Hannah Parker, Author at InfoHub https://infohubservices.com/author/hannah-parker/ Thu, 02 Feb 2023 09:47:39 +0000 en-US hourly 1 https://wordpress.org/?v=6.1.1 https://infohubservices.com/wp-content/uploads/2019/10/cropped-INFO-HUB--96x96.png Hannah Parker, Author at InfoHub https://infohubservices.com/author/hannah-parker/ 32 32 All You Want to Know About Pathology Billing https://infohubservices.com/all-you-want-to-know-about-pathology-billing/ Wed, 01 Feb 2023 07:53:52 +0000 https://infohubservices.com/?p=47829 A lot of medical facilities are on a lookout for assistance to make their stress a little bearable. Pathology billing involves deep expertise in billing and coding of the varied services offered. A lack of it can affect the financial health of the practice. One of the ways is to outsource medical billing to an offshore medical billing agency. Know everything about Pathology billing with us.

 

What is Pathology Billing?

Under pathology, there are two types of tests which are called qualitative and quantitative respectively. Pathology Billing is a billing which includes clinical pathology, anatomical, general and other fields along with sub specialties.

 

Types of Tests Included

In case of drug testing the above mentioned two tests can be deployed. For instance, qualitative testing is used to determine whether a drug is present and quantitative test is utilized to determine the amount of drug present.

 

EMR System

Since any form of medical billing must be done in a cautionary manner in order to avoid any errors which cause claim getting delayed or denied altogether, a lot medical facilities have hence adopted an EMR System or Electronic Health Record (EHR) system.

Such a system has proven to be immensely effective to reduce the number of errors resulting due to incomplete or missing records. This system helps to develop a singular channel to locate findings by the pathologist, physician notes and charts which enable multiple systems to access and share the required patient information.

 

Vital Codes

An important thing to keep in mind when dealing with pathology billing is that Pathology codes are not measured by the test results but are measured by the number of tests performed.  Here is a list of top ICD-10 codes use in pathology billing –

  • ICD-10-CM Code K29.50 – Gastritis related medical ailments
  • ICD-10-CM Code K20.8 – Diagnosis of allergic inflammatory condition occurred in esophagus
  • ICD-10-CM Code N20.1 – Code used for kidney stones
  • ICD-10-CM Code C50.911 – Code used to help in order to specify breast cancer amongst women

Pathology billing works is slightly different from other types of medical billing. As mentioned above, pathology codes are measured by the number of tests performed. A simple example to explain that could be, if someone is undergoing a test for both alcohol and phenobarbital, then these will get added as two separate procedures.

 

Common Know-How’s

Always remember to accurately put down details of the patient’s demographics. This is important as or contains some of the vital details about the patient and the illness they suffer from. Along with that, it is necessary that the person undertaking billing procedures must be aware of which pathology service is non split billable and which is split billable.

Additionally, a strong understanding of correct codes as per the guidelines is recommended. In case of any errors do take place in billing codes, pathology claims scrubbing can be utilised. This can be used to locate and eliminate any errors in billing codes.

Reduced number of errors in billing procedures will in turn reduce the number of claims denial. This is vital for maintaining a healthy revenue cycle of the medical facility. And to add up to that, a healthy revenue cycle boosts up employee morale to serve the society with even more zeal.

Keeping in mind the highly demanding nature of the medical industry, medical facilities are opting for medical billing agency and medical billing company which can deliver error free work and reduce claim denials. The staff is experienced and experts in their field and they are also well aware of the latest updates in compliance. This can benefit the facilities to a great extent.

At Info Hub Services, we house an enthusiastic team of experts which are highly knowledgeable in the field of medical billing, to deliver quality output. Our experienced billers can assist in streamlining pathology billing process and generating revenue.

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“No Pain, All Gain” – Hiring An Offshore Medical Billing Company https://infohubservices.com/no-pain-all-gain-hiring-an-offshore-medical-billing-company/ Mon, 30 Jan 2023 10:22:02 +0000 https://infohubservices.com/?p=47819 Keeping in mind the stress and time-sensitive nature of the medical industry, many facility providers are always on the lookout for the next best thing. When you opt for offshore medical billing services, not only will you save precious time and stress for your employees, but you will reap great benefits for your practice.

In this blog, we will look into how offshoring such a tedious process can prove helpful.

Quality Talent

Companies that specialize in medical billing, house a pool of talent who have a sizable amount of experience in the medical billing field. Along with that, they also possess the right knowledge and are abreast with the latest developments in the healthcare industry. A combination of these skills gives you a team that delivers error-free and quality claims submissions.

