Prostheses Care is Complex For Several Reasons
The complexities of medical billing don’t stop at services. Prostheses, orthotics, and durable medical equipment (DME) all have to be coded and submitted in a claim before insurers or government payers will cover any of the costs. Every payer has different prostheses billing guidelines & rules about what is covered and under what circumstances, making it very difficult for medical office staff to keep up with all the details.
Outsourcing Medical Billing And Coding
Outsourcing medical billing and coding to a professional revenue cycle management (RCM) company like The sure ways solutions has proven to be a stress-free solution that increases our clients’ income. Our billers are certified and experienced in dealing with prostheses, and all our staff are also trained in HIPPA compliance, so you don’t have to worry about patient data being secure.
Why Prostheses Medical Billing Should Be Outsourced
Even a practice that performs routine exams and treatments benefits from having their billing managed by dedicated professionals, but for something as involved as prostheses, which may even be customized for each patient, medical billing requires experience and expertise to get it right. And because each item can be a high-dollar claim, it is important that coding be right, or significant amounts of revenue can be lost. These are a few additional aspects of prosthetics that make coding and billing complex:
Overlapping Codes
There is some overlap between the codes for providing and adjusting prostheses and time spent by a skilled clinician training the user. Anyone billing for prosthetics must know how to properly identify and code for each instance and know how to use modifiers to indicate reduced services so that there is no duplicate payment. Failure to do so can result in over-coding, and ultimately in fraud charges against the physician.
Uncoded Products
Not all prosthetic devices have been submitted for product review, so they do not have their own codes. Medical coders and billers must know how to find the correct codes to use in these cases. Tracking down information can be time consuming, leading labor costs to exceed the value of the claim.
The sure ways solutions is an industry leader and trusted name in medical accounts receivable collections because we know how to get results. Our mastery of complex medical coding and AR management services sets us apart. But it’s our breadth of knowledge that allows us to shine. Our medical billing company successfully serves healthcare facilities of all types and sizes, and we specialize in medical billing for physicians, laboratories, radiology & imaging centers, and hospitals. We know it’s difficult to remain entirely focused on patient care when you’re worried about your bottom line. If you’re spending valuable time and energy trying to diagnose finances, then perhaps it’s time to enlist the aid of a professional medical billing company like The sure ways solutions.