4 Steps to Telehealth Success in Rural American Hospitals

Expanding your services to include telehealth may seem like a challenging endeavor, but this new provision and management of medical care provides a sound solution to improving the rural communities’ access to quality healthcare.

Using telehealth in rural areas can help reduce the difficulties patients usually encounter, such as distance, travel time, and transportation issues. Telehealth can also make the healthcare system more efficient by improving communication, monitoring, and timeliness.

With more than 100+ years of combined experience, Coronis Health is a healthcare revenue cycle management company with global capabilities offering specialized solutions. By using industry-leading technology combined with high-touch relationship building, we can help you with the complicated coding and billing associated with telehealth, especially for Medicare, helping you focus on your patients while maintaining financial independence and cultivating financial success. 

Telehealth Services on the Rise

According to a report released by Frost & Sullivan, U.S. demand for telehealth will soar by 64.3% in 2020 because of the COVID-19 pandemic. The report predicts that the demand for telehealth in the U.S. will grow seven-fold by 2025, for a five-year compound annual growth rate (CAGR) of 38.2%. This study suggests that telehealth may become the new normal for many medical providers as the pandemic continues to reshape the healthcare landscape, bringing more opportunities for virtual care in the near-term future.

Physicians across the country must constantly adapt to new ways they can best serve their patients. Telehealth will be proven useful not only to care for infected (COVID) patients, whether at home or at the hospital, but also for patients with other diseases to prevent their exposure. So, whether we have a public health emergency or not, one thing that will never change is the need to deliver timely and quality care to all Americans. Therefore, if you are in a position to serve, integrating telehealth into your practice can be a golden opportunity for you and your patients. To help you get started or to help improve your current telehealth system, we’re providing a guide that explains the best practices to create a telehealth business model to reach rural patients. This way, they can access healthcare in a manner that is convenient and cost-effective, allowing your practice to improve on patient care.

1. Understand Patient Needs

There are factors to consider before implementing your telehealth business model. One, you must first assess how many rural patients you have, and two, you must understand what their needs are. Also consider the best ways to communicate with your patients, especially since your target demographic consists of diverse individuals. While most people will own smartphones, not everyone is comfortable communicating via video chat. Some might prefer an audio call.

2. Select the Right Tech 

Because telehealth services rely solely on electronic information, you will only benefit from the platform if you choose the right technology to deliver your services. Telehealth services technology can include streaming media, video conferencing, wired and wireless communication, and telephony, and choosing your technology will depend on your goals and the specific telehealth services you will be delivering. Do you want to accommodate more patients efficiently? Do you want to boost your practice’s revenue? Does your specialization require performing visual examinations? These are just some of the factors to consider when choosing your technology.

But regardless of your goals and the type of telehealth services you’ll be delivering, there are fundamental features that any communications platform should have. Specifically, your chosen technology must:

• Enable a clear flow of communication between physicians and patients
• Allow for omnichannel access (this will enable patients to text, email, call, or video chat with their physician)
• Allow for seamless collaboration with the patient’s team of healthcare providers
• Be secure
• Be flexible and scalable in order to accommodate your workflow as well as your patients’ chosen method of communication
• Be cost-effective (short-term and long-term)

3. Promote Your New Telehealth Opportunity

No matter how efficient your telehealth business model is, it won’t matter if no one knows about it. Be sure to get the word out about your new platform. Promote your telehealth care through your website, social media, newsletters, and fliers so your patients can be informed of your new services.

4. Measure Your Success

Offering telehealth services is just half the battle. Evaluating your telehealth services is another crucial element of your success. What comprises its evaluation?

• Establish benchmarks for quantitative research (e.g., how many people are using your telehealth services and what is their satisfaction level in availing those services) 
• Measure those benchmarks either through surveys or through tracking
• Evaluation should be a constant process, so set a schedule for it (once every six months or once a year)

How Coronis Can Help

Offering telehealth services can help you serve rural communities in a way that is convenient and cost-effective, while still growing your revenue. To help you navigate through this new concept, you’ll need the assistance of a partner who can lighten your load and let your practice focus more on patient care. At Coronis Health, we remain at the forefront of medical services and billing for our niche clients, including rural community facilities. We are technological innovators and are fully integrated with the latest software, so we input coding instantly and execute collections fast and efficiently. And because of our full transparency, you’ll know exactly how your numbers look and how they’re affecting your business. We also believe in personalized service that exceeds what most big box companies offer. No customer is the same, so we don’t treat all customers the same. As you build your telehealth services platform, we will anticipate your needs and focus on your success. 