Increased Focus on Patients

Shaking off a major time-consuming task such as medical billing provides domestic staff with much-needed time to focus on areas that require improvement and attention such as administrative tasks. Improving such tasks can be greatly beneficial for patient relations and employee engagement.

Best For Revenue Cycle Management

When you hire an offshore medical billing agency, it plays a huge role in improving your revenue cycle by optimizing the claim submission process and reducing the occurrence of revenue leakage due to denials. This leads to improvement in the quality of the revenue cycle with accelerated cash flow.

No Underbilling Or Overbilling

The medical billing agency houses a medical coder who provides expertise on how the medical billing facility is not supposed to bill too high or too low. Such scenarios of underbilling or overbilling can attract penalties for your practice.

End to End Medical Billing Solution

An offshore medical billing services company can provide you with a number of benefits such as a setup of practice management system or EMR system, registration of patients, eligibility verification, pre-authorization and scheduling, precise coding, denial management, patient support with customer and patient access solutions, credit balance management and resolution, account receivable or A/R, claim submission with rejection or edits of work.

No matter how big the medical facility is, the procedure of medical billing takes time. And while the above-mentioned list is concise, there is much more than an offshore medical company can offer.

Reduced Stress For Internal Staff

When the workload is high, human errors are bound to take place. And when the staff is new to the job, the initial struggle while switching to ICD-10 is bound to take place. This is more common in smaller medical facilities most likely to be understaffed. In such cases, more time and effort are employed to fix the issues such as claim denials. These factors add up to the already stressful work environment. Such errors occur on lesser occasions when you outsource the medical billing procedures to an offshore medical billing agency with experienced staff. This can then lead to reduced stress on internal staff and allows them the necessary time to focus on other tasks.

Lower Costs

While the idea of offshoring your medical billing process might sound costly, it’s actually very cost-effective. It is reasonable to hire medical coders offshore compared to domestic ones. They also have an extensive amount of experience in the industry, so not only are you saving in terms of hiring costs but also when it comes to savings in the long run.

Considering the many benefits that an offshore medical billing company offers, many medical facility providers are now opting to outsource medical billing to an offshore medical billing company or medical billing agency. With all the benefits they provide, it is hard to turn down such a deal.  At Info Hub, which is one of the leading offshore medical billing companies, our team offers expert medical coders that are highly skilled and certified, being one of the best at their jobs. No matter the specialty, we extend impeccable and flawless services for increased profits to every medical billing practice.

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Improve Patient Engagement By Hiring An Offshore Medical Billing Company https://infohubservices.com/improve-patient-engagement-by-hiring-an-offshore-medical-billing-company/ Wed, 25 Jan 2023 10:54:39 +0000 https://infohubservices.com/?p=47782 Since many medical facilities are now opting to offshore their medical billing services to medical billing company or medical billing agencies, it not only saves them substantial amount of cost but also gives them space to concentrate on other areas like employee satisfaction and improve patient engagement.

Maintaining good patient engagement is necessary as it will help in reputation building of the medical facility. In this blog we will learn about how hiring an offshore medical billing agency will help you improve patient engagement.

 

High Quality Patient Care

Since medical billing is a time consuming task and is still prone to human errors, many medical facilities tend to save a lot of time when they outsource their procedures to an offshore medical billing company or medical billing agency.

When time is saved, core medical staff can concentrate on their job in a much better manner. That is why, services which they provide can be of high quality leading to lesser complications. This can provide the medical facility with dual advantage as it will provide the client with satisfying services and quick billing.

 

Patient Satisfaction

A satisfied patient is a success in itself for any practice. Patient satisfaction can be achieved by providing quality services, open communication and educating them about their patient care journey. Since medical billing procedures are data heavy and prone to errors, there is immense pressure on the staff.

When you decide to offshore medical billing services to an offshore medical billing company, patient satisfaction can be achieved in a number of ways. In could be in terms of medical service and better medical billing.

 

Improve Practice Reputation

Maintaining high levels of reputation in medical industry is vital as this industry gives a lot of importance to credibility. A simple rumor or complaint can ruin the image of the medical facility.

A lot of things can be a put off. It could be simple inconveniences or some major dissatisfaction with procedures performed. A lot of things could go wrong but keeping the patient happy is the only way to avoid it.

Similarly, a good word travels fast too. Even during these days, a lot of people rely on recommendations provided by friends and family in order to receive any treatment. This can be extremely beneficial for the facility.

 

Employee Satisfaction

Happy employees make a happy organization. And when the employees are happy, they tend to provide better services. And with this, the trust levels between the patients and the medical facility at quite strong.

