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A Look At Medical Billing Profits In 2021. Who Earned & Who Suffered?

The healthcare business is continuously changing. How hospitals and health systems respond to these changes can make all the difference in their ability to maintain a healthy bottom line and continue serving their communities.

The factors that will drive revenue cycle market momentum in 2022 and beyond are technology, investments, efficiency, patient experience, underpayment recovery, and coding automation.

We are witnessing a new surge of consolidation, inventiveness, and innovation following a lengthy period of struggle due to COVID-19 and an already challenging economic situation for hospitals and healthcare organizations.

Here are some critical medical billing statistics –

75% of patients are searching up the cost of medical treatments online.

62% of patients said knowing their out-of-pocket expenditures beforehand of service impacts the possibility of pursuing care.

49% of patients said having accurate information on expected out-of-pocket costs before receiving treatment affects their decision to use a healthcare provider.

According to a new study, patients’ average out-of-pocket expenses increased by 11% in 2017, advancing from $1,630 in 2016 to $1,813 in 2017. The analysis also showed that in 2017, on average, 49% of patient out-of-pocket expenses per healthcare consultation were below $500, 39% were $501-$1,000, and 12% were more than $1,000. In addition, the entire hospital revenue of patient financial responsibility after insurance rose 88 percent between 2012 and 2017.

69% have a budget process that takes over three months from initial implementation to board presentation (the methodology takes more than six months for 9% of these institutions)

41% use rolling forecasts to supplement or to substitute an annual financial plan (31% have plans to implement rolling forecasts)

50%+ CFOs want access to more straightforward report creation, better dashboards and visuals, and enhanced ability to delve into reports to understand innate details (2/3 struggle to pull data from multiple resources).

If you have an in-house medical billing team or are looking for help in a specific area of expertise, we at 24/7 Medical Billing Services are here to assist you. We recognize the hectic schedules of medical professionals and services, which is why we are committed to taking on duties to assist you in maintaining a healthy work-life balance.

COVID-19 pandemic has altered the dynamics of the healthcare industry; here are some highlights of who is profiting and who is losing on margins:

Omnichannel payments are impacting healthcare.

68% of consumers prefer electronic payment methods to pay their medical bills

80% of consumers prefer online payment channels to pay their health plan premiums

20% of online healthcare payments are made on a mobile device

Healthcare data is under attack.

2016 saw more healthcare data violations and breaches than any other year on record

90% of providers report that payment security is critical when collecting patient payments

59% of consumers have significant concerns regarding the security of making payments for both their medical bills and health plan premiums

Consumers are demanding more from healthcare.

92% of consumers want to know payment responsibility before a provider visit

74% of consumers are confused by EOBs and medical bills

73% of providers report that it takes one month or longer to collect from patients

Let’s look at 2021 profit earners who benefited from the pandemic and earned the top spot in the latest trends –

According to forecasts, the medical billing outsourcing market will reach almost $16.9 billion in 2021. As a result, many significant business groupings, including healthcare software businesses and other companies that service the healthcare industry somehow, are invited to participate in the multibillion-dollar merger. Regardless, many organizations adopt an offshore business strategy through captive centers or partnerships, either directly or indirectly.

Most healthcare professionals are willing to outsource their revenue cycle management services because of the ability to maintain and circumvent changes in healthcare revenue payment regulations and the ability to hire and train office staff; compliance issues, in addition to operational factors, are too risky.

There will be an increase or growth in regulatory compliance as patient responsibility increases. Therefore, medical billing businesses should take on the task of acquiring the ability to detect and remedy revenue leakage.

It generates and gives the optimum performance ecology using KPI, essential in revenue cycle management. Medical billing trends for 2021 aim to build a strong path for revenue reimbursements while also encouraging collections service.

Let’s take a look at the processes that suffered in 2021 –

By the end of 2021, according to Kaufman Hall, hospital operating margins will have fallen by 80% from pre-pandemic levels. With hospitals operating on razor-thin margins, forecasting cash flow and the ability to maximize revenue cycle efficiency is more important than ever. As revenue cycle executives and managers strive to improve business outcomes, key technological and process innovation will be driven.

Finally, Some Key Takeaways:

Reduced patient appointments and walk-ins due to apprehensions of catching COVID-19 in the waiting room cause lower patient service revenue in medical practices.

It makes sense to outsource medical billing services to a third party if you compute a higher flow of revenue by leaving the task to experts.

While it can cost more for Revenue Cycle Management Outsourcing than for the work in-house, the more increased success rates on insurance claims offset the higher fees.

Healthcare organizations can concentrate on their core competencies to deliver high-quality healthcare by taking their billing functions beyond the office to third parties.

The conclusion regarding whether to outsource your healthcare billing services to a third party deserves careful consideration.

Read more : Medical Billing Services In 2022 – Changes To Expect

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Medical Billing Services In 2022 – Changes To Expect

Due to the COVID pandemic, hospitals had to operate on tight margins and extract the maximum out of the revenue cycle more than ever. The pandemic highlighted the importance of medical billing services all the more as it had become a struggle to keep up with the testing and immunization records. The post-COVID healthcare industry will be much more complex than earlier. In the coming year of 2022, this will result in the introduction of key technologies and process innovations to improve business outcomes.

There have been a few recent changes that have impacted the medical coding and billing industry significantly. Let’s understand these changes and how they might affect 2022.

Adding COVID-19 Codes

The sudden pandemic and its effects forced the healthcare industry to make some changes in their system, to cope up with the situation. A few codes had to be added for streamlining and tracking the procedures, medical tests for COVID detection, treatment, and immunization related to it. These changes will be an important part of the medical billing system, specifically in 2022.

Transitioning to New ICD Systems

The medical billing industry has already made a major shift to ICD-10 from ICD-9. It is a global system used to classify and code symptoms, diseases, and medical procedures. Though ICD-10 was implemented as early as 1999 for reporting mortality, it was very recently implemented by medical providers and insurance companies. The new system made way to more than 140,000 new diagnostic codes and procedures.

The World Health Organisation (WHO) has already approved the usage of ICD-11 from January 2022. Hence, the new system will come with more changes; for which all professionals need to be trained to keep up with the new codes, rules, etc. This will also shed light on the importance of continual training that goes beyond certification credits or continuing education units (CEUs).

Replacing Medicare Physician Fee Schedule

This recent major change enacted by the Centers for Medicare and Medicaid Services (CMS) in 2021, is one of the first implemented in more than 10 years. Hence, reimbursements and fee schedules in the future will be changing. This will also require professionals to get additional training to keep following the new changes.

Increased Automation

Automation has proved to be a boon in the healthcare industry by helping to reduce physician burnout, increasing accuracy, and streamlining workflow. It has efficiently boosted productivity for various professionals through processes like automated appointment reminders, online scheduling, or patient check-ins. Not only for saving time, but automation has also helped in reducing delays and denials during reimbursements.

The next year and the future look promising on this front. Increased automation can provide for more thorough documentation and completion of tasks in less time.

Increase in Use of Artificial Intelligence

With the other industries, healthcare has also adopted AI and machine learning as its part. It has helped to cut costs and increase patient satisfaction by integrating billing workflows and creating work queues for claim re-submissions. It has also been used to correct and verify the demographic information of patients and customize billing statement releases.

It’s a myth that AI being a part of Computer-Assisted coding (CAC) will reduce human jobs, but it has been proven that the software has been less accurate without the help of a professional human coder. The technology is perfectly designed to enhance the capabilities and increase the productivity of medical billing professionals.

Aligning EHR Software

Almost 86% of office-based physicians already use the EHR software and it has many proven advantages. This feature never stops expanding and surely won’t in the coming year too. It ensures robust reporting and helps perform digital payment processing via patient portals. It also helps in reducing the need to photocopy each billing sheet, using cleaner claims to reduce coding errors, accessing data from a single location, and keeping manually filling forms at the minimum.

Changes in Medical Billing Industry Statistics and Outlook

According to the Bureau of Labour Statistics, employment in the field of medical billing is expected to grow by 8% on a national level in 10 years, from 2019 to 2029.

Family healthcare insurance plans have moved to a higher-deductible model and consumers will be able to use their Health Savings Accounts (HSAs) for covering the costs.

Patients have become more aware of their payment responsibilities and generally want to know their bills upfront considering the growth of electronic payments. Unfortunately, traditional medical billing may delay the collection process by as much as 30 days. The industry is coming up with new payment models such as Revenue Cycle Management (RCM) which can help manage patient payments easily and streamline the whole process.

Some other upcoming changes in 2022:

CMS has come up with a few provisions related to the Affordable Care Act (ACA) coming into effect in 2022. It will help in better medical access for U.S. residents.