Schedule an Assessment With Coronis Health

Telehealth services can give you a competitive advantage over other healthcare providers. By choosing the right healthcare communications platform and having an efficient billing and coding system, you can make it easy for your practice to offer telehealth services to your patients in a way that is simple, secure, and effective. To learn more, contact Coronis Health to schedule a consultation or request a free financial checkup.

from
https://www.coronishealth.com/blog/4-steps-to-telehealth-success-in-rural-american-hospitals/

Get Your Medical Practice On Track for Medical Billing Success

Staying up-to-date on the latest medical billing best practices can be overwhelming for in-house billing staff as they are trying to stay on top of day-to-day responsibilities and even manage old or denied claims. 

Technology and regulations improve and change constantly, and these updates should be watched to ensure your practice is providing the best possible billing experience for patients and is generating revenue.

Coronis Health brings together the best in healthcare revenue cycle management and medical billing to create a team with more than 100 years of experience helping niche healthcare practices and facilities get every last dollar of what they are owed. We ensure practices and facilities create a smooth process for patients, manage their revenue cycles effectively, and follow claims and appeals best practices.

4 Easy Ways to Improve Medical Billing for your Patients

Do you want to improve your practice’s medical billing and claims process? It can be a challenge to manage everything from billing procedures and patient accounts to the revenue cycle. It is time-consuming. It burdens your front-end employees, hurting the efficiency of your practice.

If you want your patients to be happy, you want to keep functions, such as medical billing, simple for your patients. Here are 4 easy ways to do so.

1. Verify Patient Insurance

It is important to verify each patient’s insurance before an appointment. This should be done a few days before the appointment so that it can be rescheduled if their insurance has not been verified. You may want to assign an employee exclusively to this task.

2. Use Medical Billing Technologies

You can enhance your collections process using the latest tools, such as the automated revenue management tool, in which automated reminder messages can be set up for payments. Now there are tools available that let you track all information on your mobile devices too.

3. Collect Right Away

It is ideal that collections are made when patients are in your office, whether it is past due balances, co-pays, deductibles, or co-insurances. Create a system so that patients clear all dues before they leave your office.

4. Claim Accuracy

Train your staff to verify the accuracy of all patient information so that your claims are free of mistakes and you can reduce denials and increase revenue.

Manage your Revenue Cycle Effectively

In a medical practice, it is essential to stay on top of revenue management to ensure a healthy bottom line and to keep the practice going. Revenue cycle management has come a long way, thanks to medical billing technology and modern hospital or medical practice management. Here are 2 simple steps to manage your revenue cycle more effectively.

1. Patients should be able to pay easily

Patients always look for convenience. If you wish to improve the patient experience, make it easier for patients to pay. The best way to ensure smoother payments is to inform them upfront about the billing procedures and how much they are expected to pay. You can keep credit card records to speed up the payment process.

2. Track Performance

It is essential to track your staff’s performance to ensure that all billing and revenue related functions are being carried out accurately and on time. An easy way to track this is to check the claim denial rate, the cost to collect, and patient service revenue. Such figures will help you determine if your revenue management is happening the way it should.

Claims and Appeals Best Practices

As a medical practice, you must be well-aware that insurance companies do not always pay every claim for the agreed-upon rate, for various reasons. In the case of denials or underpayments, it is best to identify whether the claims need appealing. Since appealing is a lengthy process, the following should first be considered.

Correct Billing

Claims denials are the result of data entry errors. Before appealing a claim, check whether the claim was billed accurately and correctly the first time.

Common data entry denials might be due to :

• Incomplete or inaccurate patient information
• Bundling denials due to incorrect modifier usage
• Missing information
• Inappropriate modifiers used
• A mismatch between the CPT and diagnosis used

CPT Guidelines

CPT guidelines compliance may not always be easy to achieve. Insurance companies are not required to follow nationally recognized guidelines now. So, accurate claims are even more important now. If you are sure that the claim was billed correctly initially, check the insurance payor’s provider billing or administrative guide.

Payer-Provider Contract

Check whether contracted services are being billed appropriately. If contractual procedures are not being followed, then it may not be possible to appeal a denied claim.