And when the employees are happy with their jobs, they are less likely to resign early. This saves the medical facility tones of resources in terms of training and hiring.

When the facility outsources medical billing to medical billing company or agency, a big chunk of their time consuming work is done away with. This keeps the employees stress free. Outsourcing of medical billing can have substantial impact on the medical facility’s reputation, improve its revenue and can help improve patient interactions along with providing high levels of employee satisfaction.

Since the medical facility decides to give away one of the most stressful parts of their processes, employees are more relaxed on the job and invest it in client servicing. This thus balances both sides, delivering happy employees and clients.

 

Conclusion

Info Hub Services is one of the leading offshore medical billing agencies that come with extensive experience in streamlining RCM services for every specialty. At Info Hub, we house a team of experienced professionals who have in-depth experience of medical billing industry. Being HIPAA compliant and working hard towards reducing claim denials that will lead to revenue generation, our team is available round the clock to ensure practice growth and patient satisfaction.

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Coding Guidelines For General Surgery Billing Services https://infohubservices.com/coding-guidelines-for-general-surgery-billing-services/ Tue, 24 Jan 2023 05:59:58 +0000 https://infohubservices.com/?p=47730 What is General Surgery?

Surgery that targets the esophagus, stomach, small and large intestines, liver, pancreas, gallbladder, appendix, bile ducts, thyroid gland, and other organs is known as general surgery. Billers and coders for general surgery must be knowledgeable of the codes and terminology used in the field.

The advancement of cutting-edge technology that makes it possible for general surgeons to undertake complex surgeries also necessitates that they continually study and upgrade to stay current, leaving little or very little time for general surgeons to concentrate on medical billing and reimbursements.

 

 Coding Guidelines

It is important to be thorough with coding guidelines for general surgery in order to be rightly reimbursed for the services rendered.

Read on to know a few guidelines so you don’t lose money on the table. 

  1. Vascular and/or airway access are necessary for many invasive procedures. Pre-procedure or intra-procedure work includes the work necessary to secure the required access. The post-procedure work includes the tasks necessary to get a patient back to the proper post-procedure state.
  2. The endoscopic procedure is not separately reportable from the non-endoscopic surgery if it is carried out concurrently with it to make sure that no intraoperative injuries occurred or to confirm that the procedure was done appropriately.
  3. An operative procedure includes exposure to and investigation of the surgical field, which is not reportable independently. The existing protocols may typically be recorded separately if further research into a surgical area leads to additional surgeries beyond the main treatment. However, an operation that the CPT code descriptor identifies as a “separate procedure” is not separately reportable if it is carried out through the same skin incision, orifice, or surgical approach in a location that is anatomically connected to the other procedure(s).
  4. The incision and opening of the organ are both included in an excision and removal. It is prohibited to report an HCPCS/CPT code for a -otomy procedure alongside a -ectomy code for the same organ.
  5. Multiple methods of doing the same task are incompatible and should not be reported individually.
  6. Only the finished procedure may be provided if a procedure using one technique fails and is changed to a procedure using a different approach.

General Guidelines to Ensure Your Coding Is Accurate

The first step is to review the header of the report. Followed by reviewing the CPT codebook and it is always advisable to start with the index. Then comes a slightly tedious part which is checking if the documentation is in place. This must be followed by making a preliminary code selection.

Once the selection is done, there are certain guidelines given for the codes which must be reviewed. You can eliminate any extras by reviewing the policies and can add any modifier required. The steps mentioned above will help the coder to deliver a neat operative report with correct coding.

 

Avoid Duplicate Billing

It is not uncommon for medical surgeons to perform multiple procedures during a single surgery. There are also times when the procedures, which are scheduled are changed during the surgery. In such scenarios, cases of duplicate billing are not uncommon. Since medical billers do perform a lot of coding, mistakes due to human error are bound to happen. That is why when medical facilities outsource procedures to a medical billing company or a medical billing agency, they can access the expert level knowledge of the staff and avoid such errors.

 

Audits and QC

Repetition of errors in general surgery coding specially is quite high. One way to avoid this from happening is to undertake several and regular quality checks accompanied by audits performed frequently. This reduces any denials and rejection of claims, thus keeping the revenue cycle in a good shape.

 

Upcoding

While coders are generally advised and well aware that their work is quite detail oriented, a single error can have a direct impact on the financial health of the medical facility. In such cases, maintaining a practice management software with required entries is advisable. Such entries must match with diagnosis and codes of procedures done by the surgeon.

