Specialties

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ANESTHESIA

Not understanding the anesthesia billing is one of the major drawbacks a practice faces while billing, impacting their actual revenue. Anesthesiology deals with the total care of patients before, during and after surgery. The core element of the specialty is the use of anesthesia to support vital functions throughout perioperative care. An anesthesiologist administers the right doze of drugs to the patient so that they do not feel any pain or regain consciousness during the surgical procedure. They monitor the patients vital keenly during the surgery, altering the dosage accordingly. An anesthetist is also responsible for the patient’s post-operative care.
There are diverse levels of anesthesia provider – Anesthesiologists, CRNAs, RNs, CRNAs and AAs. They take on a critical role in understanding the patient’s history and conditions, physical status during surgery and patient recovery post-surgery.
Billing for anesthesia gets trickier as it involves evaluation and management, time factor, anesthesia specific modifiers. Therefore, a biller should have extensive knowledge about ASA codes, Physical modifiers, Time calculations, different monitoring techniques that provider performs during surgery and eventually resolution of bundling issues.

WOUND-CARE

With the rapidly evolving healthcare landscape, the intricacies of reimbursement and payer policies remains a significant challenge for wound care providers. One of the challenges in wound care is navigating the maze of insurance policies for reimbursement. As a leading RCM service provider in the realm of wound care and HBOT. Our innovative RCM solution is designed for extending services to Podiatry, Vascular Surgery, Dermatology, Plastic Surgery and Skin substitutes.
Wound care is a specialty with straighten rules and regulations. It is mandatory to follow Medicare guidelines for Skin Substitutes. Extracting information from EMR is critical to demonstrating the practice follows operational and clinical guidelines. This is an area where most RCM contractors fail. Providing suggestions to practice on payer policies is a crucial function to keep the transparency.
Our RCM program is designed to bridge the gap between service rendered and payer policies. Offering seamless integration of clinical services and monetary management. We ensure that all aspects of wound care billing, from accurate documentation to timely submissions are managed efficiently, maximizing the reimbursements, and minimizing the denials.

LABORATORIES

Understanding the ins and outs of laboratory billing and panel coding is essential in the always changing healthcare landscape. The specialized area is vital to the financial stability of medical facilities, offices, and labs. The comprehensive guide offers insights, pertinent facts, and advice to help you navigate these dark waters to simplify the complex world of laboratory billing and coding.
Laboratory billing is often high volume and lower value ticket set up compared to other healthcare practices. For a lab billing to be successful your RCM contractor first and foremost should understand the type and set of tests that is being performed at your laboratory. Post that, there should be a well-defined rule within the system that could automate the repetitive work. Click here to explore our automation tools.
With high test volume, remote patient interactions and increased pressure to collect with fewer resources, high quality process rules and management is critical to ensure your adequate collections. Timely billing to payers and patients is mandatory because – no one wants to receive the bills and follow up calls months after tests.

INTERNAL MEDICINE

Medical billing and coding are critical components of the healthcare industry, ensuring that healthcare providers are reimbursed for their services accurately and efficiently. For those specializing in internal medicine, understanding the basics of internal medicine billing is essential. Most of the internal medicine providers get strangled with in-efficient EMR, paper works, inaccurate coding processes.
Our team of experts specialize in internal medicine billing and coding process, including common codes, payer requirements, and tips for maximizing reimbursements. Accurate coding, use of appropriate modifiers, compliance with payer requirements and well structured is essential for provider to receive proper reimbursements for their services. Staying informed, adhering to the coding guidelines, and conducting regular audits helps improve accuracy, reduce denials, and ultimately enhance the financial health of internal medicine practices.

PODIATRY

Podiatry is a medical practice that deals with diagnosing, treating disease, injuries, and defects of the human foot. Podiatric medicine involves diagnosing medical and surgical treatment of the foot, ankle, and lower extremity. This specialty also includes medical, surgical, mechanical, and physical treatment of the foot. Podiatry billing can be complicated in many ways, beginning with the need to determine and prove the treatment’s medical necessity to the coding nuances.
In addition, podiatry practices primarily treat the elderly, necessitating additional billing and coding efforts. As Medicare covers this population. It also demands meticulous use of modifiers and an understanding of coding for inclusive procedures.
Podiatrists usually hire an in-house team of coders or billing companies that claim to have experience in podiatry billing. Many of these resources lack the expertise to track, record and rectify underpaid or unpaid claims consistently. Thereby creating a need for podiatrists to shift to outsourcing their billing and coding needs to reliable and successful revenue management.
With seasoned resources and institutionalized best practices, we can constantly improve collections by over 25% and reduce denials by over 50% by identifying and correcting key issues in podiatry billing and coding.

