5 Ways Outsourcing EMS Medical Billing Services Can Improve Your Organization’s Bottom Line

Every business wants to optimize profitability, and those in the healthcare industry are no exception. Collecting payments from insurance companies and patients can be time-consuming and complicated, adversely affecting your balance sheet. By outsourcing EMS medical billing services, you can extend your organization’s accounts receivable department, increase efficiency, focus on your core business strategies, and better your bottom line. 

Emergency medical services are a vital component of overall public safety and care. At Coronis Health, our extensive experience working in the healthcare industry has allowed our partners to continue providing emergency care that often makes a lifesaving difference while generating additional revenue for their business with minimum effort on their part. Below, we share how outsourcing EMS medical billing services can help improve your organization’s cash flow.

1. Save Time and Money by Outsourcing Your EMS Medical Billing

Calling a patient to confirm their insurance coverage, training your staff, and relying on paper billing can prove to be costly and a waste of time. Cutting down on these tasks will lighten the burden on your current employees, giving them more time to focus on more important tasks for your facility. By partnering with a reliable medical billing company, the workflow becomes more efficient, the billing process becomes automated, and hiring and training staff for this purpose becomes unnecessary. By outsourcing your EMS medical billing, you can save time and money without cutting corners.

A medical billing company will also provide you the flexibility to choose which specific services you need, and the most affordable option and payment scheme suitable for your organization.

2. Streamline Your EMS Billing Process and Improve Cash Flow

The billing process involves handling documents ranging from patient documents to medical publications and other multimedia resources. A billing company will enable optimized search and retrieval tools, along with EMS medical billing software to be seamlessly integrated into your existing office system. Existing documents (including EOBs and other billing-related paperwork) can be scanned and organized into a secure system, where they can be accessed from mobile devices anywhere in your facility. With admin outsourced, you avoid billing errors while enabling your staff members to focus on providing outstanding patient care.

3. Reduce Accounting and Administrative Overhead Costs

A huge factor in ensuring good returns from your EMS services is cutting down on your expenses. Operational costs come with the territory of running a facility, but you want to keep them under control to ensure a healthy revenue stream. Many facilities do not see how they’re spending too much when it comes to the bigger picture of their operations. The following factors contribute to a higher operational expense for a facility that uses in-house medical billing:

• Hiring skilled, trained, and certified billers and coders
• Paying hourly wages (including taxes and employee benefits)
• Licensing for software (depending on the number of employees, you may be charged per license)
• Clearinghouse fees 
• Statement fees and postage, including the cost of printing
• Potential for increased rejections and denials with a smaller, less productive in-house billing team
• Decreased collections and cash flow
• Increased patient debt

These factors impact your facility’s ability to maintain a reasonable rate of operational expenses. When the costs of the above are factored into the cost savings of outsourcing your EMS medical billing, you will discover that the increase in your revenue will surpass not only your previous operational expenses but the fee you pay for your outsourcing. You end up making more in the long run. 

4. Increase Efficiency and Accuracy of Your EMS Billing Procedures

Billing errors can create a potentially large hit on your revenue. Errors include inefficient collection policies, incorrect coding for EMS medical billing, errors with patient registration and insurance verification, and lack of documentation with a claim. One mistake can result in a denied claim or delayed payment, which will ultimately result in costly results. 

Medical billers specialize in many fields, from ambulatory services to primary care and surgery, so it’s important to outsource with the right company that understands the intricacies of your facility. This ensures that you see fewer mistakes with billing, which means your net collections increase, your denials decrease, and your operational costs are more than manageable. 

Certified medical billers and coders are trained to apply coding that correlates correctly with clinical documentation and are consistently updated on any changes that apply to coding or billing procedures. Outsourcing your medical billing ensures that you are working with a team that focuses 100% of their time on EMS medical billing and coding. You will see an improvement in compliance with billing regulations as your outsourced billing is following the guidelines set forth by the government and CMS. 

5. Maximize Reimbursements and Minimize Denials

Part of your revenue cycle is tied to your collection processes, and without a process for collecting on outstanding payments from insurance payers and patients, you will see a decline in your facility’s revenue. Streamlined billing services for your facility will ensure that you experience an increase in revenue, rather than a decline in the lifeblood of your facility’s operations. Specifically, the accurate, compliant, and timely return of your organization’s documentation will conveniently be expedited and in some cases, increase your revenue because coding denials will be minimal and claims will be cleaner, helping to maximize your reimbursements. 

