Overcoming Gastroenterology Billing Challenges with Efficient Billing Services

Gastroenterology is a sprawling discipline dealing with multiple anatomies and diseases that afflict them. And this makes a gastroenterological treatment episode very dynamic, one where  an episode starting with a normal screening can lead to surgery, bringing in divergent care components within a treatment episode making claim preparation, which includes assigning proper code to each care component deciphering where one started and ended and whether the incursion of a new care service changes the character of the treatment from a billing perspective – very difficult. On a specific note, there are mainly three components of a gastroenterological treatment – screening, diagnosis and biopsy and an episode can include all of them.

Two years ago, a patient showed low-risk symptoms and had a screening colonoscopy but now displays symptoms that warrant diagnostic colonoscopy. Will Medicare reimburse the second procedure?

This is just one of the many instances directly related to treatment billers and coders face. Similarly, there are multiple issues related to areas around a treatment, like:

·         The code to use for a first time visit

·         The code for an emergency room, etc.

And if not paid attention to, the result is inaccurate coding, claim rejections and shrunk finance.

To increase the number of successful reimbursements, you have to make sure that you are thoroughly familiar with all aspects of gastroenterology mediacl billing, your knowledge of codes and related matters is frequently updated and you have records to support your claim.

This necessitates three things: sound documentation gathered and archived such that they can be easily retrieved when preparing claims, training for billers and coders which will help develop a sound knowledge of billing and coding modalities and appropriate software platform to ensure efficiency and regulatory compliance.

It’s little wonder that gastroenterology practitioners are increasingly turning to professional billers and coders to handle their billing and coding activities.

MBC’s Revenue Management Consultingservices can help you to put your revenue management cycle in order by assessing it and ensuring that revenue leakage gaps are closed through smooth flow of gastroenterology data, installation of proper software applications and staff training in how to handle gastroenterology codes.

Medicalbillerandcoders.com, the largest consortium of billers and coders in the US, has also been helping several gastroenterology care centers, in big and small cities of the US, with its Outsourcing services handling the entire range of activities involved in billing and coding starting from preparation of claims through submission to post-submission follow-ups. Our service modules are flexible that allow you to pick and choose only those bits and pieces of our services that meet your coding needs so  that you can avoid paying additional cost.

Chiropractors Avert Escalating Denials with Medicalbillersandcoders.com!

   Medicalbillersandcoders.com billing services has recently become the preferred choice amongst a high number of Chiropractors across all 50 US States, to reduce AR days and avert escalating denials. This is mainly because MBC experts with vast industry knowledge can completely focus on optimizing billing and collections, equipped with their intricate understanding of Chiropractic billing.
Challenges which may delay Chiropractor payments-

• Various different injuries which require to be treated, multiple patient issues and therapies all eventually result in overwhelming billing concerns which need to be tackled appropriately

• Constantly changing billing regulations and coding recommendations poses another challenge, hence needing someone experienced in pain therapy billing, to handle the claims accurately

• The topmost challenge for most Chiropractors’ is creating a positive culture amongst the practice staff and provide proper training to help attain a consensus between employer and employee in order  achieve complete accuracy in medical documentation and billing

• Practices need to alter their billing to the changing payer environment and its various challenges such as declining reimbursements, decreased Chiropractic patient benefits, higher out of pocket expenses for patients, fear of potential CMS and other payer audits. This makes it essential for the medical biller to be completely educated on coding, billing and documentation requirements

• The earlier business model is not applicable anymore for running a healthcare business in 2013 and the Chiropractor practices require to regularly update all its systems especially the billing, operating and financial systems to improve their bottom line

• Primary billing challenges due to which Chiropractors payments get denied or delayed are – modifiers, incorrectly reduced codes, incorrect payments, claims in review for an excessive amount of time, coverage issues (pre-existing condition, no coverage, lapse of coverage, no chiro benefits) and insufficient documentation

MBC Chiropractic billing experts believe as change is constant - streamlined billing and updated technologyis the answer to help resolve most of the above challenges. This would help insure minimized risk, due to improved documentation, scheduling and billing systems.
Resolving the Problem with MBC billing services …
MBC Chiropractic billing experts reduce AR days and denials by ensuring-

• Completed forms and documentation before filing claims
• Properly done insurance verification to eliminate increased A/R days
• Regular updating of all the new payer regulation and norms
• Evaluation of the practice set-up and assisting the Chiropractor to ascertain the areas which require technologic up-gradation to improve documentation, etc.

MBC experts also regularly undergo training to be able to provide the highest level of billing and collections service. Being experienced in handling various insurers and with knowledge about the latest chiropractic billing procedures and codes, MBC team easily help procure maximum reimbursements.
MBC also customizes their services to fit the chiropractic practices billing needs, helping the practice save money and also optimize the patient’s health.

My Staff is Reluctant to Change to ICD 10, What Should I do for my Billing and Coding?

  Billing and coding procedures are set to become more complex due to ICD-10. So, if you want to minimize claim denials and maximize revenue you need to have well-trained staff at your practice. Providers need to understand that coding complexities will affect the productivity of in-house staff. They will be confronted with requirements for updated, complex encounter forms and super-bills along with greater knowledge of medical terminology and anatomy.
ICD-10 changes are going to be extensive and with less than a year left, staff should be encouraged to learn the new coding system to eliminate chances of errors. Early preparation and timely review can help overcome any challenges that arise due to ICD-10.

What measures need to be taken by practices?

Practices can either invest time and money in providing procedural training to the staff or outsource their coding and billing requirements to a billing company.

• Money needs to be spent on conducting training sessions and buying learning materials for the staff
• Sufficient time will have to be invested by providers to learn accurate documentation which will eventually help coders
• Staff needs to be trained on new systems and procedures including EHRs, practice management system and computer assisted coding
• They will also require training on handling super-bills and ensuring compliance to HIPAA and other reforms
• Practices will have to retain employees by increasing their payments as they will be handling increased workload due to ICD-10

Is lack of time and resources posing problems?

With so much to do in such less time, it becomes challenging for the doctors to focus on quality patient care. Small practices with limited staff and resources will be the worst hit with ICD-10. Hiring new staff and ensuring their retention becomes a challenge due to lack of money whereas training existing coders becomes a challenges due to time constraint.
Since they can’t afford to reduce cash flow or affect the provision of care, outsourcing billing and coding needs makes sense. A billing company will eliminate the headache of hiring new coders or staff to handle complexities of ICD-10.
Such companies have a team of expert coders and billers who are constantly updated with the reforms in the healthcare industry. Since a well-trained team will be assigned to handle the billing tasks of a medical practice, doctors will be able to focus on patient care rather than internal ICD-10 testing and training.

Medicalbillersandcoders.com offers expert help to practices in smooth transition to ICD-10. We not just offer effective solutions for maximizing practice revenue but also help providers in finding drawbacks in their billing procedures. Latest technologies are used at MBC for handling daily operations of a practice. Apart from offering services related to payer interaction, HIPAA compliance, consultancy and research MBC can also help you in placement of trained coders and billers for your practice. While we work towards strengthening your financial health, you can concentrate on patient care.