Billing and Coding in a nutshell- The pictorial section will help you understand the 'this and that' of billing and management. Go through the infographs for an understanding of process, in short.
Although plastic surgery is generally indentified as a looks enhancement medical procedure, in many cases it’s done to address genuine health concerns. And often a singular treatment episode may include both: measures to address health concerns (reconstruction) and improve looks (cosmetic). This tangled nature of plastic surgeries often presents a considerable challenge to patients and surgeons as surgeries done purely for cosmetic purposes are not covered under insurance while the ones performed to address genuine health issues are.
This leads to incorrect verification of insurance entitlement often leading to time spent on preparing claims for surgeries that don’t enjoy insurance eligibility or oversight of components of a surgical treatment that come under insurance coverage. Both instances affect the revenues of the plastic surgeon or the clinic of which he/she is a part.
Our medical billing services in Florida can help you to increase your revenue with the reduction in the number of denied and unpaid claims. Our billers present in all the major cities like Jacksonville, Miami, Tampa, St. Petersberg and Orlando can provide you with less paperwork and more accurate medical claims to improve the efficiency of your practice. Here are some of the services which our billers have shown their proficiency in:
Our billers in Florida have been tracking the rate of reimbursements which has been dipping in the state past a decade. They also have analyzed the solution to this dip, the answer lies in the state of Florida’s reimbursement statutes itself. These local Florida billers are the key to unlock blocked cash flows and can provide you with updated methods to improve the efficiency of your practice.
The Florida medical billing and coding services that we provide are not just limited to cities such as major cities like Jacksonville, Miami, Tampa, St. Petersberg and Orlando. They also extend to almost all other towns and smaller cities in Florida. These medical coders and billers surpass HIPAA compliance and are also trained in preferred language such as Spanish. They have been recommended in their past engagements for their medical billing administrative skills, excellent Data Entry management, along with good written and oral communication skills.
Our medical billers and coders in Florida at medicalbillersandcoders.com perform specialized tasks such as reviewing encounter forms for accuracy in ICD-10 and CPT coding, maintain records of existing billing and coverage rules, posting charges and payments to accounts, make follow up calls to insurance companies to resolve any inconsistency in payments and to patients whose accounts were past due to set up a payment plan, report to physicians regularly, offer customer support by comprehending and elucidating insurance EOBs, co-pays, co-insurance and deductibles to patients and enter and revise patient demographics.
Florida medical billing specialists can not only assist in increasing your income but also guarantee suitable reimbursement, provide medical billing and coding services in specialties including Otolaryngology, Primary Care, Optometry, Family Practice, Hospitalist Billing, Cardiology, OB Gyn, Physical Therapy, Pediatrics, Internal Medicine, and Dental.
Physician shortage would always be a problem in Florida and is not only affecting doctors but also bigger hospitals, hospices, nursing homes, nurses and resident doctors. The shortage would mean long working hours and more accurate medical coding and billing practices. However, implementation of EMRs is proving to be of immense help since most of the paperwork is diminished and doctors have real-time information about patients and other related data. Our coders and medical billers are expert in software such as Medisoft, Misys Tiger, Eclinicalworks, Advance MD, GE Centricity, and Altapoint.
One of the unique challenges that physicians and healthcare provides face in Florida is dealing with Florida Medicaid Institutional Care Program (ICP) patients. This is because Florida has a large elderly population (65 years and older) which is projected to grow nearly to 26% of the state’s total population which is the highest among all states in the US.
The fact that these elderly patients are either disabled or are fighting chronic illnesses makes them frequent visitors to physicians’ offices and various hospitals. This fact coupled with the recent health care reform would ensure that health care providers would be required to ensure accuracy and compliance with legal guidelines in order to avoid a drop in revenue or negative legal repercussions. Our medical billing specialists ensure that problems such as inadequate reimbursement due to claim denial and other related factors do not take its toll on your practice.
Our medical billers and coders at medicalbillersandcoders.com can ensure an improvement in the efficiency of your practice by employing the best methods of optimally using your EMR, their exposure of various Practice Management Systems also provides greater collections for your practice.
MBC’s medical billing and coding services cover the entire range of insurance-claim-related requirements for plastic surgery, starting from eligibility verification of the patient to claim submission and post submission follow-ups. With years of experience in dealing with plastic surgery cases in particular and insurance claim preparation and submission in general, our medical billers and coders understand the nature of your organization, its size and scale and bring to you an approach that’s customized to your specific needs. It helps you meet your administrative and technical responsibilities involved in claim preparation and submission and improve your finances.
MBC delivers this both through a consulting model where it helps you to streamline your revenue management cycle by recommending appropriate software applications, helping plug sources of revenue leakages and trainings where required, and also outsource your entire billing and coding responsibilities to MBC.
Breast Reconstruction :
Although a type of plastic surgery, it is for the most part a complex reconstructive or health-related procedure, where, if the attendant health risks are not adequately addressed, the patient would go through long suffering and be faced with serious health hazards. This being the nature of the surgery, it often presents the physician with the challenge of separating the parts of the procedure that are covered by Medicaid and the parts that aren’t. Our medical billers are coders are adept in handling these complexities and helping you prepare an air-tight claim with minimal chances of denial.
A surgery to repair cleft palate, this procedure involves parts that are not purely cosmetic but reconstructive presenting the challenge to physicians or clinicians to identify such parts of the procedure as would be eligible for insurance reimbursement. Our medical billers are coders are skilled in helping you conclusively separate the parts of the procedure that have reconstructive character and therefore insurance eligibility from parts that don’t.
A procedure to correct hooded eyelids, even though it’s cosmetic in nature, it is a surgical correction of a defect with the potential to damage a body part – the eye – and therefore reconstructive in parts at least. We help you identify the reconstructive areas of the procedure to ensure you are reimbursed for them.
Rhinoplasty (nose job):
It involves correction of a part of the nose that, if not properly aligned, can affect the functioning of the nose. However, as Rhinoplasty is broadly cosmetic in nature, physicians often overlook this reconstructive element which is eligible for reimbursement.
MBC’s billing and coding professionals have helped health care providers involved in plastic surgery bring down their insurance denial rates substantially leading to timely payment of their services and optimal use of their staff either by helping them to focus solely on healthcare or by providing consultancy services so that they handle their revenue management responsibilities more effectively with the help of appropriate software applications and smoother and easy-to-follow processes.
MBC will help you perform the perfect plastic surgery by taking over what MBC does best so that you have to only do what you do best – surgery.