BEHAVIORAL HEALTH

Behavioral health is the study of emotions, biology and mentality causing a person to behave in a certain way and how it affects their day-to-day life. Behavior and mental health billing are complicated due to the type of care offered to patients and funding provided for the treatment.
The current epidemic of opioid abuse, involving both prescription pain relivers and heroin, has a significant impact on the US healthcare sector. Services for the prevention and treatment of substance misuse and substance use disorders have traditionally been delivered separately by other mental health and general health care services.
Counselors and Psychiatrists treat patients using various methods such as therapy, drugs, meditations etc. These treatment methods take various methods, amount of time based on the type of patient and illness. A patient with disabling behavior issues needs additional job training, literacy training, rehabilitation, etc. Unfortunately, insurance protocol differs from the actual time taken. Causing discrepancies while billing for service

ONCOLOGY

Oncology is a complex and long drawn process with comprehensive treatment plans to prevent and cure cancer. As a result, the Oncology billing process requires detailed medical treatment documentation and timely follow-up with insurance companies to get paid. Accurate coding and billing at the end of each treatment phase ensure that the Oncology practice receives adequate reimbursements.
In addition to its procedural complexity, Oncology billing faces frequent change in the codes and compliance policies. Often, payers are unaware of the latest changes and technology leading to a significant reduction in reimbursements. Lack of understanding of reimbursement policies and inadequate understanding of the procedure is another nightmare. Oncology is also a multidisciplinary field requiring surgeries performed by specialists from other medical disciplines and post operative trauma and mental health specialties to help patients recover in health and mind. These complexities require a certified coder and billers who can ensure excellent accuracy while billing.
Our team of coders and billers possess unique expertise and acknowledge that no detail is trivial in Oncology billing. Our team could help your practice reap multiple patients care and reduce your administration backlog.

HOME HEALTH

Not understanding the Home-Health billing is one of the major drawbacks a practice faces while billing, impacting their actual revenue. Mostly, RCM contractors lack knowledge of RAPS and Follow up claims which is a bottleneck in generating adequate revenue for the agency. Just like any other facility, a home health agency needs to keep track of different factors for medical billing, beginning with patient’s diagnosis and ending with receiving payment for service rendered. This crucial process requires a firm understanding of medical terminology and health coding systems. Understanding of payer guidelines and episode period is necessary. Accurate, timely billing and fast collections are powerful tools for ensuring a practice’s long-term financial health.
Accurate reporting related to billing and collections is a powerful tool to ensure an agency is performing better financially. We provide detailed reports related to billing and collections. Our team of experts takes a proactive approach to keep your practice at the top of the collections by minimizing the denial rates and DSO (Days sales outstanding).
Our team monitors unbilled and billed claims so that the follow up claim is being submitted to payer in no time.

PHYSICAL THERAPY

Physical Therapy is an intense specialty, and patient care is of utmost importance. In Physical Therapy, the physicians spend a lot of time drawing treatment plans as per the patient’s needs. Most of the time, physicians do not have enough time to focus on accurate billing and coding. Like any other specialty, on-point billing and coding are essential to keep a financially successful physical therapy service.
Physical therapy billing is intense and challenging as it comes with multiple reasons that lead to claim denials. The most significant reason for claim denial is the “Medical Necessity CO50/OA50” of the service offered. Apart from this hiring an inhouse billers can be expensive, and it requires a lot of time and effort.
Our team of subject matter experts in coding and billers with a great degree of familiarity with physical therapy billing, understands the nuances of denials and offers strategic solutions to improve revenue and reduce practice denial rates.

CARDIOLOGY

With rapidly evolving technologies and complex diagnostic protocols, experts best do cardiology billing. Constant advancement in the specialty is leading to complex, ever-changing codes for almost all procedures. In addition to this, the physicians do not have the time to manage billing and coding of cardiology services they deliver.
In cardiology billing there is always a chance for upcoming under-coding a procedure. As frequent changes in codes occur in procedures such as lilac repair, angioplasty, stent replacement, ECG recording etc. Cardiology practices lose a large amount of revenue to erroneous billing.
Our experts are certified, trained coders and billers, informed with the recent advancement and developments in cardiology billing. They are technically sound and are aware of complicated MACRA (Medicare access and CHIP reauthorization act) regulations. We are capable of identifying and fixing issues in your billing system and increasing revenue.
Our expertise in cardiology includes but is not limited to:
• Peripheral studies
• Diagnostic Cardiologic Procedures
• Cardiac-Periphery Interventions
• Pediatric Cardiology
• Nuclear Cardiology