Our specialized wound care billing services are designed to reduce administrative burdens, minimize errors, and ensure timely reimbursements. Whether you run a small practice or a large healthcare facility, our expert team has a proven track record of achieving 90% collection ratios and improving cash flow.
Outpatient wound care coding is complex for several reasons. One is that it may take place in different kinds of facilities, even for a single patient treating the same wound, such as when a hospital patient is released and wound care continues at an outpatient center. Each encounter must be billed correctly, including the code details indicating which location was used. This complexity is further compounded when wound care involves specialties such as general surgery medical billing, internal medicine medical billing, and infectious disease billing services.
In today’s financial climate, with costs rising and budgets being cut, it is especially important to have effective medical billing so that all claims are properly reimbursed. Most practices that don’t have specialists managing their coding and billing are losing significant amounts of revenue.
Medical codes are complicated and on top of that, they change every year, making it extremely difficult for staff in medical practice to keep up, which results in expensive errors. Outsourcing to a professional revenue cycle management (RCM) company like MedCare MSO ensures that you receive the highest possible reimbursement. These are three of the reasons it is especially beneficial for wound care centers to outsource medical billing.
Most wound care patients come in on referral and the referring physician’s office will usually have checked to see if their insurance covers your services—but you can’t assume that is the case. When each new patient makes an appointment, the wound care center must verify insurance coverage.
Wound care supplies include some very expensive products, such as cellular and/or tissue-based products for skin wounds, but reimbursements are going down. This means it is vital that every service delivered is properly coded and billed so there is no lost revenue due to claim rejections and denials.
Many insurers and payers require prior authorization for treatment and will reject a claim that isn’t authorized in their system, even if it is something they would have authorized and paid, so it is important to find out about authorizations when confirming that the exam/visit is covered. Wound care also may be ongoing over a period of time and require additional authorizations, so staff must be proactive and attentive to such limitations.
Outsourcing medical billing has proven to be a low cost way to increase revenue. All our staff are trained in HIPAA compliance to ensure your patient information is safe, and we have certified billers who are experienced in wound care billing and coding. An additional, and perhaps an even greater, benefit of having us take care of all the billing and coding hassles is a tremendous reduction in stress for physicians. Our clients report finding their practice enjoyable once again.
MedCare MSO is dedicated to medical revenue cycle management (RCM). Billing is our most popular service, but we offer a customized suite of services to our clients that includes our proprietary software to make sure all your claims are filed with the most up-to-date codes. We can manage payer credentialing, compliance reviews, annual payer adjustments and payback, and much more.
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