At Info Hub, we house a team to expert medical billing professionals who understand the nuances of General Surgery billing services. Our team is well versed in latest updates taking place in medical billing arena ensuring we provide excellent services to the providers we work with.

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How Offshore Medical Billing Companies can help Providers in 2023? https://infohubservices.com/how-offshore-medical-billing-companies-can-help-providers-in-2023/ Wed, 18 Jan 2023 12:48:19 +0000 https://infohubservices.com/?p=47690 Medical field is notorious for keeping its staff on their toes. While it does provide a high level of job satisfaction, it is also one of the most stressful industries to work for. In such a scenario, adding up any more tedious tasks can disrupt the work life balance amongst employees. That is why many medical facilities are now opting for a medical billing company to make their medical billing process efficient.

Being a detail oriented industry, a single error in billing procedures can have a direct impact on the medical facilities’ finances. In this blog, we will discuss how offshore medical billing companies can help their providers in the year 2023.

Expertise 

Most medical billing agencies and medical billing companies house staff that is well trained in the medical billing procedures and have extensive experience in the field. You can leverage their expertise and experience in medical billing and coding, along with other know-hows of the medical billing process.

Cost Saving

An offshore medical billing company enables saving costs by removing overheads in your practice. Be it hiring staff, ensuring updated knowledge, investing in EHR or covering other miscellaneous costs, medical practices have boatloads of expenses. This can be resolved by cost-effective offshore medical billing agencies that can help providers lower their costs while increasing profits.

Time Efficient

Since medical billing procedures are prone to a lot of errors occurring due to human tendencies, such errors can lead to a lot of claims getting denied or delayed. This can lead to a lot of time spent to track to rectify them. In such cases, outsourcing medical billing process to offshore medical billing agencies can help, all thanks to the staff which deliver quality output.

Reduced Claim Denials

Your in-house staff may not be competent enough, or you may face a paucity of trained coders and billers to ensure error-free claims submission. Claim denials are one of the prominent reasons for loss of revenue, and if you don’t have a dedicated team to check into the causes for denials and rejections, there are grim chances of you being fully reimbursed. Offshore medical billing agencies are equipped with the skillset to determine denial causes and to do all that it takes to turn lost revenue into dollars.

Automation

Most offshore bulling companies invest in latest technology that make the entire medical billing process simple. With such tools and software at your disposal, there is little room left for errors in the RCM cycle. Practices can leverage this automation to grow their practice.

A/R Management

A/R follow-up is crucial to ensure a good flow of revenue. The team is responsible for checking denied claims and opening them up for maximum reimbursement. If your practice lacks an A/R team, you may want to consider offshore medical billing, who with their dedicated team will help maximize the revenue for services rendered.

At Info Hub, we house a team of extremely talented and experienced personnels which can help you improve your medical billing and revenue cycle to its maximum potential. From credentialing, to eligibility verification and medical billing, our team is always around to assist physicians in addressing revenue leakages, increasing reimbursements and boosting their RCM Cycle.

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How Can Physicians provide PCM Effectively? https://infohubservices.com/how-can-physicians-provide-pcm-effectively/ Wed, 11 Jan 2023 12:35:04 +0000 https://infohubservices.com/?p=47635 Understanding PCM

With effect from 2022, Medicare stopped using two Healthcare Common Procedure Coding System G codes and started accepting four new CPT codes for principal care management (PCM) – CPT Code: G2064 and CPT Code: G2065. According to experts, the new codes give doctors the chance to increase outcomes while also increasing their earnings because they are paid at a greater rate than the G codes.

In that both services are provided to patients who need continuous clinical monitoring and care coordination, PCM and chronic care management (CCM) are comparable. To be eligible for PCM, patients must only have one complicated chronic condition, as opposed to three or more for CCM, which is the opposite of PCM.

 

How Will PCM Affect Healthcare Industry?

Practitioners may now be compensated for giving their patients care management solutions that are more focused within their own specific area of specialty thanks to the new PCM codes. A patient’s primary care doctor may nevertheless offer more comprehensive care management services as necessary. The new PCM codes, like the CCM codes, may be used in conjunction with Remote Patient Monitoring codes (CPT Codes 99453, 99454, 99457, and 99091), and they may be used incidentally by a billing practitioner while being overseen by the clinical personnel performing the services.

 

Learn About the Principal Care Management Billing Criteria

Patients must have one complex chronic disease that satisfies all six of the following requirements in order to be eligible for principal care management (PCM) billing.

