What practitioners may not realize is that a comprehensive medical billing and coding service starts with the patient’s first contact with the office, in the scheduling phase, and follows through with the whole process, up until any remaining bill is paid. That way, the biller confirms what is covered and how much the payer will pay, so the patient understands the bill from the beginning, and there are no unhappy surprises and far fewer unpaid bills.
The Challenge of Medical Coding and Billing for Dermatology
Medical coding and billing is a challenge for any practice, but it can be even worse for dermatology. The following have been identified as some of the more frequently occurring issues.
Varying insurance coverage:
More than perhaps any other specialization, dermatology includes numerous different treatments and procedures for which every payer has different rules governing what is and is not covered by their policies. This requires a higher level of specialization by medical coders, who have to understand subtle differences and be aware that how they code a procedure will often mean the difference between the practice being reimbursed or having the claim denied.
Cosmetic vs. medically necessary procedures:
Because dermatologists treat so many conditions that may or may not be “medically necessary,” depending on the severity, additional conditions and other factors, the coding details make the difference in whether a claim is accepted or denied. Again, coders need specialized training to be aware of how to correctly identify each diagnosis and procedure and use the appropriate coding modifiers.
Bundling charges for treatments that are performed together simplifies coding in many cases, but billers and coders must be familiar with what is included in bundles and be careful not to bill for anything that is included, which would be a violation of over-coding regulations.
Denied and rejected claims:
Because there are so many varying rules and differences between covered and non-covered procedures, dermatology practices encounter high numbers of rejected and denied claims. Resolution requires that the billing staff be specialized in the field so that they can efficiently identify the error or conflict and determine how to clarify the coding so that the claim is reimbursed.
Outsourcing Dermatology Billing Services to Medcare MSO Increases Payments and Frees Up Staff
A thriving dermatology practice depends on an office staff focused on delivering excellent care to patients, and specialized medical coding and billing experts who get claims quickly and accurately filed. Rejections and denials by payers must be addressed efficiently and resubmitted before the time limit imposed by the payer. By outsourcing billing and coding to Medcare MSO, dermatology practitioners are free to focus on their practice instead of figuring out the complexities of dealing with payers.
We are innovators in the field and our proprietary software makes front-end data entry simple and far more accurate. We handle it all, from insurance credentialing and staying on top of the latest coding changes to handling rejections and denials, compliance charting, and even bill collection if necessary. Get a free demo today to see how much easier your coding and billing can be.