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Pharmacy Billing Services Oklahoma, OK

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 Oklahoma medical billers and coders can ensure that your facility gains a steady growth through proper medical billing and claims management processes. They offer effective medical billing solutions for every kind of practice, physician groups, clinics as well as hospitals.

Our medical billers dynamically operate through all major cities such as Oklahoma City, Tulsa, Norman, Lawton and Broken Arrow. They provide customized billing solutions, are adept in handling core medical billing issues and provide services such as:

  • Accurate submission of claims which leads to improved cash flow
  • Payment posting
  • Accounts receivable management
  • Follow up on denied and rejected claims
  • Physician credentialing if necessary
  • Reduction in over all costs

Most of healthcare in the state of Oklahoma is covered by the federal government’s initiative to have affordable healthcare for all. Handling various payer requirements and keeping oneself updated is not easy. Medical Billers and Coders in our consortium would go out of their way to update themselves and the practice they work for.

Value Our Oklahoma Billers Bring :

The presence of Certified Medical Reimbursement Specialists (CMRS) among our billers also means that the claims paying process is smooth and you receive professional services including ICD10, CPT4 and HCPCS Coding, Medical Terminology, Insurance claims and billing, appeals and denials, fraud and abuse, HIPAA, OIG Compliance, information and web technology, and reimbursement.

The presence of certified and professional billers and coders means that you would not only get the best services in this field but also increase your revenue and quality even under increasing work pressure. Moreover this expertise and certification ensures better transparency and offer options which integrate without a glitch with your practice’s processes and not necessitate major changes or realignment in your practice.

Our billers use accurate CPT and ICD-10 codes which help in enhancing your revenue and reduce errors leading to denials. The in-depth knowledge of the latest health care reforms and practices makes our billers more efficient and productive compared to novices in this field.

In Oklahoma about 40% of medical billers and coders work in Oklahoma City but our billers can provide services to health care providers in other cities such as Tulsa, Lawton, Edmond, Enid, Stillwater, Midwest City, Moore and almost all other cities and smaller towns.

With such a wide variety of choices and specialties, our medical billers are capable of customizing according to your need without comprising quality. These medical billers and coders are Certified Professional Coder and some of them even have CCS certification. These certifications enable our coders and billers to keep up and comprehend the changing health care requirements. These certifications also enable physicians to trust their years of experience while making sure they are taking efforts to update themselves. Moreover, sometimes these billers and coders also offer consultancy as a value added service.

Our Specialties :

These Billers are experts in Denial Management, they specialize in account receivables as they understand the reasons for denials and try to prevent them right in the beginning. Moreover, our billers have more than two decades of experience in specialties such as behavioral health and anesthesiology.

Our Software Experience :

Our billers and coders are not only HIPAA compliant but also possess various software skills needed for Electronic Medical Billing and Coding. These include Medisoft, Misys Tiger, Eclinicalworks,Advance MD, GE Centricity, and Altapoint. Such software can be used in medical fields such as emergency room departments, home health care agencies, and hospitals. The software provides many benefits such as simpler accounting, security, collections tracking systems, medical billing management, creation of super bills, and numerous other tasks associated with Practice Management and Practice Workflow.

Problems Oklahoma Physicians Face :

Oklahoma physicians are dealing with numerous problems such as increased doctor-patient encounters and shortage of doctors, and these would worsen when the health care reforms come into full effect. This would mean that doctors would require experienced medical billing and coding specialists for denial management, ensure timely reimbursement, and compliance with HIPAA guidelines. Our billers at medicalbillersandcoders.com can ensure that these objectives are met in a timely and productive manner.

These billers would help you streamline your medical billing requirements in Oklahoma locally and their expertise in your specialty can optimize revenue easily.

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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