Medical billing business requires attention to detail. This means attention to documentation as well as attention to the requirements to follow using the various coding systems needed to submit a clean healthcare claim. When your business is submitting clean claims, you keep your eye on all the details as well as the big picture. Medical billing isn’t heart surgery, but your heart has to be in it if you want to provide value to physicians. At M-Scribe, we’ve improved the bottom lines of many outpatient medical practices across a variety of specialties.
No one will disagree that quality patient care is essential to a medical practice. The same is true for quality billing. Plenty of practices get by, but the most successful outpatient practices employ professionals to take care of their cash flow. A physician can’t continue to practice medicine without the funds to do it. Large practices employ as professional billing services. Hiring experts to assemble, submit and collect on claims saves money and allows a practice to dedicate resources to patient care.
There is nothing wrong with having an in-house coding and documentation specialist. In fact, every practice should have someone on staff who knows coding and billing. The truth is, in the current regulatory and business environment, ensuring clean claims cannot be a part-time job. It takes the kind of attention to detail that only a dedicated staff of professionals can provide.
ICD-9-CM Volumes 1, 2, and 3, ICD-10-CM, ICD-10-PCS, HCPCS Level I, HCPCS Level II, CPT, SNOMED; DOS, TOS, POS, DOI, NPI, TIN; NCDs, LCDs, CMS, Title XIX, RAC, NCS, BCBS, A/R… if you know what every one of these letters mean, you must be a professional medical biller. If you are a physician, you should know most of them. If you are coming up short on half, you probably don’t know enough about the ins and outs of healthcare reimbursement.
A specialty outpatient medical practice of any size needs professional billing services. Practices that are growing are on top of the ongoing changes in the billing and reimbursement system. The days when a physician’s spouse could do the billing are over. College degrees are offered in HIM. If you don’t know what that means, it means Health Information Management. Medical documentation, coding and billing are essential components of HIM.
When the HCFA-1500 was invented, few, if any, universities offered advanced degrees in HIM. This was still relatively true when the Healthcare Financing Administration became the Centers for Medicare and Medicaid Services, and the HCFA-1500 became the CMS-1500. Nowadays, certification and ongoing education are the norm.
The Health Information Portability and Accountability Act of 1996 is a common feature in how practices conduct operations. Practices that still have a hard time complying with HIPAA requirements are going to have a hard time adjusting to the billing requirements enacted under the Patient Protection and Affordable Care Act of 2010 (PPACA). Besides the software requirements established under the PPACA, how patient’s diagnoses and inpatient procedures is going to undergo a radical change. ICD-9 is going to be replaced by ICD-10 next year. The alphabet soup that makes up a clean healthcare claim is about to get a lot more specific. At M-Scribe, we are looking forward to partnering with more clients to assist in navigating the sea change going on in medical billing.
Our certified coding and billing professionals have experience in a number of medical specialties, including dermatology, pulmonology, ER, neurology, internal medicine, pediatrics, orthopedics, chiropractic, and physical therapy. We work with physicians and their staff to create clean claims the first time in order to reduce denials, appeals, and audit flags.