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Pharmacy Billing Services Michigan, MI

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 greater potential for inaccurate Data handling and denied claims.

Our medical billers in Michigan can specifically customize their billing processes to meet your requirements. We have a reach in almost all the major cities of Michigan such as Detroit, Grand Rapids, Warren, Sterling Heights and Flint.

It has always been the goal of our medical billers and coders to provide better Medical Billing Services which exceed your expectations. They can provide you with a platform for electronic medical billing and also suggest easy to use software. Installing a Practice Management Software and help you set up your workflow so that you can keep a track of your billing. Some of the services which they specialize in are:

  • Patient demographics entry and insurance verification
  • Account receivables management
  • Physician credentialing where required
  • Customized reports on revenue collections
  • Code audits for ethically maximizing revenues

Our medical billers and coders can help you focus on patient care in your practice rather than on paperwork or your administrative staff. They can also guarantee you constant cash flow without leaves or downtime.

The goal of our billers and coders in Michigan, one of the states with the best medical billing and coding schools is to provide you experienced and well trained resource so as strengthen the growth process of your clinic. These medical billers and coders are experienced and trained in numerous areas such as denial management, medical claims processing, medical collection, and medical claims examination.

Value Our Michigan Billers Bring:

Our medical billers and coders are experienced in insurance collections which can be a tedious job for someone who lacks experience in this area. They also understand how critical timely insurance collections are for the physician as well as the patient. Our medical coders and billers at medicalbillersandcoders.com also have solid relationships with key insurance payers, like BCBS, United Health, Workers Comp and government payers across Michigan. These daily interactions with payers ensure that delays or errors in claims management can be avoided.

The skill of our billers is enormous and includes but is not limited to Past Due Collections, Electronic Medical claim filing, Medicare Audit Protection, coding and diagnosis analysis for highest permissible reimbursement, custom-made accounts receivable reports, revenue cycle financial analysis, electronic claims submissions, patient statements and patient-centric support, denials management and payment posting, committed and persistent insurance follow-up, provider enrollment support, and standardized reporting. Moreover our billers are compliant with HIPAA guidelines and are updated with all industry updates through medicalbillerandcoders.com.

Our Specialties:

Our team of medical billers and coders has experience in various areas of specialization such as Physical Therapy, neurology, occupational health, Family Practice, OB Gyn, Hospitalist Billing and numerous other areas. This in-depth knowledge makes them ideal for catering to your requirement of medical coders and billers who can perform in almost every specialized area of medicine. Their experience and relationship across all kinds of payers helps your clinic collect better revenues.

Our Software Experience:

These billers and coders are also proficient in using various EMR software and can ensure a paperless and quick revenue cycle management. Some of the EMR software that our medical billers and coders are proficient in include Medisoft, Misys Tiger, Eclinicalworks, Advance MD, GE Centricity, and Altapoint. These software ensure quick reimbursement for the services that you provide, a paperless environment, and increased revenue because of the accuracy and professionalism of our billers and coders.

Problems & Challenges Michigan Physicians Face:

Michigan is one of the better ranked states in the United States as far as health care is concerned but some problems such as lack of adequate nursing home care and lack of chronic care measures implicate increased number of doctor-patient encounters in the future, as steps are taken to provide insurance to the majority of population. To meet this demand for health care services, our medical billers and coders not only operate in big cities such as Detroit, Grand Rapids, Warren, Sterling Heights and Flint but also in all other counties, smaller cities, and towns in Michigan.

The most common challenges faced by physicians in big cities such as Detroit and Grand Rapids are underperforming accounts receivables or claims denial and collections. Both these situations might lead to diminished revenue. Our billers offer the solutions to these problems by streamlining the denial management process and offering services such as integrated medical billing with EMR. These Billing specialists believe in providing many other value added services such as sending patient statements and processing refunds to Medicare in order to preserve your practice from RAC audits.

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 – Similar to 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 Radio drug service providers improve their finances through efficient data handling, bill submission and follow-ups.

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