How to Improve In-House Billing & Coding for ENT Practices

The best way to grow your ENT practice or clinic is to focus on your medical billing system and the skills or training of your staff. The recent ICD-10 changes caused problems with many practices that were caught off-guard or unprepared. Since then, practices have been forced to improve account management along with otolaryngology billing and coding, in order to properly submit claims for reimbursement to avoid delays or outright rejections. Once your staff is properly trained with regard to the procedural and diagnostic codes used within the ENT specialty, you can then work with a healthcare consultant to ensure that the rest of your practice has been streamlined and optimized to maximize your payments.

Why the ICD-10 Changes are So Important
The whole point of the ICD-9 to ICD-10 changes was to make improvements in the way that the codes are used by specialists and general care providers alike, to submit claims for reimbursement. These codes dictate the amount of money that you and your providers will get paid for the work that you have done. This is why it is so important to determine whether your in-house otolaryngology billing and coding staff are properly using these codes to optimize your ability to get paid.

It is important for your practice to take the necessary steps required to minimize the number of denials, improve account management overall, ensure that staff are properly trained, and have the resources necessary to appeal any claims that are rejected. Under-coding is just as much of a problem in otolaryngology billing and coding as over-coding is. Practices and clinics are essentially “leaving money on the exam table” by not properly coding and billing for their services. A review of your in-house medical billing system and solutions can be done by a qualified healthcare consultant to ensure that you are maximizing its abilities.

Learning & Growing Over Time
One of the most effective methods for improving your in-house otolaryngology billing and coding solutions is to teach your staff how to learn from their mistakes so they can grow their abilities over time. These efforts can really impact your bottom line, increasing cash flow and minimizing time and money spent resubmitting claims or tracking down payments. If you have a claims denial rate that is higher than five percent, there is a serious problem that must be identified and dealt with immediately. Regardless of the specialty, there are some common reasons why many claims are rejected that can be fixed simply by using the built-in tools for your medical billing system software to flag those errors before they are submitted.

Common mistakes for otolaryngology billing and coding include:

  • missing information – dates of services, prior authorization
  • incorrect patient information
  • insufficient documentation
  • coding errors
  • late submissions
  • missing modifiers
  • issues regarding primary and secondary insurance

Communication is Key
The more that you can do to improve account management by communicating with patients about the payment policies required by their insurance payers, the better adept you will be at collecting co-pays and deductibles upfront. This reduces the amount of collections that will need to happen after the fact, providing you with more time for otolaryngology billing and coding, as well as follow-up for submitted claims. Your front desk staff can be trained to work more closely with patients to verify that your office has all of the correct insurance information. They can also be helpful in explaining the coverage policy for each plan so that the patients will understand what to expect from service charges.

Communication between physicians and medical billing system staff is also important. The ICD-9 to ICD-10 changes really revealed the importance of communication with regard to better coding practices. Physicians can improve coding accuracy for otolaryngology billing and coding services just by spending a few minutes each month in meetings that coordinate understanding between chart notes and coding staff. Healthcare consultants can also be helpful in this area, bringing in a certified coder to go over coding accuracy within the practice to identify certain procedures, treatments, and surgeries that require improvement.

Support & Training at MD Pro Solutions
If your ENT practice is in need of support to improve account management, as well as otolaryngology billing and coding procedures, you can contact our team of professional healthcare consultants who specialize in this medical specialty. We can assist in training for the ICD-10 changes if your staff is still struggling with coding accuracy, as well as provide auditing, reviews, and other beneficial services that you can use to your advantage. You will not be pressured to switch your medical billing system, but will rather be trained and provided support to help you use your existing solutions to their advantage. Give us a call at 508-946-1665 to get a FREE review of your practice or to learn more about the services that we provide to otolaryngology practices and clinics.