of time and money posing a hindrance in carrying out these tasks?
Medicalbillersandcoders.com is the largest team of certified billers and coders, helping dental practices strengthen their billing procedures and enhance their revenue. A well-trained team will be handling your revenue cycle management, filing claims, complying with HIPAA and other reform, offering denial management solutions and taking care of other essential administrative tasks. This will eliminate your headache of hiring or training a qualified billing team or investing in the latest technology for effective billing results.
Accounts receivable is money owed to you by your patients which makes AR management extremely important for running a successful medical practice. If you are not managing accounts receivable in the right manner, the financial health of your practice will get affected. This is because revenue collected from your customers is not just required for paying the expenses but also for turning a profit.
Browse All : Medical Billing Services
Lack of AR management will result in patients not paying timely or not paying at all. This will disrupt the cash flow for your practice; therefore, it is extremely important to have policies and practices in place to know how account receivables will be managed.
Considering the pressure rising due to healthcare reforms and complications in payer processes, it has become essential for physicians to collect the entire amount they are owed. It is essential to audit and clean up operations on regular intervals even if you think that your AR is running smooth. This is required to ensure that processes and cash flow at your practice are being managed well.
How to strengthen AR management?
- It is best to get rid of outdated patient data. Staffs need to be trained for verification of insurance card data and other information every time a patient visits
- Wipe off small balances such as a vaccine reimbursement from a now-defunct payer or missed co-pay from a deceased patient rather than hostgator coupon code 2014 wasting time and money in billing continuously for them
- Make sure your existing balances are being collected on the date of service rather than sending the bill in the mail to the patients. Appropriate collection measures and legal actions must be taken to collect from recurring patients
If your practice is not following any of the above-mentioned tasks, lack of AR management will eat up your practice revenue. You require continuous monitoring to make sure everything is orderly in accounts receivables.
Practices usually lack the time and resources to manage AR due to which they prefer to outsource these services to a billing company.
Medicalbillersandcoders.com has been offering successful AR management services to physicians across the US. Our aim is to help you retrieve your revenue, make profit and offer quality patient care. You can either opt for our in-depth analysis-backed AR management solutions or we can customize parts of it as per your practice needs. The well-trained team at MBC can also help you face challenges related to AR such as coding errors, claim denials, delayed payments, documentation issues and so on.
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