Medical coding is at the center of the revenue cycle for a pain management clinic. Unfortunately, practices have to deal with numerous challenges in meeting federal regulations and payer’s demands. Some issues arise from payer rules that limit procedures and cause delays in receiving payments.
In the face of these challenges, what can healthcare providers do? Here are the best practices to minimize medical coding errors in the role of providing pain management services.
Approach Therapies from a Clinical Perspective
Experts advise providers to start with simple treatments then progress to more complex procedures. Review and follow the payers coverage guidelines and requirements in order to avoid medical necessity denials.
Payers are known to be reluctant to reimburse payment for unproven procedures. Therefore, experimental and non-pharmacological treatments are bound to be problematic for pain management billing services. Understanding the payers coverage guidelines and communicating the information to patients is key.
Emphasis on Oversight to Minimize Coding Errors
Most billing errors result from delays and rejections when generating claims. That is why providers ought to have dedicated coding specialists who understand pain management billing regulations. The specialist ought to have a firm grasp of unique pain medical coding requirements.
Also, providers must communicate the cost of different procedures to pain managers and payers. Division and revenue cycle managers must have this information on hand to facilitate faster processing. Your pain management billing services can help with data analytics to assist with streamlining the billing process.
Evaluate Procedures and Billing Cycles
Medical coding problems start at the point the provider meets the patient. When there are inaccuracies in capturing the patient’s data, it often results in delays. That is why it is essential to have trained front-end staff to collect precise information.
Front-end staff will lay the groundwork for billing verification in the future. Insurance information, patient demographic data, and eligibility are critical when collecting data. Pain clinics must also inform their patients of their out-of-pocket costs and financial responsibility.
Importance of Filing and Documentation
Pain clinics should also consider migrating away from manual filing systems. While manual filing is still necessary for some of the processes, it can cause extended delays. That is why pain clinics are turning to automation and outsourcing services.
Automation can reduce the errors associated with manual filing tasks. Pain management billing services can provide tools for minimizing denials and delays in reimbursement.
Support Services and Medical Billing
Pain clinics should consider using support services to boost claims performance indicators. One such service is accounts receivable management. A/R support can help you determine where the practice has been losing money in the form of delayed but payable claims.
Submitting accurate bills on time is difficult for many practices. Most clinics have many patients to deal with, and it is often challenging to stay up to date. Outsourcing to a pain management billing service can reduce errors, save time, and maximize the cash flow.
The healthcare landscape is subject to changing rules and regulations. Clinics need to have an effective medical billing system to eliminate mistakes and maximize cash flow. Practices should consider getting support from experienced pain management billing services. For more information about revenue cycle management and medical billing, contact Tyrus Health today.