Medical Billing for COVID-19 and SARS-CoV-2 testing

Medcare MSO has the depth of understanding and experience required to be able to navigate the hazards of billing for COVID-19 and SARS-CoV-2 testing.

An Unprecedented Need for Medical Billing Support

Nothing in recent history has caused as much change and confusion in the medical billing services industry as 2019’s novel coronavirus, SARS-CoV-2, and COVID-19, the disease it causes. The usual cautious approach and coordinated efforts to create appropriate medical billing codes had to be bypassed.

New tests had to be developed and those with symptoms had to be treated immediately—leaving hospitals and labs wondering how to get paid. New medical billing codes have been released and medical billing teams are struggling to keep up. With things changing so frequently, it is almost impossible for practitioners and labs to manage their own COVID-19 billing.

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Successfully Maximizing Reimbursements for Coronavirus Services

Medcare MSO’s expertise is revenue cycle management and we don’t shy away from a challenge. Our experienced medical billers do what it takes to track down the new codes and procedures to get our clients paid.

The Challenge of Staying Current with Evolving Systems

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Updated Federal Guidelines

Not only must we keep track of frequently updated federal guidelines from Centers for Medicare & Medicaid Services (CMS), but Medicaid is administered by state agencies, so each one may have different requirements.

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Changes Made by Multiple Agencies

Billers and coders must be aware of and use the appropriate CPT, HCPCS and ICD-10 codes, and stay current with these evolving systems. Coronavirus testing is being managed by states, again producing a myriad of variables that must be correctly interpreted and factored into medical billing.

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Timeframe Restrictions

Programs and emergency billing rules have specified start and end dates, and ending times vary from one to the next. Services must be provided within the designated window for each one. Our team researches the right codes for each program and location, making sure that the necessary modifiers are used to tell the whole story and get payments without claim rejections.

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Insurer Policy Changes

Not only are the regulations changing, but each insurer and payer has to change their policies to stay in compliance. In some cases, precertification or prior authorization requirements have been suspended and billers must know that and remember to make sure they are met when they are reinstituted.

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Provider Network Rule Modifications

Many insurers work with networks of professionals and the new extensions and exemptions often only apply to in-network providers and facilities. Medicare has relaxed some requirements and Medicaid has added some new programs, depending on the state you are in.

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Time-Consuming Research

Keeping track of all the changes and new rules can become a full-time job for in- house billing staff. Medcare MSO’s dedicated billing team has the expertise to sort through it all and figure out how to meet current requirements with the correct codes.

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We Provide Manpower to Manage Expanded Telehealth Billing

To minimize potential COVID-19 exposure in medical facilities, state and federal legislation has been relaxed to allow more remote interaction. Insurers and payers have therefore had to be more cooperative in paying for telehealth and are trying to keep up with federal and state regulatory changes and updated guidelines.

Billers must know the correct procedures for documenting the platform used to reach the patient as well as the type of visit, practitioner, location, etc. Wellness visits and behavioral health have now been included in telehealth coverage. Physicians can even conduct telehealth from their own homes.

Medcare MSO has the manpower and background to manage telehealth billing correctly.

We Have the Experience Needed to Clarify Coronavirus Lab Billing

In order to encourage more people to get tested for SARS-CoV-2, testing is supposed to be performed at no cost to the patient. In reality, depending on the state, the type of facility where testing is done may determine who pays. Additionally, because some facilities have in-house labs, but others collect swab specimens and send them out to be processed, place of service coding errors are resulting in claim rejections.

We have extensive experience with lab billing, so our billers are familiar with the various scenarios that arise and know what to include in claims to make sure they are accepted.

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Streamline Your Business by Outsourcing to a Professional Medical Billing Company

The pandemic not only affects patients, but it is wreaking havoc on medical practices too. Putting off non-emergency care has resulted in far fewer patient visits for many facilities, making it more important than ever to get reimbursed the maximum possible amount for every claim. Our system tracks each claim until it is paid, so none fall through the cracks or get written off as being too much work to appeal.

In-house billing is also affected by staff absences, which are likely to increase due to illness, both from office staff becoming ill and taking time off to care for family members. Our staff is large enough to provide a buffer against absences slowing down your billing.

Medcare MSO Masters the Most Challenging Billing Situations

Medcare MSO is fully dedicated to medical billing and revenue cycle management. Our highly trained and experienced billing staff are equipped to take on the most challenging billing situations, and COVID-19 is certainly one of them. Our system is so streamlined and successful at maximizing claim reimbursements that we can take your medical billing off your hands and leave you with a net income increase instead of a cost for our services. Give us a call and we will be happy to answer any questions and explain more about how we work.

Call or e-mail Medcare MSO today to see how we can help you.