  1. Should persist for at least three months.
  2. Significantly increases the patient’s risk of hospitalisation, acute decompensation or aggravation, functional decline, or even death.
  3. Needs a care plan that is particular to the disease to be developed, monitored, or revised.
  4. Requires frequent modifications to drug schedules, and/or the condition’s care is extremely difficult because of other conditions.
  5. Demands constant contact and care coordination amongst pertinent healthcare providers.
  6. Requires PCM services for at least 30 minutes each calendar month.

 

Benefits of PCM

Similar to CCM, Principal Care Management (PCM), also offers benefits to both, the patient and the provider.

  1. Stabilization of Chronic Condition: One of the main objectives of PCM is to stabilise a patient’s chronic condition as soon as feasible so that the patient’s primary care physician can take over overall responsibility for their treatment. The patient would pay far less for healthcare as a result.
  2. Preventing Secondary Chronic Condition – The benefit of treating a chronic ailment as soon as it manifests is that it significantly lowers the likelihood of a new, secondary chronic condition developing. The care and attention that patients receive from their healthcare professional is one overarching benefit of all of CMS’s initiatives.
  3. Opportunities for Reimbursement – CMS enables providers to get PCM reimbursements, providing your practise with an extra source of income.

 

How Can Physicians Provide PCM Effectively?

 Patient Selection – PCM is not necessary for all individuals with complex chronic conditions. Be sure to note that the patient’s condition is so severe that hospitalisation is either imminent or that the patient has already received multiple hospitalisations as a result of the disease.

Patient Consent – Document the patient’s consent, and make sure to note that you’ve informed them that their coinsurance is in effect.

Bill Correctly – Report CPT codes 99424 and 99425 if a physician or non-physician performs the PCM, and record CPT codes 99426 and 99427 if a clinical staff member or other certified professional supervises the service directly.

Outsource PCM Services – Identify the PCM service types you are presently offering, but not charging. Do you have the ability to charge for those services in order to maybe defray the expense of recruiting a new employee who may also be qualified to offer CCM and TCM services? Outsourcing your services to a third party is also a beneficial option. You can opt for an offshore medical billing agency to assist you with your PCM services that can assist generate more revenue with minimal errors.

Maximize Collections and Improve Patient Care with Info Hub Services

CMS enables providers to increase revenue streams and enhance patient outcomes through PCM. You may manage your patients more effectively by using our PCM solution, which has many of the same features and resources as our CCM solution. In order to increase your revenue and guarantee patient happiness, Info Hub, an offshore medical billing company, offers its expertise with patient care enrolment and consent forms, plan assessments, and monthly PCM time tracking.

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The Ultimate Guide to Outsourcing Medical Billing Services to India https://infohubservices.com/the-ultimate-guide-to-outsourcing-medical-billing-services-to-india/ Mon, 09 Jan 2023 13:15:15 +0000 https://infohubservices.com/?p=47631 By 2026, it is anticipated that the global market for outsourced medical billing would be worth $19.7 billion, growing at an average annual rate of 11.8%.

According to a Medical Group Management Association analysis from April 2020, COVID-19 caused medical offices to see a 55% decline in revenue.

 

Is your practice experiencing dwindling revenues? The period during and after COVID-19 has especially strained physicians and made it necessary to ensure high focus on billing and reimbursements. Revenue cycle management includes a key component called medical billing services. So, while carrying out the process, comprehensive analysis is required. Any mistake along the procedure has the potential to harm the overall finances. Therefore, a lot of businesses choose to outsource their medical billing needs.

 

Understanding Outsourced Medical Billing Services

When a health facility, hospital, private practise, clinic, etc. permits a committed third-party partner to manage all or part of the back-end billing, this is known as outsourcing medical billing. This includes coding review, claim submission, payment posting, fix and reprocess claim rejections, process appeals, accounts receivable management, and patient payments and statement call centre. This is all that is required to process a claim after the provider closes the encounter and adds their visit notes to the electronic medical record. A specialist outsourced revenue cycle team’s primary goal is to maximise revenue while optimizing your processes and operations and securing payment for medical services as promptly and effectively as feasible.

 

Reasons Why Outsourced Medical Billing Services to India Are Preferred

Your practise can maintain stability and maintain financial control by outsourcing medical billing, independent of changes in patient volume, personnel levels, and other variables. You can get advantages for your entire practise over time by outsourcing your medical billing services to India. The benefits of outsourcing medical billing services for your business include:

1. Reduced workload on your staff – Outsourcing your medical billing helps reduce workload and the accompanying stress on the practice’s staff, thus enabling them to focus on other important jobs such as patient care.

