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Neurology practices are often riddled with complications when billing out charges for various encounter types.
There are numerous CPT codes and conditions to deal with in order to correctly submit your claims. Depending on your practice, you may bill for services provided in hospital settings as well as patients seen in your office.
Practicing neurologists perform a variety of tests as well as exams on a given patient which will generate an abundance of claims, involve multiple payors and can result in a myriad of claims issues. Having an experienced medical billing team, with visibility into performance, is vital to your practice’s financial health.
Etransmedia’s team of certified coders have the kind of experience necessary to ensure your Neurology practice will maintain consistent cash flow while increasing collection rates. All of our coders are certified either through the AAPC or AHIMA and uphold the ethics and standards of the profession. Additionally, our billers and coders work with your staff to learn the nuances of your practice so as to be aware of known issues. They will provide feedback on coding scenarios that need attention and possible correction.
What we know…
Neurology services include patient evaluations (E&M codes) as well as EMG’s, Nerve Conduction studies, spine and joint Injections , EKG’s
This specialty has developed in scope with the addition of utilizing new technology such as “Botox” injections for the treatment of migraines.
Many Neurologists offer Independent Medical Exams by request.
Most Neurologists follow their patients throughout their hospital stays for related conditions.
EMG studies have separate CPT codes for the EMG as opposed to the Nerve Conduction Studies. If both are performed, there are combination CPT codes to use.
Here are some of the complications that are affecting neurology revenue collection procedure:
Omitting modifiers causes denials for “duplicate” tests.
Some carriers require the use of “LT “RT” modifiers while others require “50” to report bilateral services
Not coding the EMG and Nerve Conduction studies correctly.
Annual review and update of your fee schedule so as to add new CPT codes deactivate deleted codes, checking to be sure that your fees are priced correctly so as to maximize your payments.
Collecting the Co-Pay’s at the time of service as much as possible will help to minimize losses when patients do not pay after being billed.
Obtaining proper authorization for the services.
Making sure that you are in the patients “network” so as to ensure payment.
On October 1, 2016 the Centers for Medicare and Medicaid Services (CMS) will no longer accept unspecified codes in most cases.
Starting in October, CMS requires greater specificity for claims filed in ICD-10-CM/PCS. The 12-month grace period originally introduced in 2015 said they would not deny claims for lack of ICD-10 specificity. That all changes on October 1, 2016. Payors will most likely follow suit if they haven't already.
First Pass Clean Claim Rate
Boost in Revenue*
Reduction in Cost*
We’re always on top of all the latest coding and billing updates for neurology practices.
Additionally, to make sure all claims are reimbursed on the first claim submission, our system is able to pre-edit claims prior to the initial submission for possible billing/coding errors. Our detailed end of month reports keep our clients up-to-date of what is happening in their practice so that any issues can be addressed quickly. The outcome of these processes and more is our clients have a streamlined revenue cycle with increased collection rates.
Although the new industry standards can be confusing and difficult to navigate, our dedicated team here at Etransmedia can assist in guiding you and helping to make your practice grow successfully.
*Please Note: Results are not guaranteed, implicitly or explicitly, and will vary based on several factors such as individual practice demographics, specialty, payer mix, operations, and management among others
Service and Technology Packages
Our customizable revenue cycle management service and technology solution packages allow you to outsource based on the specific needs of your practice
Silver RCM Service
This package has the core service and technology needed for revenue management allowing you maintain the responsibility of patient billing.
Gold RCM Service
This package includes the core RCM services with added denials, A/R management services, and full service patient billing
Ancillary RCM Services & Technology
Available to enhance any package