Since the pandemic, insurance carriers now scrutinize each claim due to various reasons such as chief complaints, insurance policy limitations and much more but due to our years of expertise and historical interactions with these carriers, Coronis is able to appeal and negotiate to receive higher reimbursements for our clients.

Questions About Outsourcing Your EMS Medical Billing Services? Contact Coronis Health Today to Learn More

Medical billing is a critical component of your facility’s revenue cycle, as it ensures that you are earning the reimbursements for the services you provide. If you are struggling with your accounts receivable, staffing, and an overall lower collection rate, it may be time to consider outsourcing your medical billing and coding for EMS. Are you ready to take a closer look? Contact Coronis Health for a free financial checkup.

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Why Outsource Your EMS Medical Billing Services?

Emergency Medical Services (EMS) are a vital emergency medical care service provided 24 hours a day to anyone in need of medical care. These services are the first response from a health care provider to a medical emergency. Emergency medical services can take various forms depending on where you are and what you need and can range from a single-person ambulance to a large department with multiple ambulances, paramedics, rotar, and other health services.

Due to the range of services, EMS medical billing can be a time-consuming and complicated endeavor, especially for small facilities. Coronis Health is a medical billing and revenue cycle management business that provides specialized solutions with global capabilities. Our experts offer many EMS services, including credentialing, collections, provider management, medical coding, scanning and archiving, and medical billing.

Tailored EMS Medical Billing Services Designed to Drive Results

Not all EMS services are the same, so medical billing requires a personalized approach for each provider based on the practice and services rendered. EMS billing is a complex and time-consuming process, which is why many EMS companies are now outsourcing their billing services to a billing service provider. Outsourcing can provide a more efficient billing and coding process for your company, ultimately improving results.

Efficient medical billing and claims follow-up from an experienced provider allows practices to take advantage of tailored services and maximum results. Not just financial results but efficiency and quality across the entire practice. Tailored EMS services can drive results, including:

• Better customer service and patient experience
• Reduced time on repetitive tasks
• Less time on administrative tasks
• More time on patient care and services

Coronis Health has extensive industry experience in cutting-edge billing technology executed by certified coders and healthcare and EMS veterans. Our EMS medical billing services are crafted to meet all your individual needs and can include:

• Electronic and paper claims processing
• Patient statement processing and mailing
• Insurance follow-up and soft collection services
• Post patient and insurance payments
• Secondary and tertiary insurance billing

Become a Trusted Partner with EMS Medical Billing Experts

EMS billing requires a unique set of skills and knowledge to make accurate diagnoses from your patient data. Many EMS companies outsource their billing services to billing service providers, who are uniquely qualified to meet the company’s needs. Medical billing is more than meeting billing needs; it is also creating a team that can evaluate and change together to improve billing functionalities and build a cohesive and effective healthcare service for patients.

Medical billing is more than a business contract with Coronis Health; it is a partnership to make your practice a profitable and efficient system for all stakeholders. There are many benefits to working with Coronis Health for EMS medical billing, including:

• Forensic follow-up on claims
• Operational management services
• Medicare compliance and documentation training for EMTs and paramedics
• Ambulance service start-up program
• Increase in cash collections

Coronis Health is invested in your EMS business and has decades of experience providing EMS revenue cycle and financial consulting services to help your practice thrive. During the height of the pandemic we were able to stay fully staffed and perform for our customers which was crucial to their financial health and service continuation.

Understanding Your EMS Medical Billing Reports and Data

Outsourcing your EMS medical billing can make reports and data more straightforward and accessible. Organizing and interpreting can be challenging and overwhelming when left to in-house employees or providers and may not be adequately utilized. Leave reporting and data to your medical billing vendor for more accurate financial health information. Outsourcing EMS medical billing also ensures access to experts who can better explain reports and data to positively impact financial and business decisions.

