Case Study: Anesthesia billing and coding rigor improves reimbursements

Our client, an IOWA-based anesthesia practice operating from 3 locations with 12 anesthesiologists in the group, was facing increased denials due to preventable causes. Anesthesia procedures are unique and require specific diagnosis codes. Hence, the quality of documentation by the Anesthesiologists plays a critical role in reducing coding-related denials. In this case study, we share the best practices applied by our team while billing & coding for Anesthesia practice.

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Case Study: Recovering $14.5 million by applying best practices in billing and coding of COVID 19 – Test & Vaccination claims

Our client, a Maryland-based Medical Billing & Coding Company, was challenged with billing & coding for all vaccinations done at an urgent care clinic in North Carolina. The urgent care center had partnered with the North Carolina Department of Health & Human Services, thereby conduction the majority of the Vaccination drives at their care centers. In this case study, we share the best practices applied by our team while billing & coding for COVID-19 vaccination.

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Case Study: Accurate coding of Podiatry Encounters Improves collections by 25%, reduces denials by 23%

Invalid Diagnosis codes can cause coding errors and inflate claim denial rates. Often, healthcare providers tend to utilize superbills and mark the nearest available codes on the superbills. One of our clients, a podiatry provider, used superbills. The providers habitually marked the 99309 procedure on the superbill and notified the billing team for processing. However, as per Medicare and Medicaid regulations, 99309 and 99252 need to be entered for the claims to get reimbursements. Due to the lack of a clear understanding of the coding guidelines, the providers marked invalid diagnosis codes on the superbill.

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Achieving Revenue Cycle Results for a California-based Mental and Behavioral Health Provider

Understanding California, Payer, and Behavioral health-specific nuances and diligent focus on enrollment, timely filing, and payments reconciliations reduced denial rates and increased collections by 52%.

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Case Study: Correct Coding and Electronic Submission of Podiatry Claims reduce denials by 23% and improves collection by 25%

Bad quality scanning of superbills and lack of adoption of electronic claims submission creates a charge backlog situation and consequently, result in increased denials on account to timely filing dates not being adhered to. Read this case study about how our structured approach, technical expertise, and revenue cycle rigor combine to create value for our client.

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Case Study: Addressing Notice of Levy issues to Improve Reimbursements

Notice of Levy issues may be wrongly construed to be claim denials if a thorough investigation is not done to understand the reason behind such cases. Further, it is imperative that physicians pay their taxes on time. By educating physicians/practice teams on the importance of filing taxes, an artificial surge in denials on account of notice of levy cases can be avoided.

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Case Study: Revenue Cycle Improvement for a Physical Therapy Clinic – Collections Double, Denials Reduce to 50%

Physical Therapy billing requires expertise to ensure holistic and sustainable improvement. Medical Necessity and prior authorization issues can cripple a practice’s financial health. Structured revenue cycle processes can help Physical Therapy clinics grow and thrive. Diligent tracking of issues and working with physicians can yield as much as 2X improvement in collections and reduce denials by as much as 50%. Get the strategies in this case study.

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