Let Coronis Health Help Get Your Medical Practice On Track

These guidelines might seem overwhelming to an in-house staff that is already busy with day-to-day operations. Coronis Health is dedicated to maintaining these standards for all our clients, and we can help your medical practice or facility, as well. Contact us today to get started or schedule your free financial check-up, in which Coronis Health finds missing revenue in 95% of our reviews.

from
https://www.coronishealth.com/blog/get-your-medical-practice-on-track-for-medical-billing-success/

What Happens When A Medical Practice Outsources Its Medical Billing

All types of organizations rely on receiving accurate and timely payments for their services, and this applies just as much to medical practices. 

The difference between other types of business and medical practices is the detailed coding and working with Medicare, Medicaid, and countless insurance companies that require nothing less than perfection. This is a lot of responsibility to place on medical professionals who are trying to keep their focus on serving patients but who also need to ensure their practice is generating a profit.

This is where Coronis Health can help. We’ve brought together the best of the best in healthcare revenue cycle management and medical billing professionals who combined have more than 100 years of experience supporting medical practices and other healthcare facilities. Coronis Health goes after the last dollar so your practice can remain independent and focused on patient care. Handing billing over to an outside group can feel intimidating, but our clients quickly experience the benefits of doing so.

Should a Medical Practice Outsource its Medical Billing?

When you think about the daily operations of your medical practice, do things run smoothly, as they should? What is a typical day for you and your staff like? Are your patients receiving the care and attention you want to provide? Are the medical billing and collections going as planned? Are collections efficient and the cash flow healthy?

If your answer to most of these questions is “no,” it is time to look at where things are going south. It may also be time to consider medical billing and collections outsourcing.

There are many factors to be considered when you choose a medical billing company. Remember that medical billing, collections, and revenue management outsourcing can address several headaches in your practice. However, billing companies vary in claims processing and overall efficiency. So, if you outsource medical billing and other tasks to a professional company, remember to check their experience, accuracy, and references, among other things.

Certified Professionals

The medical billing company’s staff should have the latest knowledge of all medical billing codes, especially your specialty, as well as a strong understanding of Medicare and Worker’s Compensation regulations. 

Speed and Accuracy

Both accuracy and speed are critical in medical billing and claims processing. Skilled and experienced medical billing companies can submit correct claims in a more timely manner than your in-house staff, and they will be paid more quickly and efficiently.

Follow Ups

The medical billing company should have experienced medical billers and coders who can follow up on any pending or denied claims. This is where many medical practices lose a great deal of revenue since in-house staff is often not able to keep up with denied claims and accounts receivable. A trusted professional medical billing company is able to develop unique relationships with the practices they work with. Check whether the company you are considering is able to provide you customized services based on the needs of your practice.

Coronis Health remains at the cutting edge of not just revenue cycle management and billing technologies, but also laws and best practices. We can assist you in many other areas such as:

• Verification of Eligibility
• System Integration
• Patient Access Management
• Credentialing
• EMR/Technology Integration
• Consulting

Can a Medical Billing Company Increase Collection Rates?

If you manage a medical practice, you would know that a professional medical billing company can handle many billing and collections related tasks for your practice, allowing you and your staff more time to focus on your patients.

A trusted, experienced medical billing company can help your practice become more organized and efficient, reduce billing and coding errors, and increase patient and employee satisfaction.

Another benefit of the services provided by a good medical billing company is increased collection rates for your practice.

Medical billing and collections are critical to the survival and growth of a medical practice. A skilled medical biller is able to efficiently increase collections and reduce the revenue lost due to denials. In addition, a reputed medical billing company can also help reduce the burden of collections.

Medical billing is a complex process where a number of things could go wrong. From coding errors and processing delays to dealing with insurance companies and tracking unpaid patient accounts, your in-house billing staff has to juggle many tasks and also manage patient care.

Hiring a professional medical billing company can reduce many of these time-consuming tasks for you and your staff so you can focus more on patient care. The billing company will manage denials and appeals and use proven billing and collection strategies to reduce outstanding accounts receivables and optimize collection results.

Contact Coronis Health Today 

If you’d like to stop worrying about correct coding, billing, denied claims, and more, contact Coronis Health today. You can also schedule your free financial check-up, in which Coronis Health finds missing revenue in 95% of our reviews.

from
https://www.coronishealth.com/blog/what-happens-when-a-medical-practice-outsources-its-medical-billing/

Charles Colligan Joins Coronis Health

Coronis Health is welcoming Charles Colligan to their expert team to oversee the financial and operational performance of the company as the Chief Financial and Administrative Officer, supporting Coronis Health’s continued success in providing niche clients with the best-of-the-best solutions in revenue cycle management.

