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California, CA Pharmacy Billing Medical Billing Services

Pharmacy is an integral part of healthcare, and, just like other disciplines of healthcare, it also poses certain billing challenges that may often be difficult to manage internally. Moreover, because certain drugs are excluded from insurance coverage and only a few injections and adjuvant therapies allowed, it may require experts to judge the efficacy either including or excluding the drugs during billing.

To complicate matters further, pharmacy-related reimbursements require multiple levels of data handling and follow-ups as in most cases. Although it is a separate set of medical service and provided from a separate facility, claims are prepared and submitted together by hospitals or nursing homes – either because they come later in the care chain or because it forms a small part of the care services hospitals provide. This joint-claim preparation and submission leads to a greater potential for inaccurate Data handling and denied 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

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BILLER PROFILE	PROFILE_DESCRIPTION	SPECIALTY	SIMILAR PROFILES
Cynthia Christine	Cynthia Christine Estrada is seeking an entry level position in the medical field as a Medical Insurance Biller and Coder where I can utilize all of m ...	Pharmacy Billing	View Similar Profiles

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And, even though pharmacy claims are distinct from hospital claims, they are still subject to the same HIPAA rules – which may be difficult to cope with during times of resubmission for being non-compliant with privacy or security norms.

These inherent challenges require a series of admin and data related activities, starting from verification, through claim preparation to submission, to be handled with accuracy.

Outsourcing billing to MBC

MBC’s pharmacy medical billing and coding services would not just help you accurately discern which type of treatment comes under injectables or adjuvant therapies but also take care of the entire range of your admin activities from claim preparation thorough submission to post-submission follow-ups and audits in case of over payment by the insurer, improving your finances and leaving you with more time to spend on your core competency – pharmacy dispensing.

Our services cater to all kinds: clinical, home care, and radio pharmacy services.

Clinical – these services often come under bundled payment module, which may require handling paperwork of non-clinical nature. We take care of the entire paper trail that adds up to insurance claims in a methodical manner.

Home Care – involved in preparation and delivery of injectables to home-bound patients, these services being covered by Medicare Prescription Drug Improvement and Modernization (MPDIM) require you to prepare and maintain details and do data handling that is not part of your core competency and interfere with their itinerant schedule which involves extensive travelling to patients’ homes. We have an extensive network spread across all states of the US and professionals who are experienced in handling billing activities related to home care services.

Managed Care – like clinical services, these services are often operated from big hospitals and nursing homes that often realize their reimbursement through the bundled payment model. This requires maintaining non-clinical paperwork and producing reports, slicing away from the time you spend on patients and exposing them to data and procedural inaccuracies which often count against their performance as being part of these establishments. Our end-to-end billing and coding services spare you the headache of having to maintain your non-clinical paperwork letting you spend more time on drug dispensing.

Radio – being among the most prominent adjuvant therapy services, these services come under the insurance coverage of the Medicare Prescription Drug Improvement and Modernization Act (MPDIM) and require billing and coding assistance. Our medical and billing and coding services have helped many a Radio drug service providers improve their finances through efficient data handling, bill submission and follow-ups.

Our billers aim to provide you with accurate medical billing and coding which is HIPAA compliant. Their updates on reimbursement policy and fee schedules keep your clinic at the top of collections and also helps you work with various payers, right from Medicare to Workers Comp and BCBS to all commercial payers. These billers help you even credential with new insurance, enhancing business for your practice.

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.

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Client Testimonial

“I am a mental health counselor and was previously in a group practice for several years. During this time I put my complete trust in our billing professional without truly knowing the ins and out of billing process. So when I recently became an individual practitioner I was very nervous about having to possibly figure it all out on my own.

Medical Billers and Coders was recommended to me by a colleague who was also an individual practitioner. I was completely put at ease from the start after calling and inquiring about their services. Being able to find a comprehensive service that meets my needs by providing: insurance verification and eligibility; charge and demographic entry; denial management; account analysis and follow up; payment postings; and patient scheduling has been extremely stress relieving. I was pleasantly surprised to find out that their service rate is only 7% of my collections, which is much less than what I was paying in the group practice.

The Practice Mate system was confusing to navigate at first because I was just not used to it. However, the customer service representatives were able to train me quickly in mastering the system. I have been extremely pleased with all customer service individuals I have spoken with.

My personal billing specialist has been very genuine, professional, and attentive. He has taken the time to answer all of my many questions about the process and my patient accounts. I was surprised at how thorough he has been in emailing me the minutes of our phone conversations. He is always available for me to contact.

I would strongly recommend Medical Billers and Coders to any healthcare provider who wants to work with a comprehensive billing company and professional staff that gives great results.

Juxon Morgan Lankford
Licensed Professional Counselor
Wilmington, North Carolina

Med X Medical Management Services holds your company in the highest regard as far as customer service & expertise goes; it is exceptional & very knowledgeable in all aspects of the medical claims management industry. Our decision to contract your services had as much to do with your quick, accurate, & competent response to our question, as it did with the service itself. We would never hesitate in doing business with you!

-Glorisa Harvilla