The European Commission has proposed an AI-based framework for Europe, which might be the first legal framework and might come into effect in 2022.

The No Surprise Act coming in 2022 for Americans will make health providers treat out-of-network services as in-network services, except ground ambulance transportation.

Even if it is the most crucial part, selecting the proper code and accuracy continues to be challenging in this constantly evolving field. It is integral for efficient working of bill payments and preventing fraud at the same time. Educating all the professionals periodically about billing system changes, insurance regulations, Medicare policies, and medical privacy laws.

Outsourcing Medical Billing Services to the Rescue!

Outsourcing medical billing to another company helps providers focus more on patients, increase productivity, and reduce burnouts. It enables providers to allocate their resources in other aspects of their business. Plus, these companies who take up the outsourced work are compliant with the current healthcare regulations and strive to ensure steady growth. Outsourcing help businesses lessen their burden as they take care of all aspects of revenue cycle management, manage the accounts receivable, and timely submission of claims for reimbursements.

Consider choosing 24/7 Medical Billing Services for all your needs. Simplification of your billing, dedicating resources to payer reimbursements, and ensuring the accuracy of claims; everything will be taken care of!

Read more: How To Find The Right Medical Billing Outsourcing Company?

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Importance Of Provider Credentialing Services

Getting a provider credentialed with a payer is about too many manual tasks like completing application forms, offering clarifications to questions from payers, and taking regular follow-ups to close the credentialing request. With 24/7 Medical Billing Services, you can easily keep your data updated with payers by using our Provider Credentialing Services.

Provider credentialing is in short a process of getting a physician or a provider associated with payers, which is an important step in the revenue cycle of any healthcare practice. The process lets patients use their insurance cards to pay for particular medical services availed and allows the provider to get reimbursed for the medical services provided. Thus, healthcare practices need to get enrolled and credentialed with most payers so that patients can utilize their insurance plans correctly. When failing to do so, it will result in the patient struggling for competing providers who are registered with the health insurance companies they are subscribed to.

But, the process of credentialing a provider with a payer is about a lot of manual work of completing the application forms, providing descriptions to questions from payers, and following up with them to close the credentialing request. You can trust 24/7 Medical Billing Services to get you credentialed quickly as we understand the forms required by each payer, and their policies and procedures.

Provider Credentialing Process Involves:

Application Evaluation: Completing needed documentation and knowing exceptions.

Primary Source Documentation: Confirm practitioner/ facility information from practitioners.

Outbound Call Center: Get missing documents and update the payer’s database.

Follow-Up With Payers: Taking regular follow-ups on submitted credentialing requests.

Data Entry: Get data, label, and link images to particular providers/ facilities in the payer’s database.

Maintaining Provider Data: Update provider information according to policies and procedures, and CAHQ profile.

But why Provider Credentialing Services are important for your practice?

It Prevents Healthcare Organizations from Revenue Loss

The main reason why properly credentialing providers ensures compliance to state and federal regulations. The reason why a healthcare organization seeks payment from a professional insurance carrier, or a government program like Medicare or Medicaid on the offered services by an excluded nurse, physician, aid, pharmacist, or other providers, the payer can refuse reimbursement. Wherein, if the reimbursement has already occurred, the clinic or practice can be fined, hit with civil monetary fines, and may be ordered to repay the amount of reimbursement in full and sometimes in multiple penalties.

Medical Credentialing Protects Your Patients

A credentialed provider should be continuously checked against when LEIE is the only data point. Other necessary primary source publishers to verify are FACIS®, OFAC, National Abuse Registry, Sex Offender Registries, and Social Security Death Master File, at a minimum.

Credentialing Saves Practices from Lawsuits

While provider credentialing is an important yet precautionary process that covers the bases of compliance and best practices, there are still some cases where things may get out of the control of providers and administrators.

Provider credentialing and enrolment services allow you to:

Keep your data updated with payers

Process faster payments from insurance and get more patient referrals

Minimize revenue leakage

Prevent paperwork and filling out application forms

Reduce denials and identify provider trends

Build relationships with different payers

Obtain real-time status of credentialing and enrollment transactions

Get in touch with the 24/7 Medical Billing Services team to know more about our offerings in Provider Credentialing and Enrollment Services.

Read more: Top Medical Billing Companies In The US

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How Orthopedic Billing Companies Can Increase Your Profits?

Orthopedic billing companies often find it difficult to keep their claims processing accurate and precise. It is seen that the claims rejection rate is so high that it affects their revenue generation significantly. It is such a regular phenomenon that most orthopedic medical facilities are losing out on their expected profits, although their resources are working in full swing.

Do you also fall under the same category?

Did you know?

An average of 11% of the total net revenue is lost due to underpayments every year for a medical centre? Claims processing, revenue cycle management, and billing make for around 14% of the total expenditure in the healthcare domain. It equals a whopping $2.7 trillion in monetary value.

There are two possible reasons for claims rejection:

The payer did not receive the claim

The claim is incorrect or inadequate

However, the orthopedic healthcare operations can make way for the right approach by outsourcing orthopedic billing and coding to an experienced team. This will give them a way out to earn better revenues.

Here is a quick list of how an orthopedic billing company can increase its profitability in 2022:

Collect difficult patient payments

With the usage of high deductible health plans making their way into the orthopedic healthcare domain, the orthopedic providers are finding it increasingly difficult to collect payments from the patients as they do not receive the amount from the insurance payers anymore. In fact, the smaller orthopedic practices lack the necessary resources and the funds to run an appropriate orthopedic billing system.

The good news is that outsourcing orthopedic billing and the collection system to a trusted RCM provider can help you in enhancing your revenue collections. Such outsourced orthopedic partners have the necessary resources and the time to receive the payments from the patients on behalf of your orthopedic services so that you can look at your patients.

2. Improve the rate of clean claims

When you submit a clean claim, you receive the payment quicker from the insurance provider. A clean claim leads to a faster and quicker turnaround. The quickest and most affordable way to get this done is to partner with experienced orthopedic billers and coders specializing in submitting clean claims. They are the ideal team to find out the underlying causes for the rejection of your claim so that you can recover and improve your orthopedic payment collections.

3. Specialty-tailored billing software

Using the orthopedictailored billing software is the next best thing that can help you increase your revenue in the orthopedicpractice. Many software vendors choose to offer the one size fits all kinds of solutions that often fail to meet specialist medical billing needs. If there is more information than what you need, it simply slows down your orthopedic billing workflow and prevents your practice from working at its optimal best.

With the customized orthopedic billing software implementation, you can access the tailored orthopedic billing tools that come loaded with a specific list of coding and claim filing tools. It will help your orthopedic billing give its best performance and bypass any unnecessary information. Keeping in mind the cost and time factor, this is possible only by outsourcing orthopedic billing and coding.

4. Improved scheduling

If you want to improve your orthopedic practice revenue, improving the schedule of the orthopedic billing is incredibly important. Many orthopedic facilities experience a higher number of no-shows from the patients that impact their revenue negatively. The reasons behind no-shows can be varied. Patients might forget their appointments or non-working of the scheduling workflow tool, low level of loyalty from the patients, or complicated orthopedic billing for more complex services, which can negate with an improved scheduling routine.

That’s why it is always recommended to go in for outsourcing orthopedic billing and coding to an experienced team to improve scheduling for your practice.

5. Give your patients choices

When collecting the payments from the patients, you must give them the various options to choose from. Patients are willing to pay their orthopedic medical bills just like they would pay their rents or gas bills. Allow them to pay online, not to forget their payment dues. Send them reminder emails if necessary.

Again, the correct software can help you collect payments with 24/7 accessible payment options. For instance, orthopedic billing software integrated into a patient portal will allow access to the patients for all 24 hours a day. This will benefit your revenue generation significantly, which is possible with an experienced orthopedic billing and coding company.

Get others to do the orthopedic billing for you!

Doing orthopedic billing with your in-house team can often be frustrating as it wastes a lot of money and time. That’s why outsourcing orthopedic billing and coding is mainly suggested to save your time and infrastructure costs. Let an experienced orthopedic billing and coding company handle your claims and the collection tasks. Always choose a company like 24/7 Medical Billing Services that has the requisite expertise and experience with orthopedic billing and collection. Get recommendations from other practitioners in your domain and follow up on the reviews online to outsource the best orthopedic billing and coding company.