Coronis Health is confident in our billing and coding services and has a transparency guarantee, so you see what we see. We provide clean and comprehensive reports and data that are accessible 24/7. EMS providers should always know where they stand, and our customized and detailed statistics make it easier to measure and understand financial performance.

How Outsourcing Your Billing Services Can Increase Your Facility’s Bottom Line

In today’s business environment, you need to be able to offer your customers high-quality services and products. If you don’t have the right resources or processes to do so, you may be missing out on a large amount of potential revenue. An EMS billing company can use an array of specialties to ensure that you receive the most accurate and reliable billing results. The following are just a few of the ways that outsourcing your billing services can increase your facility’s bottom line:

• Decreases costs associated with billing and claims management
• Reduces staff time on billing tasks and follow-up
• Increase your facility’s patient satisfaction
• Reduce patient delays in care
• Improve your facility’s operational efficiency
• Increased and faster reimbursements

Coronis Health leverages the latest technology to ensure the highest returns for EMS. Let us focus on securing every dollar you deserve, so you can continue to save lives and provide quality healthcare.

Ready to Outsource Your EMS Medical Billing Services and Recover Missing Revenue? Contact Coronis Health Today.

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Substance Abuse Treatment Centers: What to Know About Outsourcing Your Medical Billing Services

The goal of every substance abuse treatment facility is to help people recover from substance use disorders. Unfortunately, these facilities also have to deal with the complexities of behavioral health medical billing. Substance abuse billing comes with unique challenges, causing providers to spend precious time chasing payments rather than focusing on providing proper quality care. 

As a medical billing services company with more than 35+ years of experience, Coronis Health is committed to constantly adapting to the healthcare industry’s dynamic landscape. We keep abreast of recent guidelines, report on current and emerging health issues, and make sure your substance abuse billing services are aligned with new regulations. 

We partner with your organization to provide medical billing and coding solutions that ensure your collections are easy to manage and that denials are kept to an absolute minimum. We know you provide life-changing treatment to your patients, and we want to take the burden of substance abuse medical billing off your shoulders so you can do what you do best.

How Does Outsourcing Medical Billing Work for Substance Abuse Treatment Centers?

The landscape for mental and behavioral health is evolving rapidly. In addition to the time-consuming task of billing and coding, you are confronted daily with changing regulations, payment models, and substance abuse billing software, as well as challenges that come with out-of-network billing. 

Drug and alcohol addiction treatment centers often struggle with billing issues, resulting in delayed payments and revenue loss. By outsourcing medical billing, you gain a team of expert billers who will handle these challenges for you. A substance abuse billing company will monitor accounts receivable, promote best practices, and increase reimbursements. Specifically, a medical billing company will provide the following services:

• Facility credentialing
• Benefits verification
• Utilization review
• EMR/technology integration
• Collections
• Financial analysis & reporting
• Account management

What Are the Costs Associated With Outsourcing Medical Billing?

The costs and fees associated with medical billing for behavioral health services will vary depending on the arrangement. Some will charge a percentage of the collection claims, while other companies charge a flat fee or monthly rate. Facilities typically find that no matter how the cost is calculated, the value of a professional billing company far outweighs the expense associated with their services.

How Outsourcing Medical Billing Can Benefit Your Facility 

Medical billing is a demanding and tedious task that requires experience, expertise, and knowledge of industry standards. If your billing cycle is not optimized, you may be losing revenue before you even realize you are losing it. Outsourcing medical billing can help you build more efficient revenue cycle management to ensure your substance abuse treatment facility remains financially independent. Specifically, outsourcing medical billing provides the following benefits:

• Lower Costs – The money spent to train, recertify, and keep medical billers up to date on the latest regulations is an additional cost that can be eliminated when the billing process is outsourced. 
• Expertise – Outsourcing to billing experts who have access to the most advanced behavioral health medical billing software ensures you see fewer mistakes with billing, which means your net collections increase, your denials decrease, and your operational costs are more manageable. 
• Insight – Financial reports provide you more insight into what affects your revenue cycle for greater efficiency and profitability. 
• Better Decision Making – Financial expertise enables you to make better decisions and establish the best practices in your facility.
• Experience – Experience in billing and coding services for all types of substance abuse treatment centers provides a deeper understanding of how insurers respond to different types of claims.
• Compliance – Outsourcing your medical billing provides you with a team that focuses 100% of their time on your billing. You will see an improvement in compliance with billing regulations as your outsourced billing is following the guidelines set forth by the government and CMS. 
• Quality Patient Care – You enable your staff to focus on creating the best experience for your patients. Outsourcing medical billing gives your staff the freedom to engage with patients without the stress of adding discussions about billing to the exchange. With a better patient experience, you will see higher patient retention and satisfaction.

