Keeping Up With Industry Requirements: ENT Billing and Coding

healthcare industry requirementsOne of the biggest challenges faced by those who work with medical billing services is keeping up with all of the latest healthcare industry requirements. ENT billing and coding uses a specific range of codes, which should make it easier than trying to learn all of the coding necessary for the complete medical industry. Outsourcing medical billing services can be a solution for some, particularly overworked and understaffed practices, who want to make sure there is no confusion about what needs to be done. Working with a healthcare consultant can be extremely beneficial, and obtaining third-party services, such as offside CPA audits, can help even more.

Why Coding Matters

Physicians, practices, and clinics rely on accurate ENT billing and coding to ensure they get paid for the services that they provide to patients. Medical coding is designed to bring uniformity to the procedures and treatments that are provided through standardized codes. These codes are used by all medical practices and related agencies, recognized by insurance companies, and other third-party payers, including Medicare and Medicaid. It is essential that your staff have a solid grasp of the current coding requirements or that you choose outsourcing medical billing services instead. Outsourced services can be used as a temporary solution during training and performance of offside CPA audits by a healthcare consultant or as a long-term solution for busy practices.

Physicians document the medical records with descriptions of all the tests, services, and procedures that were provided, exactly as they were performed. Details regarding the patient’s symptoms, complaints, conditions, related illnesses, and any relevant injuries should also be included. Medical coders are charged with ensuring that all of the codes recorded on the medical claims that they submit are fully consistent with the documentation provided by the physician or practice in the patient’s medical record. Codes must also be reported in the proper order, with the specific reason for the visit being represented with a code, even if other symptoms or another diagnosis is made at that time.

Why Ongoing Education is Essential

The success of your practice relies on the services provided by your ENT billing and coding team. If they are not properly coding and submitting claims, then you will not receive the payment that you deserve. Outsourcing medical billing services can actually reduce costs for practices, eliminating the need to hire specific billing staff, keep a billing department on-site, stay current with training and software, or dedicate time to submitting claims. Outsourced services only get paid based on what they collect, so they have a real incentive to ensure that all claims are processed and submitted in a timely manner.

If you suspect that your billing department is not doing a good job, a healthcare consultant can be used to provide you with a comprehensive assessment or offside CPA audits to determine the extent of the situation. Solutions and options to remedy the problem can be offered to get your ENT billing and coding department up to industry standards, either by providing training, education, and support or outsourcing medical billing services. It is vital that any issues with claims submissions, coding, or other procedures be remedied as quickly as possible to avoid a negative impact on the practice. Lost income, delayed payments, or even charges of fraud and neglect are not uncommon if the situation is ignored for too long.

Years of Otolaryngology Experience

When you hire MD Pro Solutions to help you with account management and ENT billing and coding evaluations and support, you gain the insight, experience, skills, and knowledge of a team that has over 50 years of experience working with this specialty. Founded by a group of medical practitioners and practice administrators who specialize in Ear Nose and Throat practices, we are able to understand and develop solutions for the medical billing and administrative end of the business because we have lived it ourselves. We recognize that the only way to ensure that your practice or clinic is able to successfully navigate today’s requirements for billing and coding is to stay on top of education and have a firm grasp on the demands of the medical insurance industry.

If you would like a comprehensive evaluation of your current billing practices and administrative services, give us a call at 508-946-1665. Our consultants can assist you in a wide range of areas, offering viable solutions that you can use to make noticeable improvements in the way you do business. Call today for a FREE initial evaluation or for more information on the services that we offer at MD Pro Solutions.