Specialized Medical billing and coding services in USA

Medical billing services ensure steady earning for a medical practice. Reimbursement for rendered services is vital for a successful practice. To maintain steady cash-flow, medical billing services need to be efficient. If a practice has a robust medical billing team, patient processing will run smoothly, practice will have a steady flow of income, build a strong healthcare team, purchase innovative equipment, and provide best service possible to patients.

Best Medical Billing Specialists

Most important factor of medical billing companies is to build a team of professionals who are well versed in specialty specific billing and coding. The team must have in-depth understanding of insurance rules and regulations, keep updated on all local and federal publishing, have good understanding of insurance LCDs, fee schedule, appeal process, and medical billing codes updates. They also need to establish strong rapport with provider relations department. All these attribute needs to be ingrained into the billing system without requiring any effort from the doctors or other staff in the practice.

In FC Billing, we have a dedicated team of medical billing specialists who study insurance and government regulations, take courses in billing and coding, and HIPAA regulations. Our team is in touch with insurance companies every day. As we learn of any billing changes, we immediately notify our providers.

Our medical billing specialists team has in-depth knowledge of the health industry. We are unique among medical coding companies for our guaranteed error free services. We are a physician preferred medical billing business. Our team is ready to create success for your practice.

What Do Medical Coding Companies Do?

Getting claims ready for submission is a rigorous process. Submitting auto generated claims without proper scrubbing and follow-up will result in higher rejections and non-pays. The claim form carries all information required by insurance, such as patient’s information, doctor’s professional information, place of service details (this will indicate where the service took place, such as in-patient coding, out-patient coding, nursing homes, assisted living, etc), reason for visit, diagnosis, and treatment.

Common Medical Billing Errors

Billers should always aim to submit clean claims for fastest payments, both from insurances and patients. Most claim denials can be avoided by paying attention to some common medical billing and coding errors. Every unpaid claim runs the risk of lost income. Following are some common errors for claim denials:

Information Error

If there is any spelling error in patient’s name, incorrect date of birth, or incorrect insurance information, claim will be rejected stating, “Patient cannot be found”.

Medical Coding Errors

Many medical CPT and Diagnosis codes are replaced, updated, or deleted each year. Billing software should reflect these changes. If service or diagnosis codes are incorrect or outdated, claim will be rejected from the clearing house; and will not be transferred to insurance database. These errors need to corrected quickly and avoided in future claims to optimize billing.

Medical Coding Error for Multiple Services

If multiple tests or procedures are performed during the same visit, biller will need to ensure proper modifiers are added to the medical procedure codes and diagnostic testing codes. Additional information needs to be documented on claim to avoid underpayment or claim rejection.

Non-Covered Codes

Diagnosis documented for billed services (CPT codes) have to follow insurance Local Coverage Determination (LCD) guidelines. Using unsupported diagnosis on a claim will cause claim denial.

Exceeding Timely Filing Limit (TFL Error)

If a new claim, corrected claim, or claim appeal is submitted to insurance past their required filling time, claim will be rejected with no option for payment. Doctors will not be able to bill patients and will have to endure the burden of lost income.

Duplicate Billing

If a claim is submitted more than once, all submissions run the risk of being rejected for Duplicate Billing.

Frequency Limit

Insurances have limitation on how often a service can be rendered. This limitation is referred to as “Frequency Limit”. Claim or service will be denied for frequency limitations if service is provided beyond allowed units of a health plan.

Coverage Eligibility

If patient does not have coverage for rendered services or already used available benefits, claims will be denied for uncovered services. It is always a good practice to complete eligibility varication before appointment date.

Why Outsource Your Medical Billing and Coding to FCbilling?

FCbilling has the experience needed to get claims paid faster with highest possible reimbursement. We are a leading US medical billing company with in-depth knowledge of billing and coding and practice management. We are unique among RCM service providers because we take the time to learn and understand your practice before we start working with your account. We do detailed account study and design a success plan for your practice.

We have the in-depth billing and coding knowledge and an experienced team to take on any billing, coding, or management challenge. We will do a FREE practice consultation, provide the necessary reports, and make suggestions on maximizing your billing. We guarantee insurance payment on all your claims.

FCbilling Coding and Billing Process

Medical billing and coding process includes the following 5 steps

A. Schedule Check

Our billing team cross-checks ready to bill claims with appointment schedule to ensure claims have been generated for each patient visit. If we find any discrepancies, we immediately inform the office to get clarification. We encourage practices to properly label the visits on the schedule for better communication, such as No Show, Canceled Appointment, Post-Operative Visit, Self-Pay, etc.

B. Exam Review

After verifying the schedule, we review exam notes to ensure documentation includes supporting evidence for billed services. If there is any missing information, we alert doctors to make needed addendums. Likewise, if we find services or information in the medical records which has not been reflected on the claim, we give details to the provider to include any needed medical billing codes.

C. Confirming Medical Necessity

We document supporting evidence for billed services. If there is any lacking in documentation for diagnosis of tests or procedures, we request correction by addendum by the provider.