Things to Keep in Mind When Choosing an Outsourced Medical Billing Company

Outsourcing your medical billing lets you focus more on treatment and less on your back-office processes. However, partnering with the wrong company may result in more problems than you currently have. There are critical factors to consider when you are selecting the best medical billing company for your facility.

Reputation

A true partner is someone you can trust, which is why a complete and comprehensive background check is necessary. Do your research. Ask trusted colleagues for referrals. Ask medical professionals because you are more likely to receive reliable information from a trusted source rather than anonymous consumer reviews online.

Expertise

You will face unique challenges in your industry, and you want billers with expertise in your specialty to ensure correct billing. Choose a company that is familiar with substance abuse treatment coding, compliance, and documentation requirements, including all addiction billing standards and laws. Otherwise, you may suffer from coding inaccuracies, claim denials, and low cash flow, defeating the purpose of outsourcing.

HIPAA Compliance with Strong Privacy Protection Procedures

You have a direct responsibility to address healthcare privacy and security. By working with an experienced company with HIPAA (Health Insurance Portability and Accountability Act) compliance, you get peace of mind knowing that the company’s practices ensure the confidential handling of a patient’s health information. In addition to HIPAA, your outsourcing provider should understand other laws, medical regulations, and guidelines pertaining to your specific industry.

Maintaining patient privacy should be a top priority. The company you choose must enforce plans to protect privacy while also preventing abuse and fraud.

Transparency

You may be outsourcing your medical billing process, but you still want to be aware of the status of your claims. It’s still your business, after all. Your billing specialist must provide you with regular and transparent reports that allow you to oversee the billing process to ensure efficiency and manage your facility’s financial health.

Measurable Results

Your medical billing partner should help you achieve a more controlled approach to revenue cycle management. This proves to be more sustainable because when your medical billing process is up to date, efficient, and free of human error, you can receive payments in a shorter amount of time. Comprehensive performance reports keep you informed of critical financial numbers, allowing you to maintain control of your revenue cycle management without having to perform the tasks yourself.

Questions About Outsourcing Your Medical Billing Services? Contact Coronis Health Today

Outsourcing your billing and coding is one of the most significant practice management decisions your facility will ever make. Coronis Health employs top medical billers in the country, pooling their global resources to bring customers the best in medical billing and revenue cycle management. We’ll work with you to build data-driven solutions that meet your specific needs, allowing you to focus on treating patients. To learn more, contact Coronis Health to request your free financial checkup.

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The Difference Between Behavioral Health and Medical Billing

A common misconception about mental and behavioral health is that health insurance covers services the same way other medical services are covered. Unfortunately, this is not the case, and it can cause significant headaches for providers in the mental and behavioral health sphere. 

The differences and restrictions related to mental and behavioral health cause some providers to refrain from accepting insurance, or limit themselves to accepting only a few plans, because the billing process can be complex and arduous. A thorough understanding of benefits, eligibility, and how insurance reimburses for mental and behavioral health can help a specialist move beyond frustration and gain more out of the billing process. Coronis Health understands the unique differences in mental and behavioral health billing, which ensures you can focus on what is most important – your patients. 

What Is Mental and Behavioral Health Medical Billing?

Standard medical billing focuses on standard services such as physical exams, diagnostic testing, and follow-up visits for chronic conditions. Mental and behavioral health care varies based on different types of therapy, psychological testing, and associated medical treatments. Insurance places more restrictions on the billing practices for behavioral and mental health, such as the number of visits allowed in a month or year, or a requirement to obtain pre-authorization before rendering services. Understanding the distinct differences in mental and behavioral health medical billing is the first step to earning more from the services you provide. 

