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Tennessee, TN Pharmacy Billing Medical Billing Services

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 a greater potential for inaccurate Data handling and denied claims.

Our Tennessee medical billers and coders have been helping local healthcare professional in and around the state for many years now. They all seem to have collected their knowledge with years of practice of dealing with local payers.

They work towards eliminating your outstanding accounts receivables and make your reimbursement process seamless. They have been catering to major Tennessee cities like Memphis, Nashville, Knoxville, Chattanooga and Clarkesville and are willing to travel to your clinic anywhere in Tennessee.

These proficient billers provide customized services to meet the requirement of your practices. Some of the services our professional medical billers can help you with:

Accurate and prompt verification of benefits
Scheduling appointments
Complete charge entry for claims
Posting Payment regularly
Electronic Claims transmitted through carriers or clearing house
Thorough audit before transmitting claims

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

Over the last few years gross charges denied have grown to 18%, based on estimation for US healthcare providers. This has made the physicians from Tennessee worry about denial ratio.

Consulting professionals or expert medical billers and coders to understand the major reasons for denials works well with busy physicians. Our Billers can consult with you for your accounts receivables and insurance follow-up by being an extension for your practice. Moreover they are also proficient in medical terminology, disease processes, anatomy and physiology, life cycle of an insurance claim, health care settings, health care payers, procedure and diagnosis coding from medical records, reimbursement systems, surgical procedures, facility billing, and medical practice management systems.

Value Our Tennessee 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. By using EMR that is efficient our medical billers and coders are quick in patient statement processing which can be an increasing burden due to the rising demand for medical services. Our medical coders and billers at medicalbillersandcoders.com also have solid relationships with key insurance companies across the nation and state so that any delays or errors can be avoided when dealing with insurance matters such as claims denial and in revenue cycle management.

Billing and coding services provided by our billers and coders are a mix of specialized professionals with wide ranging skills such as insurance collections, patient statements processing, claims management, fee schedules evaluation, and the ability to establish effective relationships with patients and insurance companies and expertise with patient accounting software. With in-depth knowledge of the medical billing and coding and compliance of HIPAA guidelines, it would become easier for you to ensure that revenue and quality of patient services is not affected due to errors in medical coding and billing.

Their skills with Insurance eligibility verification and account receivables follow up, is the main reason for many Tennessee clinics to experience a growth of 20% in revenues with their Medical billing services.

Our Specialties :

Our billers and coders are specialized in various areas such as 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. Many of our medical billers and coders provide value added services to offer through specialized services like evaluating fee schedules, helping you prepare online super bills and diagnosing major reasons for denials.

Our Software Experience :

With the implementation of efficient EMR software our medical billers and coders ensure a paperless, time saving, and efficient medical billing system. The EMR software which they are already trained on include Medisoft, Misys Tiger, Eclinicalworks,Advance MD, GE Centricity, and Altapoint. Using these software would not only save time but also assist you in handling the increase in demand for your services as a health care provider. The Practice Management software that we provide in addition to the value added services mentioned above ensures that physicians in Tennessee are able to keep up with the healthcare IT sector reforms and improvements.

Problems Tennessee Physicians Face :

Physician shortage is a huge problem in Tennessee and increasing number of patients in the near future would mean requirement of experienced and skilled medical billers and coders. Moreover, lesser claim denials may be expected due to the health reform which makes it imperative that you have a flawless and professional team of medical billers and coders. Our expert medical billers and coders ensure quality revenue cycle management service across almost all the counties and cities in Tennessee and not just big cities such as Memphis, Nashville, Knoxville, Chattanooga and Clarkesville.

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Client Testimonial

“I am a mental health counselor and was previously in a group practice for several years. During this time I put my complete trust in our billing professional without truly knowing the ins and out of billing process. So when I recently became an individual practitioner I was very nervous about having to possibly figure it all out on my own.

Medical Billers and Coders was recommended to me by a colleague who was also an individual practitioner. I was completely put at ease from the start after calling and inquiring about their services. Being able to find a comprehensive service that meets my needs by providing: insurance verification and eligibility; charge and demographic entry; denial management; account analysis and follow up; payment postings; and patient scheduling has been extremely stress relieving. I was pleasantly surprised to find out that their service rate is only 7% of my collections, which is much less than what I was paying in the group practice.

The Practice Mate system was confusing to navigate at first because I was just not used to it. However, the customer service representatives were able to train me quickly in mastering the system. I have been extremely pleased with all customer service individuals I have spoken with.

My personal billing specialist has been very genuine, professional, and attentive. He has taken the time to answer all of my many questions about the process and my patient accounts. I was surprised at how thorough he has been in emailing me the minutes of our phone conversations. He is always available for me to contact.

I would strongly recommend Medical Billers and Coders to any healthcare provider who wants to work with a comprehensive billing company and professional staff that gives great results.

Juxon Morgan Lankford
Licensed Professional Counselor
Wilmington, North Carolina

Med X Medical Management Services holds your company in the highest regard as far as customer service & expertise goes; it is exceptional & very knowledgeable in all aspects of the medical claims management industry. Our decision to contract your services had as much to do with your quick, accurate, & competent response to our question, as it did with the service itself. We would never hesitate in doing business with you!

-Glorisa Harvilla