Case Study Manish Jain Case Study Manish Jain

Case Study: Improving ED collections by resolving coding and clinical documentation issues

Our client, a mid-sized hospital group, faced challenges getting reimbursed for ED visits. Sub-optimal client documentation processes led to delayed payments and reduced reimbursements. Our initial analysis revealed that delayed billing was the root cause. We conducted an exhaustive internal audit of 30 physicians working across two facilities in Washington and Florida. In this case study, we highlight how improved clinical documentation and coding quality lead to increased reimbursements.

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Case Study Manish Jain Case Study Manish Jain

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: Getting Reimbursed for COVID testing of uninsured patients under HRSA program

Amidst the uncertainties of the pandemic, our client, a healthcare provider in Central Florida, had launched Covid-19 testing for both insurers and non-insured patients. Although the client got reimbursed successfully for the insured patients' claims, they were looking for a third-party RCM management company like MBW to help them submit claims electronically under the HRSA program. In this case study, read more about how our team helped collect $60k with a first-pass claim submission rate for Covid testing under the HRSA program.

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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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Case Study: Physician Education helps resolve BMI Diagnosis Claim Denials of over $37 K

Many Primary Care Physicians lose money because of lack of understanding of payer specific claims submission guidelines. Educating physicians on their documentation responsibilities is an iterative process, that requires an understanding of the reasons for claim denials, ability to nail-down the issues that are causing the denials, determining the corrective actions, and hosting timely sessions between the denials team and the physicians to discuss them.

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Case Study Manish Jain Case Study Manish Jain

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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