Read more: A Guide To Survive Orthopedic Billing Issues

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A Guide On Neurology Billing Services

Every medical practice has different needs and approaches to medical coding and billing. Neurologists constantly deal with complex neurological conditions and diseases such as epilepsy treatment and lumbar puncture procedures to managing chronic pain and many others. So, a neurology billing company needs to maintain their medical efficiency, effectiveness along with providing their patients with the care they are meant to give. Neurology medical billing is indeed complex and complicated field with complete specific, complex codes connected to every diagnostic service and treatment available. Neurology medical billing companies need to focus on offering deep, organized, and accurate billing & coding services to avoid inadequate billing.

Medical billing and coding companies work in the medical records billing departments of neurology clinics, practices. They help in setting up billing and reimbursement from health insurance companies for providing neurology services, by implementing their expertise in neurology billing. All expert medical billers and coders, act as the primary connection between medical practices of the neurologists and various insurance companies of patients, to assist with managing insurance claims and guarantee accurate and end-to-end reimbursement for care to the healthcare providers.

Neurology medical coders and billers have a deep process for recording, coding, and processing the healthcare services provided, diagnosis made, care given for patients by neurologists; and then they create and send invoices or claims for payment to the related insurance companies. They usually track payments and follow up with patients and insurance companies regarding any debts or payments that are pending. Foremostly, the neurology billing companies help in correcting any rejected claims and resubmit those claims if required.

Neurology specific medical billing services

Medical billing and coding companies can work in both in-house environments and remote locations. When you decide to outsource your neurology medical billing services, the teams will be often remote. While companies don’t interfere directly in the neurologists’ clinical work with patients, they help physicians who make sure the care plans and prescriptions (if any) that they prescribe to their patients are crystal clear for the accurate coding required for payment from insurance companies. Medical billing & coding companies can also communicate with patients about overall costs and patient responsibility for any overages which are not covered by insurance.

While a medical billing company is providing services for various niches of the healthcare industry, they need to be specialized in the neurology field. Having a contract with a specialized medical billing company with neurological experience is the best way to establish the most efficient billing and coding processes for your practice.

24/7 Medical Billing Services for Your Neurology Practice

Now here is your chance to benefit from neurology billing services that seamlessly fit all of the peculiarities and uniqueness of your practice. 24/7 Medical Billing Services can take charge of ensuring the processes are converted to codes accurately and sent to the insurance company within time. With 24/7 Medical Billing Services, you don’t have to stress up with following up with the insurance company to remind them of schedules. That’s our job! You can rely on us for frequent claim denials.

We work hard to care for the peripheral and autonomic nervous systems of your patients can be really daunting. Our team is specialized in eliminating the need to worry about denied claims. We take good care to make sure you won’t face any issues with your billing. Everything we do at 24/7 Medical Billing Services is completely transparent so you have a better financial infrastructure.

Guide to our process to neurology medical billing services

Eligibility Verification

After you hire us for medical billing services, we begin our process with a deep questionnaire. We understand how you attend to your patients, your insurance, finances, and payment options.

Coding

We have a dedicated team of coders, project, and account managers to help you with the smoother transition of operations to our services. After each interaction with a client, our coders help you convert the diagnosis or treatment into the related neurology billing and modifiers codes.

Billing Services

We record all of the codes into our software and date them properly. All the needed information is added to bills to prepare them for submission as a claim to the insurance company.

Auditing

Before we dispatch any claims to the insurance company, we make sure that they abide by all of the guidelines and are HIPAA compliant. We also take care of the codes if they are matching and there are no errors.

Denial Management

If a certain claim comes from the insurance company without fulfilling it, we check it again for the documentation and decide on the necessary steps to be taken.

Final Claims Submission

We send the claims back to the insurance company or payer after the final corrections have been made to verify and reimburse you for your services.

Our services are for a wide range of sub-classifications in neurology

You can rely on us for every aspect of the neurology practice that we can handle. Some of our specialized neurology medical billing services are:

Behavioral

Chemodenervation

Clinical neurophysiology

Interventional

Nerve blocks

Neuroimmunology

Neuromuscular

Neurorehabilitation

Pain management

Vascular

Do you need unique billing services for the neurology treatments you offer? Are you ready to optimize your practice costs by 50%?

Meet the team of neurology medical billing experts at 24/7 Medical Billing Services.

To learn more about how 24/7 Medical Billing Services can help you with your neurology medical billing, please refer to our website: https://www.247medicalbillingservices.com/  

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All You Want To Know About Urology Billing Services

It goes without saying that the business process in urology practice is no different from any other practice. And it’s a known fact that the medical billing process is complicated too.

You’ll have to jump through various hoops if you need to get paid for the services you provide. The payment process is hard and rules are harder and complicated. The complete billing process and collection method have to be equally time saving and accurate. None of it will work if you don’t actively participate in the process.

Medical billing is a complex area even for urology practice

Complexity in the urology medical billing process can be easily managed by a company that effectively handles multiple projects and has a team of well-trained urology billing professionals.

The urology medical billing experts should be aware of the particular codes and decide that make up the universe of urology medical billing. As the cost of urology-related medical services keeps on rising, clinical practices and urology experts can’t bear to leave revenue uncollected by companies or consultants that are not known in urology charging. It’s difficult to handle insurance billing in urology practice; patient billing is additionally more troublesome. The patients frequently have high balances, complex explanations from their payers, and don’t see the entirety of the invoices they are getting from their urologists. A medical billing company that has solid urology billing experience has spoken with the patient about such statements oftentimes. A less knowledge about urology medical billing could land the practice in trouble, decreased revenue and unhappy patients.

How does medical billing work for your urology practice?

It’s important to understand that the importance of successful medical billing management is getting to know all your resources of revenue. Hence you need to comprehend how medical billing works for your urology practice.

Credentialing: Expert urology medical billing practice reaches out to the carriers of your choice to obtain network status. Especially free at the start.

Fee Schedule Analysis: You get help with research for appropriate change levels. Urology medical billing experts can enter the required amounts from the obtained network contracts to track any improper reimbursements.

Workflow Consulting: Any medical billing can’t offer this service but 24/7 Medical Billing Services can advise you on the best practices to build a successful team and processes that make sure you get proper results.

Carrier Contract Advice: Sometimes, there could be pitfalls to avoid in contracts and environments that may cause you to choose non-network status with challenging carriers. With medical billing for urology practices, you can have the additional expertise to bring help when necessary.

Coding Expertise: You get a certified and expert staff to “abstract” codes from documentation, or review what you’ve coded. You’ll also get additional revenue opportunities with compliance and audit.

Distinctive Features in Urology from 24/7 Medical Billing Services

24/7 Medical Billing Services comprises standards of excessive benefits in urology medical billing

Understanding our customers is our forte

Easy admittance to the patient reports

Faster payments at competitive rates

Online payment facilities

Constantly 24/7 access to client support

Follow up at both ends

Error-free documentation

Real report provision as per requirement

Making reasonable packages according to your needs

We are well-versed with the consciousness of guidelines and by-laws prevailing in the market for medical billing and have comprehensive information of any latest variations in fundamental laws.

24/7 Medical Billing Services is a knowledgeable partner in urology medical billing and revenue management, which can come to your rescue to ensure correct coding, efficient denial management, compliance, and a healthy revenue stream.

24/7 Medical Billing Services for Your Urology Medical Billing

Our urology billing service ensures competitive benefit through medical billing reports in electronic form, studying denied claims and following up on efficient claim realization, periodic medical billing reports including ICD and CPT code analysis reports, and arranging meetings to discuss your work status. You get to maximize your collections, reduce operating costs, and improving medical efficiency.

Why hire 24/7 Medical Billing Services?

Certified billers and coders at 24/7 Medical Billing Services have years of experience working with urology practices & urologists and are equipped with the understanding of handling coding and billing-related processes to make sure that you receive timely payments and reimbursements. Our expertise in the urology field allows our staff to meet the needs of a variety of urology providers, practitioners, clinics, diagnostic centers, and multi-specialty groups. We work alongside your practice to help identify problems and establish the best medical billing and coding procedures possible.

Benefits of working with 24/7 Medical Billing Services

At 24/7 Medical Billing Services, we have the capability to handle multi-physician, multi-location practices yet we are small enough to give the personal detailing your account deserves. We offer:

Improved collections and income

Quicker payments and reduced stress

24/7 accessibility to your patient data

Transparent revenue cycle

Full financial and practice management reporting

Areas of Expertise

Our medical billing and coding experts are well-trained and keep the latest changes in mind with urology codes and payer requirements. This is good for your urology practice in order to make sure that the claims we submit are correct and there are no delays in payment. We also take care you don’t see any denials in the claims and can appeal denied claims faster and efficiently to ensure quicker reimbursement.

