As an Urologist, your practice needs some intensive preparation in the section of medical billing and coding to ensure you get duly reimbursed. There are certain things that you as an Urologist should remember, and other than your medical procedural knowledge having the knowledge of claims reimbursement, denials, resubmission, and revenue cycle management, billing and coding regulation helps you to sustain your Urology facility in the long run.
When we speak about Urology Claims that amplifies the revenue of your practice, there are certain Do's and Don'ts's that you need to adhere too.
Likewise with any claim submitted to insurance company, verifying the patient data is basic. Make sure to get the patient's insurance data, check of date of birth and Social Security number, and also street number, and SOAP notes from the doctor after examination. Verifying patient information and prior authorization ensures that Urologist is not on the losing side of the revenue.
It's additionally vital to verify your own particular information as well. When filing for a urology claim, make sure to give your facilities right address and contact information, and identification number and EDI processing numbers.
Utilizing a clearinghouse to check the claim expands effectiveness and keep away errors in the claims filing process. A proficient clearinghouse will check your urology claims keeping in mind the end goal to guarantee that each claim is sans mistake before the final submission. On the off chance, if an error is found, the clearinghouse notifies the billing department. Fixing errors before the final submission limits the number of days that you will get reimbursed.
In the event that a claim has been denied, it presumably has been denied for a justifiable reason. Before you consequently resubmit the denied claim, check that the claim is without an error. If the claim contains errors, such as, inaccurate procedure codes, then it is possible it is the reason behind refusal. Check with the attending urologist which procedural codes ought to be doled out to the patient within the claim before continuing with resubmission. In certain events the in-house billers are incompetent in filing an error free claim, if they fail to do so, hiring a professional medical billing and coding company that knows how to deal with denied claims can help in the long run for your practice.
A few visits are not submitted for claims twice under particular insurance coverage provision. In particular, Medicare has clear controls about charging for postoperative visits. So, it's better to ensure that you don't double bill for particular visits to the Physician.
We truly can't state this enough. The reason for a clearinghouse is to guarantee that every claim is without any blunder. A legitimately composed clearinghouse distinguishes errors, and notifies the claim handlers about the errors to be rectified before final submission.
Without the clearinghouse, it is possible and likely that claims will be submitted with errors. Claims with errors are probably going to be denied based on the errors within, making your practice resubmit the right claims a second time. All these submission and resubmission takes extra time and resources, creating a deficiency in both time and money for your practice.