D. Documentation Review

After ensuring medical records support for claims and correct Service/CPT codes and diagnosis, we then examine/scrub the claims for any other errors. We check patient demographic information and insurance details to ensure claims are submitted with correct information. We also arrange listing of services in order to get maximum payments.

E. Exceptional service by FCbilling

We perform sample check of Evaluation and Management codes (E&M) to ensure correct coding levels.

• 99202-99215. Office or Other Outpatient Services.
• 99217-99226. Hospital Observation Services.
• 99221-99239. Hospital Inpatient Services.
• 99241-99255. Consultation Services.
• 99281-99288. Emergency Department Services.

We are specializing in identifying correct evaluation and management codes and help our doctors in coding correctly. Below are some of the codes for which medical physician offices have confusion with.
Medical code 99203: New patient office or other outpatient visit, 30-44 minutes
Medical code 99204: Office or other outpatient visit for the evaluation and management of a new patient, 35-59 minutes.
Medical code 99205: Office or other outpatient visit for the evaluation and management of a new patient, 60-74 minutes.
Medical code 99212: Established patient office or other outpatient visit, 10-19 minutes.
Medical code 99213: Established patient office or other outpatient visit, 20-29 minutes.
Medical code 99214: Established patient office or other outpatient visit, 30-39 minutes.
Medical code 99215: Office or other outpatient visit for the evaluation and management of an established patient, 40 minutes.
We add all needed modifiers, place of service codes, NDC codes, injury or accident information, hospital or surgery dates related to the visit. We then review the claim for all other information and submit clean claims to insurances. We submit claims within 24 hours of patients’ visit.

Benefits of working with FCbilling

The healthcare professionals at FCbilling are well-versed in their field to tackle all issues related to billing and claim processing. Before submitting claims to payers, we will review exams and scrub claims to submit error free claims. Our correct claim submission rate is 99%. Our goal is to bring in payments as quickly as possible. Our high degree of compliance safeguard built into our billing and coding process reduces refund requests and audits. We are always ready to give feedback to our providers, work with insurance on provider’s behalf, and work with practice staff to complete the billing cycle efficiently.

What Medical Billing and Coding Services We Offer

Our services can be customized based on your needs. We offer the following medical billing and coding services:

Billing Software Advantage

We work on provider preferred software. We have no requirement for providers to switch software. This way there is no downtime for the practice. We will learn provider’s software and all billing will be done on provider’s software.

We are always available to answer any questions

GET IN TOUCH

Don’t let your practice be lost in the maze of claim rejections, non-pays, EOBs, and LCDs. Put an end to the insurance chase. Team up with our experts for outsourcing your medical billing.

FAQ

What is Medical Billing?

Medical billing involves all work done to receive payment for provider services. A medical biller reviews practitioner’s exam notes to assign proper codes for procedures, diagnosis, and treatments. Biller submits these information to insurances or bills patients directly. Billing is complete for each encounter when provider receives all due payments.

What is Account Receivable Management?

Account Receivable is the money outstanding for services provided by practitioners. Managing account receivable is extremely important for a viable business. The biller’s job is to bring in money for rendered services as quickly as possible and to ensure accuracy of theses payments.

What is Medical Billing & Coding?

Medical coding involves reviewing medical provider’s encounter notes and assigning proper codes for services and diagnosis. Biller prepares claims and invoices with these codes to submit them to insurances and/or patients for payments.

How can AR Management be Improved?

Account Receivable represents lost income. Best business policy is to keep AR as low as possible. To do that, payments must be brought in as close to the service date as possible. Any action that can be taken presently to avoid income loss, should not be put off till the next day.

Why is it important to have a good Biller and Coder?

Biller is the bridge between physicians and insurance companies. The biller loads pages of documents into few numbers and codes to let insurances know all they need to about an encounter. To convert words into codes, a proficient coder in invaluable to the medical practice.

How do Verification, Authorization, Referral, and other pre-visit workup impact billing?

Billing actually starts at the time of making appointments. If any demographics or insurance information is incorrect, claim will not get processed. Thorough verification is needed before patients come to see the doctor. Referrals cannot be generated after patient’s visit, so if referral is needed, office has to receive it before the visit. Claims will not get paid otherwise. Before any procedures, biller has to contact insurance to be certain if pre-authorization is required. This also cannot be done after the fact.

What should I look for in a biller?

Speaking directly with prospective billers is a must. Also, have them review any part of your billing and suggest improvements/efficiencies in the process.

How do know if I am getting paid for all my claims?

Definitely review your insurance and patient aging reports carefully. Also, take sample claims from your high-value bills and check to make sure proper payments are coming in.

How will FCBilling handle my billing?

We bill in your software so there is no downtime for the practice. We work on claim submission, payment posting, and non-pays every day to bring in payments as soon as possible. We also guarantee insurance allowable payments on all claims.

How much do you charge for billing services?

We charge on percentage basis on payments that come in through our billing work.