Want to hire a urology billing services expert? Here’s a quick lookout for you with 24/7 Medical Billing Services

Complex urology billing codes and rules

Urology-related terminology

Office notes and operative notes

Coding for surgical procedures

Code variations related to multiple procedure rules

At 24/7 Medical Billing Services, we only use advanced medical billing software that can easily connect to your practice���s own data. Get in touch with us and get ready to shift your billing process instantly.

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Outsourcing Family Practice Billing Is Good To Consider?

If you are a practitioner whose firm is struggling with family practice billing collection, documentation, maintenance and regularizing it? Managing your organization’s family practice billing and staying updated to keep it streamlined is one of the most complicated aspects of running any kind of medical practice. There are thousands of possible codes for procedures and diagnoses, and there are multiple payers which can further complicate things. This makes the ability to have efficient family practice billing a real challenge.

Of course, how you do billing is highly dependent on what kind of medical practice you are into. One solution wouldn’t fit all.

The two main options to consider here in order to take care of Family Practice Medical Billing Services are:

In-House: The staffs of the clinic are responsible for all the aspects of Revenue Cycle Management. Typically, they submit the claims to a clearinghouse or directly to the insurance company for reimbursement, collect patient fees, set charges, and manage the accounts receivable.

Outsourced: Medicals’ practitioners can outsource their medical billing services to a third party service provider. For managing many aspects of the Clinic’s Revenue Cycle Management, these billing services charge a percentage of collections. You may also charge recurring monthly fees.

Most often, the in-house employees are very often the top contributors to the organization’s success. However, regardless of aptitude, competency, or expertise, these individuals rarely possess the time and availability to keep up with rapidly-evolving healthcare trends, particularly medical billing.

A medical billing firm sustains better consistency and control of an uncoordinated internal team’s finances as a practice’s patient volume, staffing levels, and other dynamics evolve with time. Outsourcing your medical billing is advantageous in so many ways that it touches all departments of your practice.

Here are some factors to consider that would help you make a decision as to why to opt for medical billing outsourcing services:

1.       Save Time and Money:

In the Medical field, there are tons of responsibilities to take care of at once. However, when it comes to family practice billing, it is a job that requires utmost attention. If you need your billing department to remain afloat, you will need personnel exclusively dedicated to the family practice billing process. Family Practice Medical Billing Outsourcing will help you save time and money by allowing your staff to work on other essential tasks.

2.       Enables Faster Insurance Payments:

Outsourcing family practice billing services will lead to a reduction in billing errors. These errors can be difficult to rectify sometimes. Thus, you can receive reimbursements and payments in a shorter amount of time. Streamlined workflows and better-earning potential would clear a path for costs to come through more efficiently.

3.       Reduction of Costs:

Maintaining in-house family practice billing comes with many expenses such as training costs, hardware & software installation costs, setting up correct infrastructure, and more. One would have to take care that the staff and the hardware/software would have to be regularly updated. By choosing to outsource, you can rest assured that your family practice billing is well taken care of and have a controlled approach for the same.

4.       Ensuring Compliance:

The medical field has ever-changing regulations that one has to stay in tune with. There are always one or the other protocols that have to be taken care of and updated in practice. In order to properly follow each changing protocol needs a dedicated expert. They can help you to stay up-to-date on any new information as and when it arrives. You can be sure that all HIPAA compliances are followed with outsourcing billing services.

Conclusion Apart from this, there are many benefits, such as getting expert consulting whenever required, boosting productivity, safeguarding data, and cutting down errors, thus eventually leading to increased patient satisfaction. While it is true that in-house employees help a company thrive, but sometimes passing on the responsibility to a third-party organization can benefit the company in longer-run. 24/7 Medical Billing Services specialists can provide you with advice or guidance if you need your outsourced family practice billing services needs and direction. For more details, call us at +1-888-502-0537.

Read More: Understanding The Family Practice Medical Billing In A Better Way!

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Pros And Cons Of Outsourcing Dermatology Billing Services

Billing services and revenue cycle management are one of the essential factors of medical set-ups of any size. Whether you are a small practitioner or running an extensive hospital, you aspire your financial billing systems to go smoothly so that your organization is paid faster and earned. There are two possibilities available for medical practices: owning an in-house billing system or outsourcing medical billing services. This section will explain a few advantages and disadvantages of outsourcing your dermatology medical billing services.

Dermatology revenue cycle management is more significant than just dermatology medical billing. It is a service that handles the methods that affect your bottom line, from first patient contact to paid account insights and everything connected. The system to manage your dermatology nursing center’s revenue cycle management starts before your patient visits and ends if there is zero profit owed to you.

Dermatology practices are not resistant to unpredictable economic circumstances that affect most other industries. Requirements are excellent or challenging today; dermatologists demand to foresee and prepare for a drop in collections and a reduction in revenue at some point.

Sadly, consuming an unnecessary expense of time managing your revenue cycle also makes you experience your practice by wasting less time, energy, and responsibility.

Outsourcing Your Dermatology Medical Billing?

Outsourcing your dermatology billing can give you vast experience and expertise to grow revenue by at least 15%, maximize profitability, and streamline your medical billing processes, allowing you to focus on patient care.

If you are sure about outsourcing, sensibly analyze vendor requirements and the capacity to meet your practice demands. At a point, an outsourcing dermatology medical billing group should have:

Quality of their service

Established market achievement

Dermatology billing expertise

The experienced, trained billing agents

Complete, combined solutions, including practice management and record management policies

Satisfied clients

Company stability and long-term engagement

By outsourcing your in-house resources to concentrate on acquiring or turning to a dermatology billing outsourcing company like 24/7 Medical Billing services to handle all of your billing needs and, you’ll be strong on your way to experiencing increased revenue up to 15% and beyond.

We know practice workflow.

Because our organization consists of accredited coders, billing experts, and consultants, we have the toolbox to improve your practice with whatever difficulties might appear. We can work collaboratively to ensure your system runs at the highest level possible and encourage you during any practice developments, such as staffing changes or practice growth.

When you outsource your dermatology billing, you’re not giving up authority to a third party. Alternatively, we favor thinking of ourselves as aligning your team and becoming a component of your system. We will work just like your back office, and your account administrator is just a phone call or email away for us.

We can provide practices with fee-for-service, including cash-based revenue streams. Almost all dermatology billing services cost is based on a percentage of collections, which is how we do things at 24/7 Medical Billing services; we just get paid when you get paid. Nevertheless, we take this responsibility a step far away from most other RCM services by giving any cash-based services out of the mix. Any cash fees you collect for aesthetic services are not subject to RCM fees. We get compensated for the claims we process — it’s that simple.

How can 24/7 Medical Billing Services enhance your dermatology medical billing system?

24/7 Medical Billing Services deals with multiple specializations billing and specialists at managing dermatology billing for many years. Group understands the core dilemmas of your medical billing practice and concentrates on every area, rendering you scalable resolutions all the time.

Conclusion

With the enhanced complexity in coding fundamentals of dermatologists in practices, an expert like 24/7 Medical Billing Services is required to support outsourced medical billing services and acquisitions. For top solutions for your dermatology medical billing distress, contact 24/7 Medical Billing Services today at +1-888-502-0537.

Read More: Expert Dermatology Medical Billing Services from 24/7 Medical Billing Services

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Top Challenges With Wound Care Billing Services

Denials in healthcare usually focus on high-dollar procedures like hip and knee replacements, or other MS-DRGs may also come under this radar. With wound care medical billing and coding, we have identified so many challenges.

Proper documentation is necessary for clinical substances and processes especially when support medical necessity is involved. This doesn’t attract a clinician’s judgment and medical decision-making for performing the procedure. Physicians have been conditioned to document excisional debridement, but if we think about payment recovery for these practices, they need to do a lot more than just paperwork and documentation. To handle wound care medical coding for inpatients frequently lacks sufficient documentation.

It’s now more than important for wound care providers to make sure that they are coding to the accuracy and following all the ICD-10 guidelines. While it’s not so clear about the elimination of CMS was under this grace period, it might be some things that we are working on with ICD-10 that may not continue to be satisfactory.

Many times, a wound care center offers excellent patient care, and healing rates are high. But, when it comes to calculating revenue, clinical staff is left in the dark. While providing good patient care is necessary, a center that misses tracking its revenue may soon see its doors closed.

Wound care billing and coding are at the heart of every practice and are important for the survival of the center.

Here are some challenges we found with wound care billing and coding.

The most common error is wound care facilities don’t use the add-on codes properly. If removing over 20 cm2 of tissue at a particular depth, it’s important to use the base code and the add-on code. For instance, if removing 28 cm2 of subcutaneous tissue, the notes for the coding would be both 11042 and 11045.

It’s a common myth with coding and billing that if there is a code for a procedure or product, the insurance plan will pay it. This is not always the true cause. Having a code doesn’t always mean the coverage for the procedure, hence, it’s important to know the rules under which you must operate.

