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The complexity of billing and coding encompasses all spheres of medical specialties, however tops that list. The associated interventions to patients, invasive procedures, and blood infusions add to the complexity of the specialty needing extreme deftness in billing and coding all aspects of the service.

billing and coding is contingent on billers and coders to have an excellent working knowledge of current coding rules, specific codes, and compliance standards. Inaccuracies in billing and coding can adversely affect the revenue cycle of the specialty.

BillingParadise has a long partnering experience with specialties using EHR and practice management software. Our experienced team of certified billers and coders has efficiently fulfilled their billing and coding needs.

Best Plan Approach for Billing and Coding

We assign extensively experienced certified coding professionals for billing operations. They log into the EHR of the practices to access physician office and operative notes, based on which accurate ICD-10-CM, CPT, HCPCS Level ll, and modifier codes are applied. After completion, the claims are electronically sent to the payers for reimbursements

Integration of RCM tools with

We can also integrate our proprietary automation RCM tools with the EHR. The reporting and analytic tools are valuable for end-to-end RCM operations.

Our billers have an in-depth knowledge of rules and regulations applied to Medicare billing. Be it for heart catheterization, coronary interventions, pacemakers, or peripheral vascular procedures, our coders with years of experience have been efficiently fulfilling the billing needs of practices.

In order to improve the revenue earnings of a practice, minimizing claim denials is the very first step. As a billing company, we constantly stay updated on any changes in billing and coding.

Our best plan approach for billing and coding includes:

Documentation Accuracy -

Accuracy of documentation has a great impact on the revenue cycle of a practice. Coding for cardiac procedures needs alertness, especially when it comes to cardiac catheterizations, inconsistencies in documentations may result in loss of components that potentially could be coded. Standard cardiac procedures may need additional procedures to be performed, this need to be well-documented.

Comorbidity Inclusions -

Costs play a significant part in a patient’s health status, other than the outcomes. Higher reimbursements result in patients with specific diagnosis along with comorbid conditions. The complexity of the case can be highlighted by including diagnosis codes for relevant comorbidities documented by the physician. As an example, our billing team have come across situations where a cardiologist would be treating congestive heart failure in a patient, additionally treatment for arthritis, COPD, and anemia were planned for the patient, because these were well documented by the physician, our billers and coders factored them into the treatment, which facilitated a higher reimbursement for the provider, after the payer was made aware of the estimated cost.

Emphasis More on Diagnosis than Symptom Coding-

Depending on the availability of a confirmed diagnosis for a patient, we generally avoid using symptoms code. No additional codes for symptoms associated with a disease are used, unless specific instructions are available for using them. The ICD-10 official guidelines spell out that symptom not usually associated with a disease may be reported.

Combination Codes

conditions are defined with a few combination codes in ICD-10. Our billers and coders make use of these codes wherever they are appropriate. We also diligently follow a code’s instructions to “use additional code,” “code also,” or “code first”, ensuring that complete details are projected in the claims.

How Outsourcing Billing and Coding Can Benefit Your Practices Using EHR

The multiple procedural rules, complex contractual adjustments, and codes that regularly change, make coding and billing a time consuming cumbersome task. The most challenging aspect of billing and coding is assigning CPT code, especially when modifiers have been used.

It requires a lot of time and effort staying updated with new codes, code revisions, and deleted codes. Inconsistencies in billing and coding can be detrimental for the growth of a health organization, at the same time it can adversely impact patient care.

Billing, Coding and Reimbursement Capabilities

BillingParadise with long years of billing, coding and reimbursement practices can be a valuable partner in the revenue success of your organization. Our certified medical billers have the requisite skills in all aspects of revenue cycle.

The RCM team’s expertise in understanding the nuances of payer requirements and reimbursements, especially in the realm of billing and coding has benefited several specialties improve their cash flow and revenue cycle. Our medical billing and reimbursement specialist efficient manage claim submissions in accordance with government regulations and private payer policies. We also diligently follow-up on claim statuses, resolve claim denials, and submit appeals. Additionally, we also post payments, and adjustments, and manage collections

Hiring Billers & Coders

If your organization is concerned about privacy issues that may be compromised if billing and coding operations are sourced from third parties, you can choose the hiring option. Certified billers and coders will be assigned to your organization, they will report to your in-house billing team, and fulfill your in-house billing and coding needs. The can be hired for end-to-end RCM operations or A/R and Denial Management.