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Pharmacy Billing Services New Jersey, NJ

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 and coders stationed in New Jersey, provide physicians with the latest in reimbursement strategies and government updates in terms of healthcare industry. Their presence across all major cities such as Newark, Jersey City, Patterson, Elizabeth and Edison offer Physicians options to locate well trained Medical Billers and coders easily.

These medical billers are equipped to reduce your overhead as well as perform complex administrative tasks. Their services guarantee many advantages and can help you to:

  • Reduced overheads
  • Patient eligibility verification in real time
  • Expedite payments
  • Reduction of rejected claims but follow up on them as well
  • Increased productivity of in-house team
  • Collection of overdue claims

The state of New Jersey happens to be the most densely populated and wealthiest state in United States, those are the real indicators of why healthcare is sprawling in the state. Thus, the growing need for number of physicians and a lot of medical billing specialists to support these practices is far from being fulfilled.

These Billers are well acquainted with the payers’ community in New Jersey and track major reasons for denials and plug these avenues of revenue loss first. Their detailed analysis helps you to collect more revenue as per your specialty and maintain high collections regularly.

Value Our New Jersey Billers Bring :

Our New Jersey medical billers and coders also provide practice management software that ensures that physicians can keep up with the latest health care IT reforms and improvements. They are experienced in the field of patient statements processing, claims management, fee schedules evaluation, insurance collections, and the capability of establishing effective relationships with insurance companies and patients.

Our medical billing and coding team is experienced in insurance collections which can be a tiresome job for a medical biller who lacks experience in this area. They also know how vital timely insurance collections are for the doctors.

By using EMR software that is efficient, our medical billers and coders take minimal amount of time for patient statement processing which can be an increasing burden because of the growing requirement for medical services.

Medical coders and billers at medicalbillersandcoders.com also have professional relationships with key insurance companies across New Jersey so that any setback or errors in claims management can be circumvented in right in the beginning.

Our Specialties:

The services of medical coding and billing that are provided are not limited to big cities such as Newark, Jersey City, Patterson, Elizabeth and Edison but also all other counties in the state. Moreover, our coders and billers specialize in all the branches of medicine such as Optometry, chiropractic, OB Gyn, Pediatrics, oncology, urology, Family Practice 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 and health care providers. Many of our medical billers and coders also offer value added services through specific services such as evaluating fee schedules, helping you prepare online super bills and diagnosing the key grounds for denials.

Our Software Experience:

In New Jersey many physicians are finding it a difficult to digitize their practice and switch to EMRs which would be part of the health care reform. Our medical billers and coders are specialized and experienced in a wide range of software which offers you a choice of the most efficient and updated Medical Billers and coders trained on the latest EMR systems in the market.

These include Medisoft, Misys Tiger, Eclinicalworks, Advance MD, GE Centricity and Altapoint. These EMR would ensure that your office productivity is increased along with the efficiency of the services that you provide as a physician to your patients.

Problems New Jersey Physicians Face :

New Jersey has the highest density of population in the United States and the low rate of physicians who are starting to adopt Electronic Medical Records would mean that health care providers would be scrambling to meet the adoption deadlines.

The billing and coding services assist physicians with various EMRs and are experienced with specialized knowledge about the changes related to medical billing, coding, HIPAA guidelines, denial management, patient statement processing, claims management and ability to have long term and effective relationships with patients and insurance companies.

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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