ICD-10-PCS differentiates between removable and non-removable debridement. The ICD-10-PCS root operations excision and extraction indicate excisional debridement and non-excisional debridement, sequentially. This doesn’t suggest that physicians need to use the term extraction, but if paperwork shows that the tissue was pulled or stripped away, rather than cut, the debridement is a removal. ICD-10 will need coders to note laterality and more specific anatomic wound locations.

Coders need to be aware of assigning a present on admission (POA) indicator for pressure ulcers, particularly when the healthcare service provider does not note down the ulcer until many days after inpatient admission. Coders need to report an ulcer as POA in case of signs or symptoms are POA. A query may be needed without documentation of signs or symptoms.

There have been arguments, and discussions between what’s recognized to be a “wound” versus an “ulcer.” Sometimes, ICD-10 is similar to its language, and this is an ideal situation. Be aware of the ICD-10 semantic, that medical staff takes for granted. While many service providers may replace the terms “ulcer” and “wound” as if they are replacements, they are no different when it comes to ICD-10 medical coding.

Practitioners reply to the documents during their administrative hours. Because standard physicians’ query stays in medical coding and billing and doesn’t have a great response rate from physicians, clinicians should consider automated physician queries.

Understanding the difference between open fracture debridement, wound debridement, and active wound care coding. Also, there are a few errors when coding correctly during skin grafting/replacement is involved.

The wound care billing and coding are all about a thorough evaluation of the patient’s medical record for the wound, which also includes wound dimensions, chronic diseases which includes chronic ulcers, diabetes, quadriplegia, etc. processes offered to manage the wound, follow-up, initial visit, photographs of the wound, and wound progress. To have 24/7 Medical Billing Services as your wound care medical billing and coding partner can revolutionize your practice by overcoming the above-mentioned challenges.

Read more: How To Be Careful About CPT Coding And Modifiers While Working On Wound Care?

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How To Choose A Medical Billing Company For Podiatry Practice?

There are thousands of medical billing companies across the world to serve different types of medical billing practices concerning their medical billing and coding. But not every company can handle medical billing of all specialties like podiatry, since it involves different procedural codes which can complicate if not managed by an experienced medical billing company. Through this blog, we will make you understand how to choose a medical billing company for your podiatry practice.

#1: Your billing company should be podiatry specialized

Most medical practices choose to outsource their medical billing process to a medical billing company that serves multiple specialties. By providing a wide range of services, these medical billing companies survive their existing competition. But at the same time, you should also notice that some of these companies give you cookie-cutter billing solutions, showing that they are well capable of providing generalized medical services and may attract you to outsource your podiatry billing too.

Therefore, while choosing an outsourcing company for your podiatry practice, you should look at the company’s experience in handling podiatry medical billing and its track record of serving clients and in improving their revenue cycle.

#2: Your billing company should provide excellent customer service

Patient relationships are greatly important for the growth of your business and to retain your clientele on a long-term basis. This is quite difficult to perform and maintain because insurance benefits worry patients a lot and if not cared for and conveyed properly before beginning the treatment, it may go worse to any extent. Since verification of benefits is crucial to make all patients understand pretty well, your podiatry billing company should excel in handling all kinds of patients’ billing grievances, billing disputes, claim rejections and should explain to patients about which and where it went right or wrong.

Moreover, your podiatry medical billing company should have extended customer service skills in managing patients of all ages and any queries. So when you choose a billing company, make sure that it has a proven track record of delivering excellent customer service, and then take a call.

#3: Your billing company should be transparent in explaining to you what’s happening around

The podiatry billing company you choose can take hold of entire processes and activities happening with your podiatry practice but not without letting you know what’s happening around you. The company should provide you an end-to-end report of your podiatry billing and keep you in the loop; therefore, when your patients visit your practice, you must have everything handy to provide the proper care. Moreover, right from profits, claims status, billing, and similar activities when performed, should be notified to you for your knowledge.

Since we know how well the technology has been improving, it is a good idea to find a podiatry billing company that is following the latest technology and software and make you see live about your podiatry practice’s activities and make sure you are not lost in the middle of the ocean.

#4: Your podiatry billing company should be HIPAA compliant

Information security is something very important when it comes to outsourcing your podiatry billing. Compromising your patient practice information in any way leads to huge legal ramifications. We have seen many data breaches by several medical billing companies in 2018, which should not happen anymore. Therefore, the company you choose should give more importance to information security than anything else and stay in line with the changing HIPAA guidelines when and then. Make sure the company stores every information highly secure in the software it uses that is hard for hackers, automated malware, and ransomware to access.

Conclusion

More than all these reasons, your podiatry billing company should have a great passion for podiatry specialty, so there will be upgrading of trending information whenever introduced and focusses on what is needed to enhance the revenue of your podiatry practice. 24/7 Medical Billing Services is a highly experienced medical billing company that has more than 15 years of experience in handling podiatry billing and other multi-specialty services with high quality. Get in touch with our podiatry billing and coding experts at +1-888-502-0537 to outsource your medical billing process.

Read More: Top 5 mistakes with Medical Coding Services

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Why Does Outsourcing Medical Billing Services Work For Practices?

Outsourcing in the industry means that a third party performs particular tasks that do not produce your business’s core purpose. Outsourcing offers several benefits as it provides customized, specific services to customers and diminishes the total cost of operations. While we speak about outsourcing in the healthcare enterprise, documentation and other organizational work are fundamentally involved, which cannot be appropriately handled by a foundation or a practitioner. The growing burden on hospitals, clinicians, and various other governing reasons leads to outsourced assistance in most hospitals and smaller systems. These externalized allies are professionals who share responsibility and support in the system to promote the revenue cycle.

Let us seek some advantages to your practice by outsourcing:

Maintain the costs:

Hospital staff and physicians trade more with patient responsibility in medical practice; they have no idea about coding, billing, reimbursement, etc. In addition, a crew of specialized people is usually hired to carry out these activities efficiently. That manages to more significant expenses and reasonable costs. On the other hand, outsourcing reduces the costs as the facility charges based on the totality of cases it works.

Manages operational restrictions

The outsourcing of specialist companies to some tasks helps to ensure the smooth functioning of the business. In addition, these organizations are experts in their profession, enabling them to work with external settlement bodies. That saves time and improves the generation of revenue.

Risk management

By outsourcing your business will help you to modify particular responsibilities to outsourced merchants. Since outsourced suppliers are professionals, they plan and take care of complex parts. They try to predict the possible cause of loss and evade situations that might arise in the future, such as accomplishing denial.

Help you focus on primary care.

Patient treatment and comfort are the primary jobs of all medical facilities. However, being a professional physician and an administrative worker is always a fight. It takes a lot of participation and effort to obtain your billing in-house. Hospitals would free up workers’ strength and ensure higher returns if they redirected their support from handling complex billing problems to serving cases. In addition, the transfer of specific tasks to outsourced companies encourages practitioners and employees to focus extra on their primary job and promotes goodwill.

Spare time through outsourcing.

It is challenging for physicians to keep control and balance their revenue collection team and their busy schedule of meetings. Nevertheless, medical billing requires consistent support from higher management to ensure that every claim is correctly filed, medical bills, etc., reach every service. Physicians should therefore hire a medical billing firm to assist them in this regard. They may also diminish the workload and time of the physician’s focus. In addition, outsourced medical billing partners can talk to patients, stay associated with payers and keep track of the past-due balance in a peaceful manner.

Maintain smooth operation

Medical billing outsourcing services allow consumers to keep a solid cash flow and collect more instantly, regardless of the organization’s situation. The improvement in revenue and the reduction in costs from the billing service’s hiring far surpass the billing service fee. In addition, outsourcing services such as revenue cycle management (RCM) or medical coding and billing support practice raise revenue. These organizations are coding, billing, and claims experts, which reduce the risk of denials. That means the procedure runs smoothly in times of income.

Holds you up-to-date

Outsourcing firms invest the right amount in their foundation, be it the latest technology or the brand-new software. They keep their practices up-to-date with all changes in market trends. So, hiring any such professional for your practice may help you stay up to date in this demanding field.

Outsourcing is nowadays in course due to its many advantages. Lending and involving a third party is not the wrong idea because it ensures trust and helps you maintain your business with its expertise and quick service. If you are looking for outsourced services such as medical coding, billing, or RCM, 24/7 Medical Billing Services can be your entrusted partner.