Charles “Charlie” Colligan brings 30 years of experience in developing and leading major strategic initiatives in the healthcare, technology, real estate, and financial services sectors. He served as Chief Financial Officer at Aledade, which quadrupled revenue and became profitable during his 2-year tenure. His service there earned him a finalist spot for the 2020 CFO of the Year Award for the Greater Washington region.

“Coronis Health is a growth company, and Charlie will be a valuable addition to the senior leadership team. Charlie’s success and experience as a CFO in the healthcare industry will drive success and help us achieve our strategic goals.” 

Stephen Grubbs, CEO

Before Aledade, Charles was the treasurer of CoStar Group, where he helped scale the business from $200M revenue to $1.2B and increase market capitalization from $1B to $15B. Prior to these roles, he was the senior vice president of finance for Sallie Mae. He began his career on Wall Street at Merrill Lynch in the Capital Markets Group after graduating with honors in economics from Harvard University. 

Charles will be focussing on growing Coronis Health while maintaining the personal touch with clients that we’re known for.

“I’m thrilled to become part of the outstanding Coronis Health team. I look forward to helping the company increase its growth and achieve our strategic goals in partnership with our customers. It’s especially meaningful to join at this exciting stage of the company’s evolution.” 

Charles Colligan, Chief Financial & Administrative Officer

About Coronis Health

Coronis Health offers the best-of-the-best solutions and technology in medical billing. With a team of experts who combined have 100+ years of experience in their fields, Coronis serves niche clients across the healthcare industry using the latest technology and billing processes. Coronis staff members are thought-leaders who create tailored solutions for clients, no matter how large or small their practices are. As Coronis Health has grown its resources, the company has maintained the feel of a small business, keeping a personalized touch with each client. Coronis Health provides data-driven, action-focused plans that help medical practices grow revenue so doctors can remain independent and concentrate on caring for their patients.

from
https://www.coronishealth.com/blog/charles-colligan-joins-coronis-health/

Coronis Health Adapting to Added Telehealth Services Covered By Medicare

One industry that has exponentially grown due to the COVID-19 pandemic is telehealth.

Telehealth services have been on the rise for several years now, addressing the need for making high-quality healthcare more accessible, especially to rural, and isolated communities, but it is now on a paradigm shift as the current pandemic is hastening its demand and growth. And as a response to President Trump’s Executive Order on Improving Rural Health and Telehealth Access to improve the health of all Americans, the Centers for Medicine & Medicaid Services (CMS) has taken action to increase adoption across the country by expanding the list of telehealth services payable under Medicare when provided via telehealth.

At Coronis Health, we understand the critical importance of remaining vigilant and compliant amid the changing chorus of government and carrier billing regulations and requirements. With 100 years of combined experience, we are here to help organizations adapt to not just changes in healthcare policies but new technologies as well.

11 New Approved Telehealth Services

Since the beginning of the pandemic, CMS has added more than 135 services to the Medicare telehealth services list, including emergency department visits and initial inpatient visits. On October 14, CMS added 11 new services to the list of telehealth services Medicare will reimburse during the COVID-19 public health emergency. Effective immediately and through the duration of the pandemic, Medicare will pay eligible practitioners who provide these newly added telehealth services:

1. 93797: Cardiac rehab

2. 93798: Cardiac rehab/monitor

3. 93750: In-person ventricular assist device interrogation

4. 95970: Electronic analysis of implanted neurostimulator pulse without programming

5. 95971: Electronic analysis of implanted neurostimulator pulse generator/transmitter with programming

6. 95972: Electronic analysis of implanted neurostimulator pulse generator/transmitter

7. 95983: Electronic analysis of implanted neurostimulator pulse generator/transmitter, by physician or other qualified healthcare professional; with brain neurostimulator pulse generator/transmitter programming; first 15 minutes face-to-face with physician or other qualified healthcare professional

8. 95984: Electronic analysis of implanted neurostimulator pulse generator/transmitter, by physician or other qualified healthcare professional; with brain neurostimulator pulse generator/transmitter programming; each additional 15 minutes face-to-face with physician or other qualified healthcare professional

9. G0422: Intensive cardiac rehab with exercise

10. G0423: Intensive cardiac rehab, no exercise

11. G0424: Pulmonary rehab with exercise

To view the full list of services, visit cms.gov.