2. Efficient medical billing and coding – When you outsource your medical billing to agencies, be assured that the team is adept with the nuances of billing and coding, which lead to reduced errors and increased profits.

3. Cost-Effective – Medical billing services can be outsourced at a reduced cost and come with greater financial sense. There is less reason for concern when billing services are outsourced because physicians do not have to wait for any staff to submit claims. They are not required to spend money on employing and training employees.

4. Timely Reimbursements – The team ensures timely filing and timely reimbursements, owing to their know-how of the medical billing process. They leave no stone unturned in submitting claims on time so that you do not lose dollars.

5. Compliance – When a company or organisation refers to compliance, it means that the office has a rigorous plan in place to perform out duties in line with the law. The use and dissemination of personal health data by particular entities is governed by HIPAA. The regulations are put into place to stop fraud and misuse.

6. Updated with Changing Regulations – Incredibly, the billing niche is one area where the laws and regulations of the medical industry are continually changing. It can be difficult and time-consuming to keep up with all the changes, but it is necessary to do so. When medical billing is outsourced, the outsourcing partner will manage rule and regulation changes effectively.

7. Advantage of the time difference – The time difference between India and US works in favor of the physicians, where the turn-around time helps in quick solutions.

Because the primary goal of billing is insurance company payment, representing all information on a patient’s diagnosis, treatment, procedure, and medical history requires highly specialised knowledge. The correctness and effectiveness of the claim submitted to the insurance company completely determine the likelihood of receiving compensation.

A service that offers medical billing is a response that is wholly appropriate for the medical demands of the twenty-first century. Since these services can be delivered swiftly and inexpensively, your practise can gain a variety of advantages. One of the top medical billing companies in India, Info Hub Services provides medical billing, credentialing, medical coding, and RCM Consulting services. Over the years, we have gained the trust of our clients, and assure to increase profits for your company.

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3 Most Unique Challenges with DME Billings https://infohubservices.com/3-most-unique-challenges-with-dme-billings/ Wed, 04 Jan 2023 09:48:10 +0000 https://infohubservices.com/?p=47620 The need for durable medical equipment is seeing an increase owing to the changing environmental factors, lifestyle habits, need for convenient and less dependable modes of support systems. While the demand for DME rises, so do the complexities in DME billing. The reimbursements have already been taking a hit, and the complex billing process seems not promising either.

 

What is DME Billing?

Durable medical equipment, or DME, is a type of therapeutic equipment that is recommended to patients with specific medical conditions by trained healthcare professionals. If the equipment is utilized for convenience or in ways that go beyond the patient’s reasonable medical needs, DME billings does not apply.

 

With the ever-changing regulatory compliance systems, DME billing is evolving as well, and what your organization needs the most is efficient medical billers and coders who will ensure full reimbursement. Being aware of the many issues and challenges that plague DME billing will help mitigate these. Here are the top most DME billing challenges that are unique to the specialty.

 

A) Irregular Billings

DME providers frequently struggle with timely billing, which limits revenue flows. Many attempts to take shortcuts to make up for the shortcomings as a result. But over time, rather than raising money, it creates more difficulties. The pressure on the collection rate rises sharply as denials mount and management fails to follow up. It causes additional issues, such as how to avoid them. Without adequate management, a lack of data for analytics causes billing to lag, and the processing of denials to deteriorate.

 

B) Regulatory Challenges 

Like other medical billing services, DME billings are frequently subject to legislative changes. DME providers frequently neglect to keep up with these most recent modifications and follow the new laws and regulations as a result. This eventually has an impact on how DME bills, and how much is paid out for the services. It is significant to highlight that the regulatory framework for DMEs is more intricate and stringent, which frequently puts service providers in a challenging position concerning Medicaid and Medicare Services.

 

C) Insufficient Documentation

The insufficient documentation issue occurs when a provider’s supporting documentation falls short of fully supporting the billable procedure code. Common mistakes in DME claim documentation include:

  1. Medical Necessity – The documentation must show that, in accordance with Medicare’s coverage and payment policies, the treatments charged were medically required.
  2. Use of Modifiers: When DME billing modifiers are used incorrectly, claims may be rejected or denied. Even an incorrect code might lead to the denial of a claim.
  3. Patient data verification – This is a typical factor that needs to be addressed. If there are few typographical or form-filling errors, the CMS or the insurance company may reject a claim.

 

Additional issues that DME providers face include lower collections, billing mistakes, higher training costs for new hires, and operations that are halted in the absence of office employees. DME billing services need to be handled carefully. Even the smallest error can accumulate and cause extremely poor productivity and a halt in revenue.