Here are many reasons why practitioners and practice supervisors choose to outsource medical billing services for their busy practices and hospitals. Regrettably, many physicians have a difference as to what it intends to outsource those services. While some might assume that choosing to outsource Orthopedic, ENT, or Plastic Surgery coding and billing services is abandoning control over their accounts receivable activity, the fact is that it puts you in a position of power. The advantages of outsourcing medical billing include the ability to free up more extra time to spend with patients, build a more efficient and frustration-free work environment for staff. Even improves your medical practice revenue once you learn how medical billing for your practices works, you might transform your mind about outsourcing your medical billing services.

How Does It Work?

Outsource medical billing services with 24/7 Medical Billing Services, our crew of highly trained and experienced certified coders and insurance provider specialists work on your behalf. They submit claims punctually and ensure you are getting the most revenue out of each receipt. In over 95% of the clients we have served, our team has improved medical practice revenue. However, bungled opportunities, incorrect coding, and other errors can result in your practice losing thousands of dollars per provider each year. Outsourced medical billing for your practice and other specialties means working with a team of billing specialists who concentrate only on offering claims and operating on collections for their clients. No worries regarding sick days, vacations and other staffing issues – our team works non-stop to secure that we don’t just get the job done but get the work performed correctly.

Because 24/7 Medical Billing Services specializes in the particular areas of coding, billing, education, revenue cycle, and other fundamental services for Orthopedic, Otolaryngology, and Plastic Surgery clients, we recognize the benefit of having highly qualified and experienced coders operating on your behalf. We endeavor to create a custom outsourced solution for each client based on their unique needs and demands. We can also allow consulting assistance for practice management, education, staff training, and ongoing maintenance for those who favor keeping medical billing and coding in-house. We go above and ahead to ensure that our customers maximize their efforts to develop collections, succeed in staffing issues, reduce overhead costs, and streamline the entire office from appointment-setting to ultimate payment. Our team will operate with you to improve a solution that incorporates all of the reporting, benchmark-setting, and assistance you require to receive all the benefits of outsourcing medical billing.

Benefits of Outsourcing Medical Billing to 24/7 Medical Billing Services:

Once a custom solution has been installed for your practice or clinic, 24/7 Medical Billing Services can get to work processing requests to increase medical practice revenue. Using our assistance to outsource medical billing services to overcome common issues encountered by busy practices. In addition, our organization of experts can help you overcome billing errors and shield your business from possible fraud. Outsourcing to 24/7 Medical Billing Services saves money and is a fixed cost, significantly reducing expenses than hiring and maintaining an entire staff for billing and coding in-house. Suppose you consider how much it takes to recruit, hire, finance, support, and business staff to perform in-house billing services. In that case, it performs much sense to outsource billing to save money and reduce monthly overhead staffing costs.

In our practice, clients who wish to outsource medical billing services also see increased patient well-being and better yielding with industry laws and requirements. In addition, outsourcing can help your practice manage collection purposes and enhance reporting and benchmarking across the board. Overall, the practice of outsourcing can improve medical practice revenue and decrease the amount of effort needed by your HR department, practice leader, and other in-house administration staff.

Outsourcing excludes the costs connected with training and retraining of billing staff, frees up much-needed time in the department, and can even be structured to accommodate a considerable level of audit oversight due to the detachment of duties. In addition, outsourcing makes running your business simple and encourages you to maintain a consistency of information and brand.

An objective outlook

When accounting systems and billing arrangements are neglected, chaos is usually the outcome. However, a medical billing and practice management company such as 24/7 Medical Billing Services can evaluate existing billing systems, take them over and turn to expose financial situations into positive ones. 24/7 Medical Billing Services’ high rankings in the medical billing company came about because of their expertise and fully qualified, highly equipped staff. Billing codes change, and health insurers adjust their rules and regulations, but a competent outsourcing medical billing company keeps fully up to date with all those modifications.

Outsourcing medical billing improves savings, reduces liabilities for clients, and allows their staff to focus on what they do best in the profession of medicine. 24/7 Medical Billing Services is HIPAA compliant, so all reports are kept entirely confidential and secure. Each unpaid account has been examined a minimum of once a month until all queries are resolved. Outsourcing medical billing allows the client to manage an efficient workflow while ensuring that the cash flow is not interrupted.

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How To Maximize The Growth Of Your Practice By Putting A Proper Plan In Place?

The healthcare domain is transforming and progressing rapidly, unlike any other. Therefore, over the years, it has become imperative to be ready for the future for any healthcare practices to achieve success over the years to come. Specifically, at the COVID-19 pandemic, practices confronted new and unique business and operational challenges that forced a reformation.

The pandemic has taught us that not having a proper plan for the unknown scenarios can cause a catastrophe. That brings a whole lot of importance to having the right plan in place for the practices. Businesses and practices need to be flexible with good planning and organizational skills to succeed.

What does it mean to have proper planning for practices?

Generally, a proper plan for healthcare involves setting goals and creating objectives that would map a successful venture for a business or a practice. Then constructing and executing a plan to achieve these goals and objectives is the next crucial step. Specifically, when practices need to take accountability for economic trends, policy changes, and rapid technological advancements that could impact operations on a larger scale.

While there are different ways to strategize the growth objectives of practice, the core purpose is to align a healthcare system’s mission, vision, and values. At present, healthcare providers aim for more patient-centric systems with many value-based approaches; strategizing plans for systematic healthcare is required more than ever!

Why do we need proper planning in practice?

Typically, practices and even large organizations have experienced considerable inconsistencies in performance due to a lack of strategy development. However, the businesses that have been successful over the years can agree that placing a proper plan requires a strategy that aligns employees, executives, and business groups to specific visions and goals.

Developing an approach that is flexible and adaptable where particular possibilities can be mapped or predicted becomes an advantage for practice in the toughest competition. Likewise, at 24/7 Medical Billing Services, we offer end-to-end medical billing services which can enhance your practice costs by 50%.

Placing a proper plan into action involves continuous analysis, strategizing, and monitoring that are required to achieve necessary goals and objectives. Generally, there are four factors for developing a good strategy –

Analyze and assess – analyzing and assessing the present environment in a practice

Strategy formation – setting a plan

Strategy execution – putting the plan into action

Final evaluation – evaluating the performance of the plan

To answer the question, why do we need to place a proper plan?

Streamlined communication –

Streamlining clear communication between the business groups, employees and stakeholders will help your practice to have a long-lasting future.

Creating and sharing your vision –

Planning a vision and sharing it with the organization on every level will have a certain impact. For example, employees will be more committed and motivated to achieve the vision for the practice. In addition, the vision that is developed, communicated, and executed among the individuals of an organization can lead to a successful future.

Employee engagement

Employee recognition has a significant impact on their productivity and engagement. However, employees won’t be motivated if a practice doesn’t state any clear plan for employee benefits.

Being a leader in leadership

Leaders can communicate their organization’s vision, believe in their employees, and produce high productivity levels. Helping the employees understand their roles in practice is also a critical component to achieve success.

Collaboration and cooperation

Having a plan placed that ensures employees collaborate and cooperate is essential for every healthcare industry. Effectively strategizing models that are employee-centric can help your practice to deliver high-quality care and excellent customer service.

Benefits of placing a proper plan into your practices –

It helps practices become more dynamic

Increases operational efficiency

Boosts profitability

It makes practices more robust

Conclusion:

Here at 24/7 Medical Billing Services , we believe that proper plans can ensure your practice’s successful and profitable future. And it is highly crucial to strategize your practice’s future outcomes. By opting for medical billing, medical coding, and credentialing services to your practice can maximize the growth of your business.

Read more: Top 7 Factors To Improve Your Practice Performance

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A Guide To Survive Orthopedic Billing Issues

Your medical billing methods are one of the most critical functions in your orthopedic practices. Private orthopedic billing and coding process keep revenue rolling with minimal delays, reducing cash flow difficulties and reducing stress for your practice. However, denials can be one of the essential issues orthopedics practices face, and failing to take measures to prevent denials can be costly for your practice. Here are some medical billing and coding tips your practice needs to follow to minimize the risk of rejections and survive Orthopedic billing issues

Stay On Top regarding Latest Codes

Every year the American Medical Association (AMA) attains new changes to the Current Procedural Terminology (CPT) codes, and it’s vital to make sure your practice stays current on the most advanced coding updates. If you’re arranging your billing and coding in-house, securing your billing and coding specialists to educate themselves on the most advanced codes is required. Having your coders up-to-date on recent coding changes may need investment, but it’s worth it to make sure they’re current on regulations, so you have a negligible additional risk of denials.

With significant changes arising out for the new budgetary year, orthopedic practices need to catch up to speed on those new codes as swiftly as possible.