Mental and Behavioral Health Medical Billing: What’s Covered

Mental and behavioral health medical billing focuses on the treatments patients receive for long-term conditions such as depression, anxiety, bipolar disorder, substance use disorders, or schizophrenia. The most important aspect of billing for mental health services is the restrictions placed on facilities and the patient, such as limiting the number of visits in a week or month, and placing time limits on the actual visit. Pre-authorization is sometimes required before visits are covered. 

Some insurance plans do not cover mental health services, and some providers are out of network with a patient’s plan, so mental health providers must be prepared for patients who are paying out of pocket for services. 

Billing for behavioral health services also requires a good bit of knowledge and a dedicated employee to focus on the billing component of a patient’s mental health services. Many mental health providers end up spending substantial time on the administrative process, distracting them from the vital care of their patients. Coronis Health can eliminate the challenges of mental health billing to ensure that the facility is gaining more from the services they render.

How Medical Billing Works for Each Type of Health Care

Medical billing for mental and behavioral health services requires a comprehensive level of knowledge of insurance plans, CPT codes, and reduction in denials to increase reimbursement for a facility.

• Verification of benefits ensures that services are either covered or not covered
  • This includes verification of the need for pre-authorization for services
• CPT codes used during a visit include the evaluation and management (E&M) codes, which require extensive knowledge of the difference between standard E&M codes and psychiatric evaluation codes
  • Special attention must focus on time, as the time spent with E&M codes cannot attribute to the time of a psychotherapy service
• Understanding CPT codes ensures that claims are not rejected, resulting in a higher rate of reimbursement, and a lower number of days in accounts receivable. 

Coding Regulations for Mental and Behavioral Health Medical Billing

Billing for mental and behavioral health services is more than just diagnosis and CPT codes; there are vast differences that can create confusion for billers who are not well-versed in this type of medical billing. Submitting claims can even differ from one payer to another, so it’s important to focus on the regulations and codes that apply to the services rendered, and the guidelines of the patient’s plan.

• E&M codes are not as straightforward as medical billing
• Time associated with a visit is included for psychotherapy 
• Payers may require certain codes to be submitted with claims
• Billing format is critical, and also differs from one payer to another, such as a CMS1500, or a UB-04, or electronic billing through the facilities’ electronic health record (EHR) system

The coding regulations placed on mental and behavioral health claims ensure that the services are captured accurately and that reimbursement is paid accordingly. 

How Are They Different?

The differences between behavioral health billing or other medical billing boil down to the specific services that are rendered. Medical billing includes straightforward services, such as diagnostic testing (laboratory tests or radiologic exams). Mental and behavioral health services range from psychotherapy to medical management, and psychological testing services to inpatient or outpatient rehabilitation. The biggest hurdle with coding for mental and behavioral health services is understanding the differences in coding and the restrictions within a patient’s insurance plan. 

These differences create a mountain of work for a facility, so outsourcing can save a lot of time, effort, and money. In addition, facilities that outsource tend to receive higher reimbursements, allowing them to provide better care for their patients. 

Questions about Mental or Behavioral Health Medical Billing? Contact Coronis Health Today!

Coronis Health has certified, trained billing experts that know how to help you gain the most out of your mental and behavioral health claims. If you are struggling to keep your claims current and your coding correct, call Coronis Health today. We can give you back the time you need to focus on the most important part of your work – your patients. Don’t hesitate – call us now.

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Substance Abuse Treatment Center Medical Billing Services

Substance abuse treatment centers are designed to help individuals recover from addiction and substance use disorders—not handle challenging medical billing and coding issues. Every service has a business side of operations that can either help or hurt your organization. Billing varies by industry, and even within medical billing, there are variations in services and protocols. Outsourcing medical billing to a vendor with expert behavioral health and substance abuse billing knowledge may improve your revenue cycle and free up your time to focus on your patients.

Coronis is a global revenue cycle management company that specializes in healthcare solutions by utilizing industry-leading technology and high-touch relationship building. Our services help all types of healthcare providers and facilities achieve financial success, including substance abuse treatment centers.

The Benefits of Outsourcing Your Treatment Center’s Medical Billing Services

Outsourcing your medical billing services isn’t just a practical business decision that benefits your organization; it also helps your staff and patients. Simplify medical billing by outsourcing to an expert and take advantage of the plethora of potential advantages outsourcing offers.

