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Emergency Medicine Billing Services California, CA

There are 300 kinds of services provided under Emergency Room (ER) services and a few of them are entitled to insurance reimbursement. Each procedure code has a distinct set of criteria and unless the care provider properly establishes with documentation that an emergency treatment episode meets all of them, it leads to claim rejection. Also in relation with emergency medicine, EMTALA which governs emergency services in the US mandates that emergency services be available to all regardless of ability to pay or insurance coverage.

This leaves care providers and hospitals to deal with not just an increased number of patients but also procedural complications like accurately identifying which services are eligible for reimbursement, documenting such treatment episodes accurately, and preparing and submitting claims.

Running a medical practice in California can be quite challenging when it comes to medical billing and coding. Our billers and coders in all the major cities of California including Los Angeles, San Diego, San Jose, San Francisco, Fresno can help you settle your requirements here are some of the services which our expert medical billers and coders specializes in:

  • Tracking and follow-up on unpaid claims
  • Preparing Patient statements and payment posting
  • Customizing billing reports for better control
  • Primary and secondary insurance claims filing

Value Our California Billers Bring:

Our medical billers and coders are not limited to just the big cities such as Fresno, San Francisco, and San Diego but also all other smaller cities and towns in California. Moreover our billers are compliant with HIPAA guidelines and are updated with all industry updates through medicalbillerandcoder.com. This makes sure that your practice is run in the most efficient and legally safe conditions. Our Billing specialists also ensure that your patients are hassle free and their billing queries are answered well.

The expertise of our billers is vast and includes but is not limited to Past Due Collections, Electronic Medical claim filing, Medicare Audit Protection, coding and diagnosis analysis for maximum allowable reimbursement, customized accounts receivable and revenue cycle financial analysis, electronic claims submissions, denials management and payment posting, dedicated and relentless insurance follow-up, patient statements and patient-centric support, provider enrollment support, and standardized reporting.

Our Specialties:

Our medical billing specialists are committed to improving your productivity by utilizing finest processes and health care information technology such as Electronic Medical Records. These medical billers and coders maximize your revenue, ensure timely compensation, and offer medical billing and coding services in specialties including Family Practice, mental health , pain management, Physical Therapy, radiology, Internal Medicine, neurology, orthopedic, and numerous other areas.

Our Software Experience:

The fact that physician shortage is set to quadruple in the next decade according to AAMC (Association of American Medical Colleges) makes it vital that physicians utilize professional and accurate medical billing and coding services. The various software that we provide in addition to the value added services mentioned above ensures that physicians are capable of keeping up-to-date with the healthcare IT sector reforms and improvements. Some of the medical coding and billing software that our billers have experience on include Medisoft, Misys Tiger, Eclinicalworks, Advance MD, GE Centricity, and Altapoint.

Difficulties & Challenges California physicians Face:

The most common challenges faced by physicians in big cities such as San Jose and Los Angeles are underperforming accounts receivables or collections and claims denial. Both these situations along with other errors may lead to decreased revenue. Our billers provide the solutions to these problems by making the denial management efficient and offering services such as integrated medical billing with EMR along with numerous other value added services like sending patient statements and processing refunds to Medicare in order to preserve your practice from RAC audits.

As a physician in California, it becomes difficult to keep track of all the changes taking place in the legislation related to your practice. This is where the expertise and experience of our medical billing specialists can be of immense help. It almost seems that payers are in the business of claim denial and can afford to make mistakes at your expense. Although the new HIPAA guidelines would ensure a smoother process, the amount of patient-doctor encounters would increase in the future making it difficult to extract time for coding, billing, claim denial and compliance with HIPAA regulations. Specialized medical billers and coders such as ours can ensure that your practice not only flourishes but is also HIPAA compliant.

It requires trained skills and understanding to meet all the requirements, especially because all these activities are not as straight forward as other specialties. For example, identifying which ER services are eligible for insurance requires medical understanding along with knowledge about necessary regulations.

Outsourcing to MBC

At MBC, we have medical billers and coders who have the right degree of sophistication to handle the complexities of ER billing. They can help you with the entire range of activities involved in an emergency medicine billing procedure, starting from accurately identifying the cases that are entitled to reimbursement and their procedure codes through documenting their qualifying criteria to preparing their claims and submitting them.

Apart from a theoretical and practical understanding of EMTALA, its implications and procedural necessities, our billing professionals’ years of experience in varied healthcare environments gives them an additional advantage; they appreciate the fact that ER service is but a part of a large treatment cycle where the activities are performed, whether administering a treatment or documenting it – form the basis of the entire administrative and medical episode, particularly in a big hospital that combines emergency as well as surgical services. This appreciation helps our emergency medicine billers and coders to function such that facilitates the advanced stages of a treatment procedure, in terms of documentation and other procedural matters.

Via MBC’s flexible emergency billing and coding services, you can choose the service model that suits your and your organization best. Our revenue cycle management (RCM) services will help you:

  • Tighten your revenue management process by replacing obsolete software applications by appropriate applications that suit your needs and smoothens the process of electronic transfer of data mandated by HIPAA
  • Streamlining your existing process by trimming out rambling procedures and processes and spotting gaps of revenue leakage and identifying training needs

By opting for MBC’s outsourced billing and coding services, you can completely ship out your administration responsibilities to us and solely concentrate on health care.