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Pharmacy Billing Services Nevada, NV

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.

The physicians in the state of Nevada have been serviced by the most efficient medical billers, coders and accounts receivables specialist for a decade now. They employ the latest technology and personalized services so as to ensure that physicians in cities such as Las Vegas, Henderson, North Las Vegas, Reno and Paradise receive appropriate compensation for the services provided.

With the ever changing nature of the healthcare industry, our medical billers and coders have experience in handling problems first and work closely with your staff to make your practice realize its full potential. Some of the functions of medical billing which our billers provide are:

  • Patient demographics, registration and charge entry
  • Coding with CPT, ICD-10 and HCPS coding
  • Electronic claims transmission
  • Accounts receivable management
  • Payment posting
  • Reports on a monthly basis

Our medical billers and coders stationed in Nevada have worked with all payers and have the experience to guide your practice through the highest compensation while providing highest quality of care. They manage some of the highest payers such as Aetna, Assurant Health, BCBS of Nevada, Humana Insurance Company and United Healthcare.

Value Our Nevada Billers Bring :

Experienced in insurance collections, which can be a tedious job, is performed efficiently by our medical coders and billers compared to someone who lacks experience in this area. They also know how important well-timed insurance collections are for the doctor as well as the patient. By using Electronic Medical Record that is competent, our medical billers and coders are speedy in patient statement processing which can be a rising encumbrance because of the increasing demand for medical services. Our medical coders and billers at medicalbillersandcoders.com also have solid relationships with key insurance companies all over the nation and the state so that any setbacks or mistakes can be avoided when dealing with insurance matters such as revenue cycle management and in claims denial.

Billing and coding services offered by our billers and coders are a combination of specialized professionals with wide ranging talents such as patient statements processing, fee schedules evaluation, claims management, insurance collections, and the ability to establish effective relationships with patients and insurance companies and know-how of patient accounting software . With exhaustive comprehension of the medical billing and coding and observance of HIPAA guidelines that our coders have, it would become easier for physicians to make sure that income and quality of patient services is not affected due to mistakes in medical coding and billing.

Our Specialties :

They also specialize in various branches of medicine as far as medical billing and coding services are concerned and some of the areas of expertise include Optometry, Family Practice, chiropractic, OB Gyn, Physical Therapy, oncology, Pediatrics, urology, and Hospitalist Billing. All the medical billers and coders at medicalbillersandcoders.com are familiar with ICD9 and CPT Coding which make them preferable choices for physicians.

Our Software Experience :

Our medical billing and coding services provide physicians all across Nevada with efficient EMR software such as Medisoft, Misys Tiger, Eclinicalworks, Advance MD, GE Centricity, and Altapoint. These can ensure that physicians and hospitals get quick reimbursements and do not have through go through a lot of paperwork.

Difficulties & Challenges Nevada physicians Face :

Nevada is a state that has more than its fair share of problems as far as health care is concerned since it is one of the worst ranked for doctor-patient ratio. This means that physicians and health care providers including emergency clinics are facing patients en masse and this deluge will increase with the health care reform law is completely implemented.

Physician shortage being an enormous difficulty in Nevada, the increasing number of patients in the future would mean requirement of knowledgeable and skilled medical billers and coders. Furthermore, lesser claim denials could be likely due to the health reform which makes it vital that you have a perfect and professional team of medical billers and coders. Our expert medical billers and coders are efficient in quality revenue cycle management services across almost all the counties and cities in Nevada and not just large cities such as Las Vegas, Henderson, North Las Vegas, Reno and Paradise.

This state also faces numerous other challenges which often result in negative repercussions for physicians and other health care providers. These challenges include high unemployment, and high number of elderly population. Our medical billers and coders can efficiently assist doctors and health service providers by providing services such as insurance collections, patient statements processing, claims management, fee schedules evaluation, and the capability to establish effective relationships with patients in addition to insurance companies and skill in patient accounting software.

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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