We know revenue cycle management for general surgery, let us help grow your business.
Medical billing and coding for surgeons can be complex. There are numerous CPT codes and conditions to deal with in order to correctly submit your claims.
Depending on your practice, you may need to bill for office services as well as ASC procedures and hospital visits and procedures. You will also likely bill for a Physician Assistant which brings a different type of billing to the table.
Our team of certified coders have the kind of experience necessary to ensure your surgery 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 to help drive higher revenue.
What we know…
Within the insurance industry, the rules of billing for not only the surgical procedure itself but the follow up care can be tricky to maneuver. You can bill for your services, your PA’s services and for all aftercare involved. We help to monitor the global billing periods so as to make sure that services are billed correctly.
Proper submission of the CPT codes, Modifiers and the appropriate ICD10 codes are essential for proper reimbursement. Correctly submitting your claims will minimize errors in payments received.
Various office services provided, ie: Injections, DME, Xray, supplies, along with your regular office visits and consults combine to provide effective patient treatment for your practice. Correct coding and billing for all of these services is key.
Practicing surgery providers perform multiple procedures and treatments, 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.
Here are some of the complications that are affecting surgeons revenue collection procedure:
Surgeons who treat patients within hospital services are at risk for missing billings due to difficulties in tracking services. We have established mechanism for ensuring the capture of your charges
Incorrectly bundled payments
Not collecting the proper co-pays at the time of service
ICD10 codes that are not covered under the LCD’s for your area
Incorrectly documented services that can affect the ability to file appeals for medical necessity
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 Surgeons. 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 on what is happening in their practice so any issues can be addressed quickly. Having an experienced medical billing team, with visibility into performance, is vital to your practice’s financial health.
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