Increased Profits

Nearly all of a treatment center’s profit comes from billing. Outsourcing ensures billing is handled quickly and accurately, so that revenue comes into the organization faster. Increased profits can then be put back into the organization for growth and improved patient care.

Reduced Staff Turnover and Increased Satisfaction

Medical billing is a time-consuming commitment that can overwhelm providers and staff. If staff members are juggling medical billing and other regular duties, it can lead to mistakes, burnout, and unsatisfied staff that leave for a less burdensome position. Outsourcing medical billing makes the already significant workload lighter for employees.

Improved Patient Focus

Sometimes medical billing can come between a provider and a patient. Office staff may overlook new patients or other patient-related tasks while dealing with medical billing. When clinicians are shouldering the billing responsibility themselves, it can take away from quality care. Outsourcing medical billing puts the patient where they belong—as the top priority for your center.

How to Choose the Right Medical Billing Services for Your Treatment Center

Laws, rules, and regulations that impact substance abuse treatment centers can change anytime, making it difficult to stay profitable without outsourcing expert assistance. It is essential to avoid short-term solutions for long-term problems when looking at your organization’s growth and quality. Many substance abuse centers need billing and coding expertise to decrease denial rates and increase reimbursements. Substance abuse treatment centers may be unaware of the services that could improve their operations and key performance indicators that demonstrate their success. Don’t forget to consider:

• Clean claim rates
• Denial tracking
• DSO calculations 
• Payment waterfall metrics

Coronis Health can assess your organization and recommend services to maintain financial independence and cultivate financial success. Our services and processes are transparent to your organization, so you can feel comfortable letting go of the operational processes and confident in your future success.

Common Pitfalls to Avoid When Outsourcing Your Medical Billing Services

Medical billing is a demanding and often troublesome task that can overshadow your organization. There are unique challenges to keep in mind when it comes to substance abuse billing. Unlike standard medical billing, the treatment protocols are not always as straightforward. Factors like pre-authorizations and coverage limits can affect your ability to collect from payers. Education about the various nuances of substance abuse billing can strengthen your organization and help you avoid common pitfalls.

Don’t Generalize

When it comes to outsourcing medical billing, especially substance abuse medical billing, a general vendor is not the way to go. Substance abuse facilities should outsource to an industry expert that understands unique behavioral health billing codes and protocols. Choose a company with a deep knowledge of substance abuse billing procedures and any challenges that can arise.

Coronis Health has a team of behavioral health billing experts with experience in substance abuse medical billing. Our team members hold appropriate credentials and adhere to state laws to ensure your organization gets the services necessary for success.

Ensure Privacy and Protection Procedures

Ensure the company you outsource with meets billing compliance standards by the Health Insurance Portability and Accountability Act (HIPAA) and the Office of Inspector General (OIG). Nothing is more important than patient and organization privacy when handling personal data. Compliance also means safe operations for your facility without the risk of penalties or other action.

Transparency is Key

Seek a company that offers reports with updated information and metrics to help you understand and manage your organization. Medical billing is key to substance abuse treatment centers’ success but is only one moving part of the business. Coronis ensures transparency in your entire revenue cycle so you can stay on top of decisions that lead to growth and success.

Questions About Medical Billing Services? Contact Coronis Health Today!

Our behavioral health services allow substance abuse treatment centers to rely on maximum billing and collections. It is a unique industry in healthcare and Coronis has specialized services and solutions. Our experience and technology can help substance abuse treatment centers expand revenue and focus on exceptional patient care.

Contact us for more information about substance abuse medical billing.

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Are Your Substance Abuse Billing Claim Payments from Insurance Getting Delayed?

The process of dealing with insurance claims can be a long and painful one–from denied benefits that require multiple interactions with the insurance company to billing errors that could be avoided. If your behavioral health billing is falling behind, it’s good to know that there are options available that can significantly reduce the elapsed time before you receive your payments. Billing software created specifically to support billing for mental health and substance use disorder services helps reduce the potential for errors and get your payments resolved faster than ever.

What Is the Average Turnaround Time for a Substance Abuse Billing Claim Payment From Insurance Companies?

