It is important to ensure that your practice is compliant with ENT billing and coding. Clinical coding optimization and online coding help through a professional support service can be a big help, but it is also important to conduct regular billing reviews to ensure that everything is being done as it should. Offside CPA audits and reviews by a reputable healthcare consulting firm that specializes in otolaryngology practices are the best way to go. A third-party impartial review of your billing and coding practices can help you make sure that every employee, form, method and practice is compliant with all of the rules and regulations that are applicable to your medical office.
Why You Should Hire a Professional
MD Pro Solutions offers a wide variety of services to ENT practices and clinics. We will work with you to assess your current coding, billing and documentation practices to help you identify areas where you may need assistance, training and support for your staff. We can even help you outsource ENT billing, either on a temporary basis while you improve your clinical coding optimization, or permanently if you feel that your staff’s time and efforts would be best used in other ways. We make it easy for practices and clinics to get on board with changes to the healthcare industry, such as software requirements and the recent ICD-10 implementation.
All of the offside CPA audits and billing practice reviews that we perform are designed to help you figure out where the problems lie so they can be corrected before you experience loss of income due to improper filing and coding mistakes. Our team can help you to identify any areas that are not compliant with current regulations, and will help you find areas where improvements can be made to avoid other common issues. Regular reviews of your clinical coding optimization by a professional healthcare consulting firm like MD Pro Solutions can help you avoid problems associated with the following:
- claim denials from Medicare or insurance companies
- false claim submissions
- incorrect billing due to coding errors
- errors caused by up-coding or un-bundling
- medical review investigations
All of the services offered at MD Pro Solutions, are designed to help you keep your ENT practice or clinic compliant with the ever-changing requirements made by Medicare and other healthcare industry entities for medical coding and billing. We even offer online coding help, training and support to assist your staff as they implement positive changes that will help to increase cash flow and improve the way that you do business. Our healthcare consulting firm is made up of professionals who are experienced and knowledgeable in the specialty of otolaryngology, so we understand the typical coding issues and problems that your billing department can face. So if you need to outsource ENT billing, you can count on MD Pro Solutions to handle it effectively and efficiently to provide you with the very best results.
The Difference Between Rejected & Denied Claims
It is important for ENT billing departments to understand the difference between a claim that has been rejected and a claim that has been denied. They are not the same thing by a long shot. A claim that has been rejected contains one or more errors that were discovered before the claim was processed. The insurance company is unable to pay the bill as it is written, so it is returned back to the practice for correction. Rejections can come from simple clerical errors or can be an indication of ICD coding issues, such as a lack of understanding regarding certain procedures and how they should be coded.
Clinical coding optimization training and support through online coding help can be beneficial, but the cause of these issues aren’t generally revealed until your get reviews and offside CPA audits of your department by a reputable healthcare consulting firm. Once problems are identified and the issues behind them are rectified, the claims can be corrected and resubmitted for payment. When you outsource ENT billing with MD Pro Solutions, you guarantee that our methods are checked, re-checked and tested frequently to ensure that all coding and claims submissions are done accurately and efficiently for best results.
Denied claims are different from rejected claims in that they have been processed by the insurance company are were denied because they are “un-payable” due to a number of reasons. One reason could be that a coding error or procedure matching error occurred that wasn’t caught in time to be rejected and returned for re-submission. Another could be that the claim violates the payer-patient contract in some way. When a practice or clinic receives denied claims, they will usually get an explanation so it can be fixed and sent back for processing. Unfortunately, this entire process takes a long time, reducing cash flow at the office and causing all sorts of time-consuming work.
Contact MD Pro Solutions for Audits & Reviews
Help keep your ENT billing and coding department on-track, provide them with the tools and online coding help they need to stay compliant and improve claims submissions by hiring our healthcare consulting firm to assist. Our team can help your team with clinical coding optimization, perform a variety of reviews and offside CPA audits, as well as provide a resource to outsource ENT billing, should the problem be too great to fix while continuing to process patient billing. Give us a call at 508-946-1665 to get a FREE consultation or to learn more about the services we provide.