 

Why Partner with Info Hub?

Timely and correct DME claims might benefit from having a solid staff of billers and coders who are conversant with CMS Guidelines and Regulations. Info Hub, offshore DME billing providers are capable of using the necessary resources, but they risk losing money if they use poorly coded modifiers. Many providers choose to work with offshore DME billing companies because of the challenges and complexity of DME billing. By moving their billing overseas, companies have access to a group of expert coders and billers that work hard to ensure timely payments. Here is what we offer –

  • Cost Optimization 

In order to achieve the greatest results, we constantly innovate the DME structure. In order to keep up with the evolving business environment, we streamline the client’s current operations. To help the client reduce operating costs, we use technology and business information to boost personnel throughput.

 

  • Enhanced Customer Experience

Customer experience is crucial to DME medical billing services, therefore we aid our medical clients by providing them with unique solutions to provide patients, account managers, and clinics with unrivaled support. We automate the majority of the time-consuming duties for the team so that they can concentrate on the ones that require human involvement.

 

  • Risk Mitigation

We ensure the confidentiality of sensitive customer information and corporate data as a certified DME specialist. We are a HIPAA-compliant business with the necessary security setup to carry out DME medical billing operations and guarantee data protection. We assist our clients in avoiding non-compliance fines so they don’t have to spend money on pricey billing solutions.

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Billing Guidelines for Urology Billing Services https://infohubservices.com/billing-guidelines-for-urology-billing-services/ Mon, 02 Jan 2023 09:18:10 +0000 https://infohubservices.com/?p=47614 Urology billing includes invoicing for the treatment rendered for problems with the male reproductive system and urinary system. Are you struggling with Urology billing and coding? The very nature of the process which includes complicated codes and terminologies makes billing for urology difficult compared to other specialties. Thus, medical billing for urology refers to the process used by healthcare professionals to submit claims to insurance companies for treatment provided to patients.

It takes a urology billing specialist to handle the subtleties of urology billing and coding, which calls for specialized skills and knowledge. Urology is distinct and difficult to comprehend because of its tendency to collide with other specialties like oncology, gastroenterology, andrology, pediatrics, endocrinology, and gynecology. Here are some urology billing guidelines to help you maneuver through the process.

 

Urology CPT Codes and Types of Surgeries

In order to understand the billing guidelines for urology billing, here’s a quick look at top CPT codes and surgeries that are covered.

Organ-based CPT codes include those for the kidneys, ureters, bladders, urethras, and male and female genitalia. The range of codes used are 50010 through 58294.

The types of surgeries billed for Urology include – Incision/Biopsy; Excision; Transplantation; Catheter Introduction; Laparoscopy; Endoscopy (Cystoscopy, Urethroscopy, Cystourethroscopy, etc.); Repairs; Transplantation.

 

Best Guidelines in Urology Medical Billing

  1. Prior Permission – Due to the high expense of urology operations, the practitioner must first acquire prior approval from the insurance carrier. Prior authorizations assist the practice in better comprehending the submission requirements, timely submission of claims, and receipt of reimbursements.
  2. Medical Requirement – To be able to charge appropriately for the extremely expensive treatments they deliver, the urology service provider needs to be able to demonstrate the medical necessity of the course of treatment.
  3. Denials – Denials can be minimised by confirming a patient’s eligibility & benefits at least 48 hours beforehand.
  4. CLIA number – (Clinical Laboratory Improvement Amendments). While invoicing for the lab test, the CLIA number should be updated.
  5. Services covered and not covered – Non-covered Medicare will reject A Codes like A4357, A4334, A5114, A4340, A4331, etc. as Non-Covered Services, and will not pay for them. However, some supplemental insurance will cover the costs of therapies not covered by Medicare.
  6. Maximum Benefit Coding – As permitted by the specific payers for the particular CPTs, CPT codes must be coded with the appropriate units.
  7. Billing CPTs 51701–51703 – Codes In addition to any other treatment that has catheter insertion as a component, providers shouldn’t record 51701-51703.
  8. Modifier inclusion – When charging for two urological services at once, providers are required to use modifier 59.
  9. LCD rules – Before charging for urology services, providers should adhere to LCD rules.

 

Role of Accurate Billing Process in Urology Practice

1. Credentialing – To gain network status, an experienced medical billing practice for urology contacts the carriers of your choice.

2. Advice on Carrier Contracts – There may occasionally be hazards to watch out for in contracts and surroundings that may lead you to select non-network status with difficult carriers. You can have the additional knowledge to provide assistance as needed if you have experience with medical billing for urology practices.

