Radiation Oncology Billing Services New Mexico, NM
Components & challenges of Radiation-Oncology billing
Cancer being among the most common ailments in the US, radiation oncology is one of the most used medical services in the US with care providers of all types (independent practitioners to hospitals) involved in it. This means a sizable amount of medical resources (money and medical effort) spent on healthcare in the US is claimed by radiation oncology. Alas, most part of it goes unrealized given the demanding nature of insurance procedures.
The radiation oncology insurance procedure involves patient registering, charge entry, claim generation and transmission, payment posting, making appeals for denials and incorrect claims and collection management – and electronic submission of claims to be HIPPA compliant.
Unfortunately, successful reimbursement of a radiation oncology episode requires more than careful adherence to policies, accurate handling of details and ability to transfer data electronically, it also needs:
Thorough understanding of how much coverage Medicare plan entitles you to (there are three of them Plan A, B and C)
Establishing whether the oncology treatment was medically necessary and recommended by a licensed physician
For over 10 years now, our medical billers and coders stationed in New Mexico have built a reputation of helping providers and practices ranging from small to medium to large clinics. They have proved their capability by maximizing the clinic’s cash flow and streamlining their billing and collections processes.
They are actively following the payers in all major cities such as Albuquerque, Las Cruces, Rio Rancho, Santa Fe and Roswell. More than just providing medical billing and coding services, our professionals help you offload tasks from your multitasking staff by providing services such as:
Credentialing with public and commercial payers
Post charges and payments on a daily basis
Electronic submission of claims
Code utilization with CPT, ICD-10 and HCPCS
Accounts receivable management
Insurance follow-up and in-house collections
On New Mexico, the federal government is spending $2.03 for every dollar of tax collected from the state and this rate of return is higher than any other state in the United States. The highest amount is exhausted on Medicaid with a net amount of 3.9 billion with $835 million is spent on Medicaid alone.
This shows that the federal government’s participation in terms of improving healthcare measures in the state. Optimizing your revenue and operations in accordance with the state’s effort is something our medical billers and coders can help you with.
Our Billers in the state of New Mexico are specialized to service medical practices as per the regulations of the state government. Their knowledge and experience has been acquired by years of efforts in perfecting medical billing procedures which they now leverage to help your practice collect more revenue.
The federal government’s effort to reduce healthcare cost can only be supported by physicians in the state of New Mexico by optimizing costs and enhancing revenue. Letting a specialist handle your medical billing can help you improve collections by 20%.
Accurate Coding and code audit along with timely insurance follow up and account receivables are the basis on which thesebillers in New Mexico guarantee higher profitability for your clinic. Their experience in various software and certification in the medical billing processes will support your practice to grow steadily.
Needless to say, this leaves individual physicians, physician groups, clinics, diagnostic facilities, long term care facilities and acute care facilities with unrealized payments (ARs) and consequently ailing revenues.
Outsourcing to MBC:
MBC’s billers and coders possess a comprehensive knowledge of radiation oncology billing and coding procedures. Our years of experience in handling intricacies of radiation therapy billing and coding procedures translates into a very sophisticated level of understanding of the diseases involved in radiation therapy versus the insurance procedures applicable to them.
We have been able to bring down claim denial rates for care providers across all the state of the US through accurate handling of data and rigorous follow-ups done in a methodical manner. Our quality consciousness is responsible for reduction in claim denials. Both during and after preparation of claims, we put them through various cycles of quality checks to make sure that they are completely error free when submitted.
Our service models are flexible, so that you can choose a model that perfectly fits your needs and setup. We offer two types of models:
Our consulting model involves a thorough study of your revenue management system to help identify areas of revenue leakage, outdated software applications and training needs. By helping you address these areas our RCM service will ensure a smooth revenue management process capable of handling the dynamics of radiation therapy insurance requirements and reduced rejected claims.
However, if you don’t have an in-house billing and coding team, you can ship out your entire billing and coding responsibilities to MBC. Our outsourcing model includes the entire range of billing and coding activities starting from identifying insurance eligibility of the patient to submission of claims and post submission follow-ups.
We provide services across all phases of claim preparation and submission:
Charge Entry : Our Charge Entry (CE) services ensure error free claim submission through verification of patient demographics, medical codes, DOS, POS, provider information, units, modifiers as also submission of claims to clearing houses and more. CE also involves random quality checks as part of audits.
Payment Posting : Our billers and coders can work on the most advanced electronic remittance scenarios, including denials, underpayments, overpayments, multiple adjustments, automatic cross-over, secondary remittance, reversals, etc.
Account Receivable : We reduce your claim rejection rates and ensure a timely payment of your services by following up with insurance officials ensuring that you enjoy improved revenues.
Medicalbillersandcoders.com is a national network with our team spread across all states of the US with each state represented by billers and coders familiar with state-specific exceptions. This helps us to account for the fact that the rules applicable across the US are not uniform. MBC has helped care providers across US to improve their revenues as well as quality of radiation oncology treatment by allowing them to concentrate on their core services.