Our Denials Management System means more accurate billing. And you get your money faster.
Medical coding is a fundamentally important aspect of maximizing reimbursement in today’s medical practices. Without the proper knowledge of medical coding and reimbursement methodologies, providers and practices will not receive the correct reimbursements, if any reimbursement at all.
In addition to Medical Billing Specialists, we employ Medical Coding Specialists. Our Medical Coding Specialists are generally have at least several years of clinical experience in a vast array of medical specialties, and have their CCS-P and/or CCS credentials. We ensure that we have the best in coding staff and coding services.
Medical Coding
We assign the correct ICD-9, CPT, and/or HCPCS codes derived from the medical records and reports from your practice. We ensure accuracy and appropriateness of the codes submitted to maximize reimbursement.
Medical Coding Audits
We analyze your medical records and previous coding to ensure that if you are audited then your documentation will support the codes submitted.
Management of Denials and APC
Effective denials management and APC management has assumed greater significance in healthcare revenue cycle operations with the shift in reimbursement toward more prospective payment system(PPS) methodologies, coupled with an increasing proportion of services provided on an outpatient basis.
Hospital Outpatient Prospective Payment System claims error rates = (8%-30%)
With Medical-Billing.com, medical professionals have access to a wide range of reports that can be customized to your needs and can be accessed by you from any location over the internet. When you bill through Medical-Billing.com, medical professionals have access to a wide range of reporting features:
Easy access to their book of business to make knowledgeable business decisions – APC Frequency Reports, APC Utilization Reports
Easy access to their APC winners and losers from a $ perspective: APC listing by Medicare Allowable
APC Summary Report by Revenue Center
Claims Denial Management Reports
CPT/HCPCS Listings
Outpatient Case Mix Index
PS&R
Assess and identify problematic coding, billing, registration, charging and payment issues
Review charges from time of department entry to payment
Detail level APC payment reconciliation
Ability to See the problem then correct the problem
Thousands of legitimately billable and collectable dollars lost each week can be corrected and re-billed.
An Effective Denial Management System
In a typical healthcare system, about 20% of rejected claims are never resubmitted. A maze of policies, billing requirements and regulations, as well as complex managed care contracts contribute to the number of denials that go unattended. A Denial Management system can help you take control of your denials for more efficient claims processing and accelerated reimbursements.
Our Denial Management solution can help you quickly uncover and correct the problems that lead to denials, so you can shorten your revenue cycle and enhance your cash flow. Effective denial management allows you to develop crosswalks between individual payer codes and common denial reason codes for trend tracking. With these capabilities, you can reveal billing, registration and coding process weaknesses that could otherwise tie up millions of dollars in unpaid claims. You can also identify which payers or insurance companies have historically denied payment, as well as which departments in your facility are encountering a high volume of denials. With access to such critical information you can improve your claims processing to not only recover lost revenue, but increase the likelihood that your claims will be accepted on first submission.
Medical-Billing.com is targeted to solving health care providers' growing problems with payer denials: the increasing incidence of insurers declining to cover submitted claims for any of a variety of clinical, technical and other reasons.
