Gynecology is a relatively straightforward field of medicine, with most care falling into a few categories, but that doesn’t mean medical billing and coding aren’t complicated. Regardless of what field of medicine you are in, medical billing is challenging and increases physician dissatisfaction, so outsourcing has become more usual and has proven to be a terrific relief for medical office staff—and it actually increases revenue.
Revenue cycle management (RCM) starts with first contact with a patient. When they call in to make an appointment, payer coverage must be confirmed. Then when the patient is seen, a coder must document the details of the exam and diagnosis plus any treatment. Medical billers make sure coding is correct and all expected information is included on the claim before it is submitted. Then if there are any rejection or denial issues, the medical biller will sort it out and get the claim resolved.
Having that taken care of is a huge relief for a physician running a practice, but those are only the bare bones of the services provided by a complete medical billing company. Medcare MSO handles the full RCM process, including all of the above plus collecting bills from patients, annual adjustments, compliance reviews and more.
Why It Makes Sense to Task a Professional Gynecology Billing Service with Your Claims
Billing and coding are complex in addition to being time-consuming, so having certified, experienced people taking them over makes much more sense than having medical office staff try to sort through it all. Here are a few of the reasons outsourcing gynecology billing has proven to be so effective.
High numbers of claims: Women in good health should see their gynecologist yearly and those with medical concerns will be seen more often, which means there will be a large number of patients seen on a daily basis. With a high number of claims being submitted, the likelihood of some being overlooked increases. Likewise, denied claims are more likely to be ignored by a busy medical office staff when there are hundreds of claims to be managed.
Covered and not covered visits/procedures: Gynecologists deal with many procedures that may or may not be covered by insurers, with birth control being the most common. It is important that each patient’s coverage be checked carefully because even if birth control is covered, there may be conditions that must be met or restrictions on what forms are included.
Special documentation: There are a few coding requirements specific to the specialty that an inexperienced coder or medical biller won’t be likely to know about or remember when the time comes. For example, “advanced maternal age” can start as early as age 35 and must be noted, and migraines must be carefully noted when associated with menstruation.
Medcare MSO’s Innovative Approach Strengthens Your RCM
There’s much more to running a medical practice than making money, but on the other hand, doctors and medical staff have to earn a living and there are bills to be paid. That’s why Medcare MSO maintains a staff of certified medical billers who are experienced in billing for gynecology.
We have an incredibly high success rate at relieving our clients of the stress of medical billing while helping them make more money. The small fee for our services is outweighed by the increased revenue that comes from having professionals manage your claims.
We provide a proprietary software that keeps everything up to date with the latest code changes and also take care of annual pay back and are available for credentialing, compliance review, etc. Get a free demo today and see for yourself how we can help your practice thrive.