How Coronis Health is Keeping Up With the Ever-Changing Healthcare Industry

Throughout the pandemic, Coronis Health has quickly become the designated expert for COVID testing billing. We’re trusted to handle tens of thousands of claims because of our experience, innovative mindset, and ability to quickly and accurately adapt to changes. More importantly, we are committed to ensuring our clients comply with these changes as well. 

We are a global company with a personal, high-touch service. Our private practice service group offers custom solutions to healthcare practices of every medical specialty and size. Our hospital, facility, and surgery group offers specialized financial and medical billing solutions to all types of hospitals, FQHCs, SNFs, LTCs, and surgical centers. We seek a level of professionalism and analysis you won’t find elsewhere. As technological innovators, we are also fully integrated with the latest software, allowing us to input coding instantly and execute collections fast and efficiently. We’ve developed an advanced technological system that learns how to collect, who to collect from, and how to get that “last dollar” in an efficient and cost-effective manner.

The Future of Telehealth Services

Demand for telehealth is expected to soar by 64.3% in 2020, according to a recent Frost & Sullivan report. The released report also predicts that telehealth in the U.S. will grow seven-fold by 2025. What this is suggesting is that telehealth may become the new normal for healthcare providers and patients alike.

While telehealth services fill a need, especially during the current crisis, the opportunity for telehealth products and services to become a standard of care is growing. More and more physicians are now recognizing the values of digital health tools in achieving efficiency and safety in healthcare. The pandemic has given them a broader opening and a growing acceptance of exploring better ways to connect with patients. Especially with the constant advancement of technology with devices, apps, programs, and other digital solutions proving to be effective, the demand for telehealth services will persist beyond COVID-19. If patients can receive high-quality care through digital technologies along with exceptional convenience, this enhanced experience will likely drive the traditional healthcare system to embrace this new, digital approach.

And now that lawmakers are recognizing the value of telehealth and agencies are responding with new reimbursement codes, we can foresee greater adoption of telemedicine by providers as payments will align correspondingly to the services delivered.

Schedule an Assessment With Coronis Health

Changes in payment models and new regulations are just a few of the many factors contributing to the dynamic healthcare landscape. Contact Coronis Health today to learn how you can consistently stay on top of these changes while reaching the next level of financial success and to schedule your free financial checkup.

from
https://www.coronishealth.com/blog/coronis-health-adapting-to-added-telehealth-services-covered-by-medicare/

Coronis Health Implementing New Mandatory Medicare ABN

The Centers for Medicare and Medicaid Services (CMS) have revised the Advanced Beneficiary Notice of Noncoverage (ABN) form and have announced that it will delay the regulation requiring physicians to use the new version of the form (Form CMS-R-131).

It was previously reported that CMS would require the use of the new form starting Aug. 31, but due to the COVID-19 public health emergency, the agency pushed that date to Jan. 1, 2021. An ABN form is used to inform a patient in advance of receiving a service wherein Medicare may deny payment for that specific procedure or treatment. This form shifts financial liability from the physician to the patient who will be personally responsible for full payment if Medicare does not pay for the services. ABNs, therefore, can have significant financial implications for your practice, and staying on top of these changes will help maximize your profitability while focusing on patient care.

With 100 years of combined experience, Coronis Health understands the critical need for remaining up to date with the most current regulations in order to meet the ever-changing demands of the healthcare industry. We also know that your most important financial asset is your billed services and accounts receivable. We work to safeguard this asset and help you avoid medical billing and coding errors by employing a professional team possessing a perfectionist approach to accuracy, execution, organization, and timeliness.

The New ABN Form

The revised ABN replaces the ABN form that was last released in June 2017. You can use the new ABN version immediately if desired, but all uses of the older version must cease on January 1, 2021.

There are non-substantive changes to the ABN form itself, but the guidelines for dual eligible beneficiaries (patients who are dually enrolled in both Medicare and Medicaid) have been added to the form’s instructions. These individuals may be classified as a Qualified Medicare Beneficiary (QMB). A provider—whether a Primary & Specialty Physician, Hospital and Surgery Center, or Behavioral Health practice—who is treating a QMB patient may not collect deductibles or copayments for covered services. For a claim to be submitted for Medicare adjudication, dually eligible beneficiaries must be instructed to check Option Box 1 on the ABN form. The official instructions on the form state:

“Special guidance for people who are dually enrolled in both Medicare and Medicaid, also known as dually eligible individuals (has a Qualified Medicare Beneficiary [QMB]Program and/or Medicaid coverage) ONLY:

Dually Eligible beneficiaries must be instructed to check Option Box 1 on the ABN in order for a claim to be submitted for Medicare adjudication.”

