Are You Getting What’s Due?
Sometimes a new or growing office will do its own billing. The advantage to this is that you get to know something about the billing process and become familiar with basic forms and requirements.
Often, the next step is to hire an entry-level billing service. The basics of medical billing can be learned in a technical or online school, and there are many providers at this level.
But either situation leaves you with questions. How do you know, without doubt, whether all the money due to you is actually coming in?
You are a Professional. Hire a Professional.
Consider the following situations, common with in-house and entry-level billing services:
- Entry Errors. One keystroke mistake on data entry causes a modifier 25 to be reported as a modifier 26. Claim denied. Is your biller following up on the denial, or accepting the write-off? How do you know?
Miscoded Bundled Procedures. While performing a surgery, a bundled procedure is done. The surgery is coded
xxxx1, and the secondary procedure is coded
xxxx2. According to CPT, the secondary procedure goes unpaid under this code. However, had the coder known to go to HCPCS, the
xxxx2could have been changed to
aabb3and the secondary procedure would have been paid without question.
- Improper Patient Registration. A patient is on file as having Blue Cross and Blue Shield. The patient comes in and is never asked if their carrier has changed since their last visit. The submission is denied, and the responsibility is transferred back to patient. The practice sends a statement to the patient, and another, and a third. By the time the patient responds (if they do at all) to say their new insurance carrier is ABC Insurance, the window for claim filing has expired.
Would you be surprised to learn that 5%, 10%, and as much as 20% of your entire A/R is either in limbo, or you're not going to see it at all?
The fact is, you didn't have to miss any of it, and some of it may still be available to you. So, why isn't it there?
Learn why you can rely on Premier Surgical Billing to improve your revenue cycle.
Why wait another minute? Contact us and schedule a free consultation today!
Case Study: Within 18 months of taking over billing responsibilities at a renowned US sports medicine practice, the Chief Billing Manager of Premier Surgical Billing personally found and recovered over $640,000.00 in lost revenue.