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.
Wound care has acquired a new significance as a healthcare discipline and due to a growing aging population in the US; a sizable portion suffer from ailments that expose them to the risk of wounds that require protracted wound care treatment.
The challenge it presents to physicians, hospitals and also to patients is that all types of wound care are not covered by insurance and the ones that are covered require a series of administrative activities, like proper documentation with accurate detailing of medical details of the treatment episode to establish insurance eligibility, which also involves maintaining and furnishing details to establish that the treatment was administered upon the advice of a physician and carried out in the physician’s presence when required.
But even before starting this cumbersome process to prepare and submit claims, care providers have to determine whether the wound treatment they are claiming reimbursement for is covered by the insurance coverage policy framed by Medicare and Medicaid (CMS), which requires familiarity not just with medical necessities but also with insurance coverage.
MBC’s team of medical billers and coders are experienced in handling the entire cycle of activities ranging from determining insurance eligibility to submitting claims and performing routine follow-ups. However, wound care being a treatment that’s administered by care providers of all sizes and also independent physicians, choosing a billing and coding service model which is scalable enough to fit any size and need becomes a challenge for care providers.
MBC offers two types of service models, one an outsourced billing and coding and another revenue management consulting model:
Both the models have helped big and small care providers involved in wound care in all the states of the US to overcome the challenge presented by administrative activities to claim insurance improve their revenues and optimize their in-house resources: either by streamlining processes and training them such that the staff have a thorough knowledge of activities they have to perform and details handle to prepare and claim insurance accurately minimizing chances of claim rejections or by thoroughly sparing themselves the responsibilities to handle insurance administrative activities themselves.