To ensure timely payments, your staff must verify all necessary insurance information, your billing processes must be up to date, and your substance abuse coding standards must be accurate. Even when you’re able to perfectly submit all of your documentation and it is accepted by the insurance companies, you’re still faced with between a two- to four-week turnaround before your facility receives payments from insurance companies and that’s a best case scenario for commercial insurance.

How Can You Ensure That Your Billing Process Is as Efficient as Possible to Receive Timely Payments?

When your behavioral health billing software works as it should, you may be able to reduce your facility’s outstanding accounts receivable timeline. Maintaining this type of behavioral health billing software can be a challenge, which is why many facilities decide to work with third-party billing partners instead of doing this complex work internally. Outsourcing allows your staff members to focus on providing the highest quality of care instead of getting bogged down with the details of coding and billing for the behavioral health space.

What Are Some Common Reasons for Claim Payment Delays in the Substance Abuse Billing Industry?

There are a variety of reasons for delayed or unapproved substance abuse billing company payments. These can include challenges with the coding that has been done on the individual patient accounts, requests that are not submitted in a timely manner, and a mismatch between diagnosis and the billing that has been completed. In some cases provider or facility credentialing was not done correctly from the start.

How Can They Be Avoided?

Fortunately, avoiding these billing challenges doesn’t have to be a nightmare. When you partner with a trained and highly-qualified team of billing specialists, you can be rest assured your substance abuse medical billing will meet all current and future standards, which will also reduce overall cycle time and ensure patient satisfaction. Your team will be able to focus on the quality of your patient care rather than trying to keep up with ongoing changes to medical billing or frustration from working with antiquated billing systems.

Questions about Claim Payment Turnaround Times for Substance Abuse Billing? Contact Coronis Health Today!

Why risk extending your timeline for receiving payment from substance abuse insurance claims? When you work with the knowledgeable professionals at Coronis, you can be confident that you’re getting high-touch support from thought leaders who are continually looking for ways to reduce payment timelines and maximize your revenue cycle. With tailored solutions that can scale with your facility, Coronis offers significant advantages over internal solutions for medical billing software for substance abuse facilities. Contact us online today to request your free financial checkup.

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New Codes Coming: Is Your Practice Ready?

The clock is ticking for 2022-2023 pathology coding changes. Highlights to date include proposed changes to the 2023 Physician’s Fee Schedule and the addition of category 3 (temporary) digital technology codes that will be add-ons to the primary category 1 CPT (eg: 88305, 88342).

The 2023 ICD-10 changes are slated to go into effect on October 1, 2022. Physician Fee Schedule and new digital pathology codes are effective January 1, 2023. Coronis Health Laboratory and Pathology keeps clients abreast of changes that will affect their billing cycle, preventing revenue disruptions during these events.

2023 Physician Fee Schedule Updates

Centers for Medicare and Medicaid Services (CMS) released its proposed 2023 Medicare Physician Fee Schedule on July 7. The goal of these changes is to ensure more accurate payments for the technical component of pathology next year. They will also decrease pathology payments by about 1% from 2022 to 2023. The conversion factor will also go down by 4.4% to account for the expiration of the 3% fee increase for 2022. 

Digital Pathology: New Category 3 (temporary) Codes Effective 2023

The College of American Pathologists (CAP) announced thirteen (13) new digital pathology Category III CPT codes beginning January 1, 2023. According to CAP, codes 0751T through 0763T will define clinical staff work associated with digitizing glass slides for primary diagnosis. 

The goal of the Digitization of glass microscope slides enables remote examination by the pathologist and/or in conjunction with the use of artificial intelligence (AI) algorithms. Category III add-on codes 0751T-0763T may be reported in addition to the appropriate Category I service code when the digitization procedure of glass microscope slides is performed and reported in conjunction with the Category I code for the primary service.

Do not report Category III codes in this subsection solely for archival purposes (e.g., after the Category I service has already been performed and reported), solely for educational purposes (e.g., when services are not used for individual patient reporting), solely for developing a database for training or validation of AI algorithms, or solely for clinical conference presentations (e.g., tumor board interdisciplinary conferences).