3. Fee Schedule Analysis – This helps find the right change levels. Experts in urology medical billing can enter the necessary sums from the acquired network contracts to monitor any erroneous reimbursements.

4. Coding Knowledge: A qualified staff member to “abstract” codes from documentation or to check your coding is beneficial. Compliance and audit will also provide you with more options for revenue.

 

Urology Expertise at Info Hub Services

For those who are unfamiliar with the precise codes for particular procedures, urology billing and coding might be challenging. It is easier to identify the treatment being performed if you are familiar with the pattern and the codes, thereby streamlining the urology billing process. Remember that accuracy in your codes and paperwork is the key to success if you want to be properly reimbursed.

It can be difficult to locate qualified urology billers and coders, expensive to hire them, and difficult to keep them trained. At Info Hub, our team consists of CPC-certified urology coders with extensive training who can process 25–30 operation reports each day.

We cover the most challenging CPT code material in our urology specialty coding service, and we teach our coders how to deal with all procedural, modifier, and diagnostic coding issues. At every step of the billing and coding process, we guarantee HIPAA compliance. To prevent denials, our team undertakes prior authorization of the patient’s eligibility & benefits. Info Hub is one of the best offshore medical billing companies that can help boost your revenue.

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All You Want to Know about Payment Posting Services https://infohubservices.com/all-you-want-to-know-about-payment-posting-services/ Thu, 29 Dec 2022 06:01:11 +0000 https://infohubservices.com/?p=47609 Payment posting, in simple words, stands for logging of payments into the medical billing software. It also stands for viewing the financial status of the medical facility by making day to day payments visible. Payment posting is considered vital for any medical facility’s revenue as it provides insight into the daily revenue stream. Such data can then be used to detect any potentially occurring issues and to curb them well in advance.

The medical billing process is a complicated one. There are several steps involved and the staff who is in charge needs to be experienced and must possess thorough knowledge about the process. In case if there any mistake or any information is missing, the claim might be denied or delayed. This has a severe impact on the revenue cycle and financials of the medical facility.

Which is why payment posting is the first line of defence while avoiding such problems. It helps in identifying any issues in their infancy stage so that they can be acted upon promptly. Issues such as services which are not covered, medical necessity denials and prior authorisation are unearthed even before they escalate. This leads to a smooth functioning of the process and less friction while processing any claims.

There are two types of Payment Postings:

Automated Posting: This process is favoured by many medical facilities primarily because it quickens the medical billing process. This is a software driven approach which ensures lesser human made errors contributing to a healthy revenue cycle. Since this a digital based solution, many medical facilities are inclined towards it, owing to its error free delivery.

Manual Posting: As the name suggests, manual postings are done manually. The person who is in charge must post the entries and this is a time consuming process. This process is also at a risk of higher number of errors since the postings are done manually. In case if any error occurs one can expect delays in payment postings.

Payment postings allow any medical service provider to monitor the payments which are incoming. When such payments are properly organised, it brings any issues or problems to the surface. Even in case of incorrect payment posting done by the staff, the balance of the paid account will be reflected in the system. In such cases, the AR team steps into the picture in order to reimburse the claims.

Almost every medical facility is plagues with some kind of recurring issues in their revenue cycle. Usually, such problems persist within the revenue cycle. Accurate payment posting can help resolve such issues in order to ensure a seamless functioning of the facility’s financials.

 

Here are the ways payment postings makes your Revenue Cycle Efficient:

 

Identifies the Denials: Verifying the patient’s eligibility and benefits will help the revenue cycle significantly as this leads to identification of any denials and helps avoid them.

Patient Responsibility: It helps identify and move balances to patient responsibility.

EOD and ERA Posting: Payment postings ensure that data from EOC and ERA match the payments.

Simple Analysis of Revenue Cycle: Analysing the revenue cycle helps in the enhancement of financial health.

Identification of Recurring Issues: With the help of accurate payment postings recurring issues in the revenue cycle which leads to claim denials or delays can be studied and avoided. It helps to identify any specific problem plaguing the revenue and makes it easier to eliminate it.

Resolution Time Is Minimised: Payment postings helps in implementing a denial tracking service. Such process helps in minimising the claim rejection and quickly resolves the issue.

A healthy revenue cycle ensures a healthy financial state of a medical facility. Medical billing is a tedious task which requires a great attention to detail. We at Info Hub Services house a team of experienced and knowledgeable staff to ensure your finances are in safe hands. To start your medical billing journey with us, call Info Hub now!

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