Allergy, Asthma & Immunology
We understand your specialty, let us help you drive higher revenue.
Medical billing for Allergy, Asthma & Immunology practices is highly complex.
The allergy, asthma, and immunology specialty continues to be a rapidly growing demand in the medical field. Last year alone, an estimated 25 million people in the U.S. were diagnosed with asthma, and over 50 million Americans suffered from some type of allergy. The complex nature of the treatment and coding in this field can oftentimes present a challenge to providers as they try to navigate complex insurance carrier billing requirements while still maintaining high quality patient treatment standards.
Our team at Etransmedia has the knowledge and skills necessary to successfully work denials and provide our Allergy, Asthma, and Immunology clients with valuable feedback to assist in managing and decreasing the most frequently seen denial types, while streamlining revenue and increasing your practice’s collection rates. Getting you paid fast!
What we know…
Treatment of asthma and allergies can be achieved through identifying factors which trigger symptoms. Typically identifying the cause of the allergy will be performed by introducing common allergy factors into the patient by a small needle prick on the back. If there is a reaction such as redness a treatment plan can be formulated to assist in treating this reaction or overall eliminating the adverse reaction. Prevention and treatment is often established by giving injections which introduce the trigger into the person’s system and over time increase the dosage to help the body develop a healthy tolerance to it.
Here are some of the complications that are affecting Allergy & Immunology revenue collection procedure:
95004/95024 with 95117/95115 – use a 59/XU on the 95117/15
95004 – Percutaneous tests (e.g. “pricks”)
If more than this amount for these two insurances break out and bill on 2 lines with mod 59 on second one.
If office bills on 2 lines with different dx’s combine on one line and put both dx’s on the line.
96372 – Injection administration (usually for Xolair) For Xolair – 150 mg = 1 unit
95076 – Ingestion Challenge(first 2 hours) / 95079 –T(each additional hour)
95079 cannot be billed without 95076
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 Allergy, Asthma & Immunology 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