Be Informed of and Avoid the Common Denials

It’s also essential to make sure your orthopedic practice is aware of the most common claims denials so you can avoid them. For example, one of the biggest reasons orthopedic procedures encounter rejections is for duplicate claims or services. Another apparent reason for claim denials is the cost surpasses the fee program.

Make sure your service tracks the root causes of the most common denials. Then you can put methods into place to prevent those denials in the future. These are some of the best actions you can use to avoid denials include:

Making sure that patient data is correct when it’s received

Remaining diligent about insurance verification

Operating with an automated billing service

While Outsourcing is the Key

In many cases, deciding to outsourcing orthopedic billing and coding can increase your revenue stream while reducing costs for your practice. It usually protects practice time with re-filing or appealing claims denials, which can be expensive. On the other hand, assume you’re looking for ways to increase revenues, maximize profitability, and reduce your overhead costs. In that case, outsourcing to a company skilled in orthopedic billing and coding may be the right choice for your practice.

With 24/7 Medical Billing Services, proper billing needs to mention every single code accurately. To ensure the billing is on the right track, we have proper ICD-10 coding that has helped our clients achieve high productivity in billing for their orthopedic specialty.

Advantages of ICD-10:

ICD-10 coding has totaled 15,000 new codes

We assist you to cope up with new billings and bone displacements

Doctors get more extra time to concentrate on treating instead of billing the patients

All these terms are complex to be consolidated into a simple invoice. But they can be defined with the help of codes that are set for specific bones.

Why 24/7 Medical Billing Services?

We endeavor for excellence, unlike any other billing services in the industry.

Our services assure growth in revenue.

We offer various services under one roof.

We provide high-quality software exclusively.

247 Medical Billing Services, we’re happy to provide complete claims management services and additional add-on services to help your Orthopedic billing issues with revenue cycle management and more.

Call us at +1 888-502-0537 now to experience our orthopedic medical billing services or visit 247 Medical Billing Services for more info.

Read More: How Can Outsourcing Orthopedic Billing Aid In Improving Collections?

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How To Be Careful About CPT Coding And Modifiers While Working On Wound Care?

The misuse of CPT coding and billing modifiers is widespread and frequently done in the case of wound care practices. This mistake can even make big holes in your pocket once the inaccurately used medical billing modifiers are traced by the insurance company or the third-party payers on a claim. Perhaps you can be expected to return the insured money as well that insurance or third-party payers paid you.

Disappointingly, misused wound care billing modifiers may also trigger an audit that can cost your practice hefty fines. In fact, such audit fines can go up to as high as $10,000 for each mistakenly used modifier on a claim. That’s why an in-depth understanding of codes for wound care services and other documentation requirements is crucial for ensuring accurate reporting. Another easy way out is to outsource wound care medical billing services to an experienced company.

No matter whether you outsource wound care billing services or hire an in-house team, active wound care management involves the following CPT Codes:

CPT Codes:Wounds involving subcutaneous tissue

11042: Used for debridement, subcutaneous tissue (including dermis and epidermis, if performed) for first 20 sq cm or less.

+11045: for each additional 20 sq cm, or part of.

Wounds involving muscle and/or fascia

11043: Used for debridement, muscle, and/or fascia (including dermis and epidermis and subcutaneous tissue, if performed) for the first 20 sq cm or less.

+11046: for each additional 20 sq cm, or part of.

Wounds involving bone

11044: Used for debridement, bone (including dermis and epidermis and subcutaneous tissue, muscle, and/or fascia, if performed) for first 20 sq cm or less.

+11047: for each additional 20 sq cm, or part of.

Evaluation/Re-assessment is Included in Wound Care Service

Generally, it is considered to be wrong to report an E/M service in addition to a wound care service (e.g., debridement, suture removal, application of an Unna’s boot, etc.).

E/M can be reported additionally if the physician performs and documents a significant and identifiable service separately during the wound care encounter. Also, the E/M service must be distinct from the scheduled visit for the same wound care and require medical evaluation and treatment for the same wound care.

According to modifier 25, the E/M service can be reported separately if the evaluation and management service is done by the same physician or any other trained health care professional on the exact same day of the procedure or any other service.

Documentation Essentials

The narration of the wound includes size along with length, width, depth, and total square cm. the appearance, undermining, drainage, character, infection, presence of edema, the disease-causing underlying complications on healing the wound, and other problems related to it.

Description of the things used in the debridement procedure, for example, scalpel, curette, scissors, nippers, etc.

A complete narration of which deepest layer of the tissue was removed in the debridement process, for example, devitalized dermis and/or epidermis, fibrin, subcutaneous tissue, biofilm, exudate, muscle, and/or bone.

Post-op care instruction provided on the progress of the wound with the specification of the dressing applied and follow-up notes in brief, future process plans.

Complete narration on wound improvement or any measurable changes like inflammation, pain, swelling, necrotic tissue slough, wound improvement or declination, wound dimension changes, etc.

A complete and precise description of the tissue that has been cut away in the chart notes.

A complete description of the steps to address the new condition that might include oral antibiotics, further testing, consultation request for vascular interventions, a biopsy of the wound, and podiatric consultation for off-loading or bracing.

You must watch out for these coding errors!

According to a recent Medscape article, the most common issues that can initiate claim denials for wound care billing services are:

Confusion between whether there is a separately billable service or not, i.e., incorrect use of modifier 25.

In the case of wound dimensions for the debrided area, not considering the add-on codes.

Absence of or poorly documented wound dimensions

Medical billing service providers for wound care have to be very careful about puzzling between selective and nonselective debridement.

Use coding for debridement of multiple layers per site instead of the deepest layer of debridement. As an example, bone and muscle debridement cannot be coded together for the same site.

Coding for change of dressing of wounds separately from an E/M service.

The financial health of any wound care practice depends on revenue cycle management and complete wound care billing solutions. It’s essential to be careful while using modifiers correctly, precisely recording patient records and healthcare provider’s notes, and certifying that the claims are definitely not under or over-coded. This is precisely why you should outsource wound care medical billing services.

24/7 Medical Billing Services experts know all about the ins and outs of insurance and third-party payers, acknowledging the prevention of denials and rejections in the first place. In fact, this is the best “cleaning solution” of receiving the revenue quicker.

Read more: Why Outsourcing Wound Care Billing Can Help Your Practice?

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Why Outsource Pharmacy Billing Services?

Are you finding it hard to survive in an economy where lower margins and increasing competition is changing the scenario of your practice and business? You need a system that can automate your billing management system. Moreover, you need accurate pharmacy billing process which can be outsourced easily.

Pharmacy billing services Irrespective of the sector and the vertical can be relied upon automating their management systems. Pharmacists are attracted to these services because it makes every day functioning of a pharmacy with precision and integrity.

Outsourcing pharmacy billing services to an expert medical billing company can save you a lot of time and money, moreover, saving you from errors, can increase your revenue and transform your business.

24/7 Medical Billing Services provides pharmacists with the required pharmacy billing services which help them accelerate your billing procedures by automatically calculating the discounts, taxes, postings, reimbursements, etc.

But why pharmacy billing outsourcing is beneficial?

Here are the top reasons you may consider before taking the next step.Responsibilities

The roles and responsibilities of the pharmacy staff are accurately decided while doing pharmacy billing.

Documentation Challenges in Pharmacy

Pharmacists may not document codes correctly, which might affect the entire system for codes. Pharmacy billing outsourcing can take care of your behalf.

Patient Satisfaction

Information about allergies is always being updated. The pharmacy vigilance department looks after it. This information such as allergies caused by various drugs is valuable and medical billing agencies can guide you through various updates which help you reduce claim denials and avoid revenue loss.

This information is important for rich patient satisfaction and has an impact on profits. Poor patient service is poor patient satisfaction. That’s why it’s recommended to outsource your pharmacy billing.

Flexibility

The pharmacy billing system is not always flexible. Outsourcing medical billing services for pharmacists can help you with vaccine claims covered by the pharmacy or medical benefits.

Incorrect payment posting in Pharmacy Billing

Inaccurate payment posting may affect A/R calculation. This may happen because of errors in the submission of data. Moreover, wrong payment posting affects revenue and budget planning. You need a good agency for this.

Frequent Claim Denials

Missing information may cause frequent claims denials. Denials may also happen because of a lack of updated patient information, lack of drug codes, eligibility, or wrong medical codes. This may lead to a major loss in revenue of your pharmacy billing.

Underpayment and Scalability

The pharmacy billing system needs to be scalable. Wrong charge description master or CDM may cause underpayment, claims denials, and penalties. Outsourcing pharmacy billing services can help your practice become more scalable.