Medicare asks you to strike through some of the phrases in Option Box 1 if the beneficiary is dually eligible. In the Instructions, they note:

“Strikethrough Option Box 1 as provided below: OPTION 1. I want the (D) listed above. You may ask to be paid now, but I also want Medicare billed for an official decision on payment, which is sent to me on a Medicare Summary Notice (MSN). I understand that if Medicare doesn’t pay, I am responsible for payment, but I can appeal to Medicare by following the directions on the MSN.”

Furthermore, they also state:

“These edits are required because the provider cannot bill the dual-eligible beneficiary when the ABN is furnished. Providers must refrain from billing the beneficiary pending adjudication by both Medicare and Medicaid in light of federal law affecting coverage and billing of dual-eligible beneficiaries.”

Medicare will review the other considerations pertaining to dual-eligible beneficiaries and how those claims are processed. Also included in the instructions are details regarding when it is acceptable to charge and collect from the beneficiary in advance and when it is not.

Should Medicare deny a claim where an ABN was needed to transfer financial liability to the beneficiary, the claim may be handed over to Medicaid for adjudication based on State Medicaid coverage and payment policy. Medicaid will then issue a Remittance Advice based on this determination.

Click here to access the newest version of the ABN Form and instructions for use.

Why Compliance Is Necessary

While ABNs can have a significant impact on your practice’s finances, they also serve a critical fraud and abuse compliance function. Under Medicare law, billing for unnecessary services could result in sanctions in the form of administrative, civil, and criminal penalties ranging from monetary fines and damages to prison time and exclusion from the Medicare program. ABNs can serve as a tool for rebutting an argument that claims were submitted with fraudulent intent. Particularly, these forms serve as records of the patients’ acknowledgment that the services may not be covered or may be considered medically unnecessary. The form also validates their decision to still undergo the procedure or treatment.

Adapting to the use of the new ABN form can be taken as a beneficial opportunity to assess your organization for improvements that can augment your revenue. There is no better time than now to familiarize yourself with these new rules and incorporate them into your practice. At Coronis Health, we understand that it is of critical importance that practice managers remain constantly vigilant and compliant amid the changing chorus of governmental or carrier billing and documentation regulations and compliance requirements. Allow us to help you focus on patient care as we guide you through the dynamic structure of the healthcare landscape. We adapt to new policies and regulations with accuracy and we make sure clients are 100% compliant and able to receive patients and bill either out-of or in-network. Coronis Health goes after the last dollar using our seasoned team of tireless and tough negotiators. Our clients receive timely, relevant, and accurate information in a way they can understand. We don’t just help them get money, but we help them financially grow.

Get Your Free Financial Checkup with Coronis Health

With rising operational costs and minimal reimbursement, every possible dollar collected for services is critical to your practice’s financial health. It is therefore necessary to be aware of payment rules that can help increase your revenue. Contact Coronis Health today and learn how we can help you achieve financial success and to schedule your free assessment, in which Coronis Health finds missing revenue in 95% of the assessments we perform.

from
https://www.coronishealth.com/blog/coronis-health-implementing-new-mandatory-medicare-abn/

How to Avoid Medical Billing and Coding Errors

Given the many intricacies of medical billing and coding, it is no surprise that mistakes can occur during the process. The most common errors, no matter how trivial they seem, can lead to claim denials, loss of revenue, fines and penalties, and may even impact patient care. Therefore, by knowing how to eliminate medical billing and coding errors, you can lower rejected claims, maximize your reimbursements, and keep your patients happy.

With more than 100 years of combined experience in various healthcare niches, including hospitals of all sizes, anesthesiology practices, and more, Coronis Health offers customers tailored solutions and high-touch relationships you won’t find at a “Big Box” medical billing company. We are composed of the top medical billers in the country, pooling our global resources to bring customers the best in medical billing and revenue cycle management.

We constantly seek a level of professionalism and analysis you won’t find elsewhere, and we are committed to helping any medical practice reach the next level of financial success. Below are ways to avoid medical billing and coding errors, making your life easier by eliminating the headaches of the revenue cycle, lowering your risk, and increasing your collections.

