Medical and technical developments in recent years have increased the success of treatments in pulmonary practices but have also resulted in new and more complex medical coding and billing requirements.
As a relatively high-cost medical field, pulmonology stands to lose greater amounts of revenue when billing and coding errors are present. The complexity of the ever-changing codes mean that there may be errors—however, a coding and billing team that is experienced in pulmonology will minimize them, and will be able to efficiently handle rejected and denied claims, unlike a less experienced office staff, who may spend hours sorting out each claim, and may never get the more complicated ones resolved in the required time frame, resulting in significant losses of revenue.
Challenges Associated with Pulmonology Billing
Complications start with scheduling:
The medical billing process starts in the scheduling phase when insurance coverage and payer requirements have to be confirmed. Pulmonology frequently includes rescheduling appointments due to coordination with other specialists and hospital procedures and annual processes that need to be tracked and accounted for.
Seasonal services must be part of the cycle:
Flu shots, vaccines and other preventive practices that need to occur on a seasonal or annual basis have to be tracked and scheduled, adding another set of coverage and coding questions that have to be addressed.
In a general medicine practice, there may be hundreds of patients through the doors daily, resulting in an enormous number of low-dollar claims being filed daily, but in pulmonology, examinations and treatments are of a different, more in-depth and time-consuming, nature. A physician may see 10 or 15 people on a normal day, meaning the loss of revenue for a single unpaid claim can be substantial.
Complicated procedures and treatments involve complex coding:
An important part of coding is the modifiers, which are required to give the pertinent details needed to be reimbursed for all services delivered. Inexperienced coders can look up the general code for a procedure, but often do not know how many levels they need to go down and all the numerically-coded details that need to be added.
Medcare MSO Increases Revenue and Reduces Billing and Coding Headaches
With payers and medical institutions forever looking to cut their costs and pulmonology medical billing getting more complicated all the time, it becomes even more important to have an effective revenue cycle management (RCM) system in place. Outsourcing billing and coding to Medcare MSO allows medical professionals to focus on patients, knowing that certified and experienced specialists are handling their RCM from start to finish.
Medcare MSO’s services begin with scheduling and follow through all aspects of billing through debt collection, when necessary. Our staff of certified coders are experienced in over 40 specializations, including pulmonology. Our billers know how to identify over-coding and under-coding red flags and make sure clean claims are submitted.
Because we specialize in medical billing, we are able to stay up to date on government offers and can be sure to maximize revenue from government incentives. We handle daily billing, respond to denials and rejections swiftly, and even manage annual payer adjustments and pay back as needed.
Medcare MSO’s proprietary software is an integral part of our service. We strive to bring innovation to medical coding and billing to assure all our clients receive the compensation they deserve. Get a free demo today to see how we can increase your revenue and relieve you from the stress of managing billing and coding.