AMA has published the preliminary codes as follows:

• +0751T – Digitization of glass microscope slides for level II, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure) (Use 0751T in conjunction with 88302)
• +0752T – Digitization of glass microscope slides for level III, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure) (Use 0752T in conjunction with 88304)
• +0753T –Digitization of glass microscope slides for level IV, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure) (Use 0753T in conjunction with 88305)
• +0754T – Digitization of glass microscope slides for level V, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure) (Use 0754T in conjunction with 88307)
• +0755T – Digitization of glass microscope slides for level VI, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure) (Use 0755T in conjunction with 88309)
• +0756T – Digitization of glass microscope slides for special stain, including interpretation and report, group I, for microorganisms (e.g., acid fast, methenamine silver) (List separately in addition to code for primary procedure) (Use 0756T in conjunction with 88312)
• +0757T – Digitization of glass microscope slides for special stain, including interpretation and report, group II, all other (e.g., iron, trichrome), except stain for microorganisms, stains for enzyme constituents or immunocytochemistry and immunohistochemistry (List separately in addition to code for primary procedure) (Use 0757T in conjunction with 88313)
• +0758T – Digitization of glass microscope slides for special stain, including interpretation and report, histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) (Use 0758T in conjunction with 88314)
• +0759T – Digitization of glass microscope slides for special stain, including interpretation and report, group III, for enzyme constituents (List separately in addition to code for primary procedure) (Use 0759T in conjunction with 88319)
• +0760T – Digitization of glass microscope slides for immunocytochemistry or immunohistochemistry, per specimen, initial single antibody stain procedure (List separately in addition to code for primary procedure) (Use 0760T in conjunction with 88342)
• +0761T – Digitization of glass microscope slides for immunocytochemistry or immunohistochemistry, per specimen, each additional single antibody stain procedure (List separately in addition to code for primary procedure) (Use 0761T in conjunction with 88341)
• +0762T – Digitization of glass microscope slides for immunocytochemistry or immunohistochemistry, per specimen, each multiplex antibody stain procedure (List separately in addition to code for primary procedure) (Use 0762T in conjunction with 88344)
• +0763T – Digitization of glass microscope slides for morphometric analysis, tumor immunocytochemistry (e.g., Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (List separately in addition to code for primary procedure) (Use 0763T in conjunction with 88360)

Pathology Coding Changes

The 2023 ICD-10-CM codes are going into effect on October 1, 2022, with more than 1,400 new diagnostic codes added. New codes must be submitted to all payers, including Medicare, Medicaid, and TRICARE. Since these codes indicate the necessity of medical services, failure to use the codes properly could result in denied claims and forfeiture of reimbursement for services rendered. 

Highlights of the new codes include: 

• OB/GYN code expansion (includes more than 400 new codes)
• Concussion/brain injury code expansion (includes more than 100 new codes)
• Dementia cod expansion (includes nearly 100 new codes)
• Methamphetamine overdose code expansion (new code category for poisoning by meth)
• Electric bike injury codes (allow for additional information about accident)        

More Coding Changes

In addition to the code expansions highlighted above, the following specialties and conditions will also see significant coding changes: 

• Atherosclerosis (I25.- series)
• Alcohol, cannabis, opioids, cocaine, and other substance use (F10.9 series)
• T-cell lymphoma (C84.4 series)
• Limb girdle muscular dystrophy (G71.03 series)
• Von Willebrand disease (D68.0 series)
• Candidiasis of the vulva and vagina (B37.- series)
• Acidosis (E87.2 series)
• Slipped upper femoral epiphysis (M93.0 series)
• Muscle wasting of the back (M62.5A series)
• Hemolytic-uremic syndrome (D59.3 series)
• Short stature (E34.3 series)
• Newborn sleep disorders (P28.- series)
• Patient noncompliance with provider’s orders (Z91.1 series)       

Let Coronis Health Maximize Your Coding Processes to Increase Revenue

Coding is one of the most challenging aspects to running any type of laboratory, with a direct impact on your revenue cycle and bottom line. Let Coronis Health take the stress out of coding, with services that get your claims right the first time. To learn more about our professional coding support, contact Coronis Health today. 

from
https://www.coronishealth.com/blog/new-codes-coming-is-your-practice-ready/