Insurance Coverage in Pharmacy Billing

Your team needs to be aware of the covered set of drugs, therapies, and injections. When you outsource your pharmacy medical billing, you get a team of experts advising you on if it’s worth including or exclude them during medical billing. At 24/7 Medical Billing Services, we handle insurance coverage in the patient eligibility step which removes this issue.

Less Access

Pharmacy billing outsourcing can improve access to patient legibility at the time of service to your staff.

Staff Availability

Your pharmacy practice may lack a workforce which may lead to waste utilization of time and energy while doing the process, outsourcing can help you even with serious cases that need management.

Why Choose 24/7 Medical Billing Service Pharmacy Billing Services?

When you outsource pharmacy billing to 24/7 Medical Billing Services, we work with pharmaceutical companies to understand the billing cruxes. Our ultimate objective is to prevent delay or denial of payment. Our team works proactively to reduce these risks from coming in the way of efficient billing. Our experts in charge of billing functions offer more than just billing solutions. Here are some benefits you can enjoy by partnering with 24/7 Medical Billing Services-

Certifications

Data Security

High Accuracy and Quality Service

Short Turnaround

Scalability

Reasonable Pricing Options

Single-point Contact

Physician Billing Services Software

Experienced Team of Pharmacy Billing Experts, and Medical Coders

Modern Infrastructure

Secure Data Sharing

Round the Clock Availability

Be it medical coding or billing, we can handle everything for you. With an active mix of advanced technology and billing professionals, 24/7 Medical Billing Services has developed solutions that help you get all the billings posted automatically reducing your turnaround time.

Contact us to explore more features of our pharmacy billing services, our executives will be glad to assist you.

Read more: 7 Basic Facts About Pharmacy Billing Services

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Why DME Providers Are In Favor Of Outsourcing Their Billing Services?

The DME billing procedure is entirely different than that of the other medical billing and coding processes. DME has been classified under the HCPCS level II codes. These codes are of 5 digits and come in a combination of alphabets and numeric. Adhering to these codes requires domain-specific expertise. There are multiple steps involved in coding the DME billing. The process consists in getting the prescription from the medical practitioner, assigning the codes, and processing the billing for claims from the insurance payer. Finally, getting it distributed to the patient.

What are the Rules & Regulations that can Impact the DME Medical Billing Process in 2021?

Do you know that COVID-19 has not only brought medical emergencies worldwide but also impacted the DME Suppliers by waiving off certain requirements?

These rules and regulations have changed the entire outlook of the DME Medical Billing Process as impacting the DME suppliers would mean directly affecting the DME Providers. This has led to the Medicare and the Medicaid Services updating their rules in April 2020 that are pertinent to the Medicaid and Medicare policies.

While these policy changes equipped the US healthcare system with the much-needed flexibility to respond quickly to the pandemic, they also impacted the DME Suppliers. The suppliers execute the claims submission process and get the authorizations that are integral parts of a DME billing process. The regulations that affect the suppliers, therefore, have a consequent impact on the overall billing process. This is why it is a necessity to outsource the DME billing process to external professionals.

Let’s look at a few of the waivers that are about to impact the DME billing process in 2021.

Requirements like face-to-face interaction along with the recommendation from the doctors about the requirement of the DME equipment for the DME replacement item are waived off. DME suppliers must describe the replacement claim and document the loss or damage of the equipment. This requires time for suppliers to complete the procedures that can impact the regular DME billing process.

The new requirement does not need the patient signatures and proof of delivery notes to abide by the no contact policy for the pandemic outbreak. Because of the pandemic, the suppliers must note the DME equipment delivery date and mention the inability to get the patient’s signature. These are additional steps along with the regular DME billing process.

Under the Coronavirus Aid, Relief, and Economic Security (CARES) Act, CMS will ensure higher payments for specific DME equipment in classified areas like non-rural and non-competitive bidding within the US pandemic period.

What are the right moves to outsource the DME billing in 2021?

The brighter picture amidst the Covid-19 pandemic has cleared the dilemma that has plagued the question about outsourcing the DME medical billing by the healthcare practices. In-depth knowledge about Medicaid, Medicare, out-of-pay, and other industry mandates is not enough for DME billing. The dynamics and the changing regulations in the healthcare sector will require special expertise in the DME billing process in 2021.

Let’s have a look at the different factors that will help you in making the correct decisions about outsourcing the DME billing in 2021:

Robust Technology Infrastructure

An immediate requirement is to have faith in the latest technological innovations that can help you speed up the DME billing process. This can compensate for the time taken additionally for aligning the billing process to the present regulatory framework. However, as a healthcare practice, investing and train your employees on the latest technologies can be an added burden, especially during this Covid-19 pandemic. Thus, outsourcing the DME billing process to third-party vendors with the appropriate technology infrastructure and expertise to execute the process seamlessly is even more relevant.

Robust Reporting

As an emergency Covid-29 outbreak, most hospitals in the US suspended their non-emergency medical care. This resulted in more than USD200 billion losses within four months, as per the estimation by AHA1. Stepping into 2021, it is crucial to partner with a DME billing service vendor to reduce the overall operational expenses. An experienced vendor will provide accurate reporting that will showcase the areas of improvement in the DME billing process. These will minimize billing errors and increase the prospects of saving costs.

It’s Time to Increase Your Revenue..!

Are you already super busy with managing your DME supplies? Have you started feeling drained from doing the medical tasks on your own? No one can ignore the fact that medical billing errors have a direct impact on reimbursements. Simultaneously, there is a complexity in generating and collecting the revenue. The best and one-stop solution to all your medical billing-related problems is the 24/7 Medical Billing Services. Call our experts immediately to enhance your revenues more than ever.

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Understanding The Complexity Of Ambulance Billing Services

Fraud is just one part of the complexities involved with ambulance billing. There are multiple complications and challenges involved with it which one needs to understand thoroughly. Especially when cost and time are to be saved. The processes like changing healthcare reforms, the ever-updating ambulance rules & regulations from CMS, and the compliances that all healthcare providers need to follow, even ambulance services.

A good number of complexities related to ambulance billing services have caused regular errors which result in claim denials by insurance carriers. To avoid and reduce such claims denied or processed, everyone related to emergency medical care and transportation needs to have a better understanding of the below mentioned factors in order to improve the overall performance of the practice and ambulance services. This article is handy for you if you are coming across the most commonly overlooked aspects of ambulance billing.

Unlike regular medical billing services, ambulance billing is not seen on a definitive diagnosis. Here, the patient is diagnosed quickly and treated immediately when first “met” with.

Medical billing and coding are handled based on the patient care report filed by the ambulance crew together with the additional inputs from the “run sheets” as filled in when the patient is picked up. Appropriate documentation in the Patient Care Report (PCR) is of the highest importance, particularly for compliance and thereby proper claims. This report has to include all detailed information of the patient’s condition which reflect the injury or condition on the patient’s anatomy, and also terminology is required to be applied, besides Mileage documentation, Level of service in terms of Basic Life Support (BLS) or Advanced Life Support (ALS) service offered which can make a difference to creating a proven Revenue Cycle Management (RCM) process. For example, if an emergency call is received for an ALS dispatch, and ALS assessment was conducted, but no ALS intervention was mentioned, yet the ambulance billing was done based on the ALS call, this can be termed as wrongly billed! But based on Medicare guidelines this would be right. Knowledge of the CMS Medicare Benefit Policy Manual should be thoroughly studied by the ambulance billing billers and coders.

For many ambulance services, the single largest payor is Medicare. Medicare is also the payor with the most complicated rules and the most difficult penalties for improper medical billing. Furthermore, Medicaid is handled by each State, so rules may change drastically. There are various challenges like short “timely filing” periods, retroactive eligibility, Medicaid Managed Care, that need to be known while ambulance service providers file their claims.

While most of the codes are related to various parts of the body, there are also modifiers for ambulance services, as there are for other healthcare providers. But, for ambulance services, the particular modifiers identify the place of origin and destination of the ambulance trip which needs to be submitted on all ambulance claims. The modifier needs to be placed near the Health Care Procedure Coding System (HCPCS) code billed. Using modifiers incorrectly leads to longer processing time and/or denial of services.

For correct billing, all important signatures on documentation are necessary too. Including Advance Beneficiary Notices and Physician Certification Statements, are also important for billing to be compliant and avoid denial claims.

Just like any other healthcare provider, ambulance billing and coding must be done correctly every time. If you are expecting to reimburse in a timely fashion, you need to take care of all the things mentioned in this article. Ambulance providers and companies need to have deep knowledge of all procedures, billing codes, and modifiers. This article will help you considerably, and so will take some extra time to particularly document every claim submitted to an insurance carrier.

Also Read: Medical Billing Guidelines For Emergency Medical Billing Services