Ensure Patient Information is Correct and Properly Aligned with Data

When managing a medical practice, information can be mismatched if a medical biller is not careful. Incorrect or missing patient names, addresses, birth dates, gender, insurance information, and dates of treatment can be grounds for claim rejection. Busy billing departments can sometimes overlook these details. 

Inaccurate information can be avoided by taking the time to double-check all fields and verifying all pieces of information about a patient before submitting a claim.

Avoid Upcoding

Upcoding is when the medical coder reports a procedure that has a higher reimbursement cost than the one the patient actually underwent, such as when tests are performed by techs but are coded as being done by physicians. This can occur when the billing staff makes a mistake when entering diagnosis and treatment codes, or if the employee misunderstood the information provided by the physician. Since codes for certain procedures and tests demand higher payments, this illegally inflates your revenue as well. Upcoding will not only lead to claim denials but can also cause your practice to undergo an audit or be penalized.

Utilize the Latest Medical Coding Manual

Medical coding guidelines are constantly changing, so if you are using an outdated reference manual, your claim may be denied, impacting your reimbursement process. It is important that medical coders are up-to-date with the latest billing rules and regulations. This can be done by coders having the latest coding manuals and attending seminars to refresh their coding strategies. By keeping abreast of current codes, you can have a seamless processing of claims in a timely manner without loss in revenue.

Avoid Duplicate Billing

This occurs when a patient is billed multiple times even though they only underwent a procedure once. This common error can magnify the chance of claims being denied, leading to not only delays in payment, but also a bad reputation in the industry or possibly a fraud investigation. While it may seem easy to avoid, this can occur when there are large amounts of data due to disorganization when submitting claims. To avoid this, turn to auditing to minimize errors. By carrying out chart audits, you can prevent these errors from accumulating.

Verify Insurance Benefits and Coverage in Advance

One reason why medical billing claims get rejected is because of a medical practice failing to verify insurance coverage. Insurance companies all have different policies regarding what types of services they cover. More importantly, the details of a policy can change at any time. Even if a patient is a regular client, a practice cannot simply use their recently entered information. This can lead to errors if there has been a change in the patient’s policy limit, terms of service, or insurance provider.

To avoid claims being denied, your practice must independently verify the patient’s eligibility each and every time services are rendered. Verify and communicate details such as healthcare benefits, coverage terms with the insurer, and co-payment options. All this information is necessary for billing the patient without errors.

Hire A Professional Medical Biller

Medical billers are responsible for keeping practices on solid financial ground by maintaining a reliable and efficient system for processing insurance claims. It is not an easy job. Medical billers are constantly faced with challenges, from getting claims rejected to having to dispute them. But when you place the responsibility of your billing and revenue cycle management on yourself or your employees, you are not only adding to the stress at work, but also increasing the likelihood of medical billing mistakes, resulting in loss of income.

By outsourcing to a professional medical biller, you can avoid mistakes that are caused by inexperienced medical billers and coders. Having a team of qualified medical billers and coders who can expertly keep track of the thousands of medical codes, diagnoses, and outpatient procedures can help you reduce claim denials. This also ensures that your staff will no longer need to spend time on these billing concerns. You and your staff can then use this freed-up time to focus on patient care.

Recognized by Healthtech Outlook as one of the Top 10 Medical Billing and Coding Solution Providers in 2019, Coronis Health offers experienced, courteous, and professional staff members dedicated to providing comprehensive medical billing and coding services. We are a full-service provider of medical billing and revenue cycle management solutions, and no matter the size or scope of your business, we can help. By using industry-leading technology combined with high-touch relationship building, Coronis Health will allow you to focus on patient care, maintain financial independence, and cultivate financial success. Not only do we save you money by outsourcing all billing and coding, but we help you find lost revenue, close aged payments, and lower your time in AR. We are invested in your financial success. 

Improve Your Medical Billing and Coding Systems With Coronis Health

Hiring the best medical billers will provide your practice with countless benefits. From a streamlined process and consistent payment schedule to the correct usage of codes and submitting claims in a timely manner, you get to spare your practice from undue stress while safeguarding your practice’s revenue into the future. To learn more about how Coronis Health can help your practice function more smoothly with an optimized revenue cycle, contact Coronis Health today, or request a free financial checkup.

from
https://www.coronishealth.com/blog/how-to-avoid-medical-billing-and-coding-errors/