September 22, 2011
"Consequently, physicians’ medical bills get an imperial stamp of authenticity, and nullify the chances of undesirable delay, denial, resubmission, and audits from highly stringent medical insurance companies"
Notwithstanding physicians’ integrity in preparing honest Superbills, comprehensive analysis has become imperative before these can be submitted to payers for reimbursement because of the highly dynamic nature of US healthcare industry. Apart from being assured of the accuracy of the bill, a routine analysis saves the healthcare providers from being embarrassed with undesirable delay, denial, and resubmission notices from insurance payers on account of factual errors in the claim forms. Considering the efficacy of such a convention, the question is who should carry out Superbill analysis? Well, it is immaterial whether physicians get it verified in-house or outsource the procedure to an expert third party as long as it serves the purpose of authenticating medical bills.
But, judging from the historic reference of failed in-house verification experiments, outsourcing Superbill analysis, from proven Medical Billing Management providers with their professional expertise, seems an ideal solution.
How is Superbill analysis carried out?
Having established the wisdom in outsourcing Superbill analysis, it would make sense to highlight how Superbill review vets out the accuracy of various crucial pieces of information contained in the document. Well, getting to the crux of the matter, Medical Billing Management specialists scrutinize the Superbills for accuracy of:
Provider Information, wherein last/first name and degree, service location, and signature are verified
Ordering/referring/attending physician, wherein last/first name and degree, NPI (national provider identifier) are scrutinized.
Patient Information, wherein patient’s first and last name, patient DOB, insurance information (insurance name/and id), date of first symptom (upon necessity), and last date seen (upon necessity) are checked.
Visit information, wherein date of service; procedure codes (CPT) – list of commonly used codes by medical provider according to the provider specialty; diagnosis codes (ICD-9) – list of commonly used codes by medical provider according to the provider specialty; modifiers (location and conditions modifiers); time (for timed codes); units and quantity for drugs, and authorization information, (if applicable), are cross- verified.
Thus, Superbill review and analysis process culminates in authenticating the Superbills for claim submission only after ensuring the following:
Establishing the legitimacy of the bills in terms of signature by provider of service
Filling up of required fields for information
Legibility of the information
Apt CPT and ICD-9 codes with corresponding description of service/diagnosis
Physicians can hire outside services for the entire process of Superbills preparation, verification, submission, and realization of medical bills from the insurance companies. Such services come with utilities such as preparation of super bills from the physician notes and transcriptions that are available in their system; utmost care while coding; adherence to HIPAA compliance and CPT, ICD-9, and HCPCS coding; and assigning of appropriate modifiers and related information into the Medical Billing Software accurately.
Consequently, physicians’ medical bills get an imperial stamp of authenticity, and nullify the chances of undesirable delay, denial, resubmission, and audits from highly stringent medical insurance companies.
Medicalbillersandcoders.com, being the largest consortium of medical billers in the US, has made Superbill analysis – comprising coding of the diagnosis and the procedure, checking the compatibility of the diagnosis with the procedure code, checking for the modifiers in relation to the procedure, quality checking before the generation of the claim – an integral part of its comprehensive Medical Billing Management Services.
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