24/7 Medical Billing Services handle the challenges of DME billing

DME coders will have to be prepared for coding changes coming their way. For DME providers, the only way to survive 2020 will be through hiring experienced coders or by letting an reliable third party handle the challenges of DME billing. 

Proposed Rule by CMS

The DMEPOS fee schedule has been updated by the CMS and several new codes have been added to the HCPCS file. For instance, DMEPOS fee schedule file includes fees for three home infusion G-codes - G0068, G0069 and G-0070. For other new CY2019 codes, the fee schedule amounts will be established under DMEPOS fee schedule update.

Fees have also been added for new HCPCS code (E0467). Fee schedule amounts are also being adjusted for shoe medication codes and mail order DTS. For CY2019, update factor of 2.3% has been applied to few DMEPOS fee schedule amounts. CMS is also implementing monthly fee schedule payment amounts for stationary oxygen equipment.

It has been published by the CMS in order to drive innovation in DME and also to modernize it. Here are some of the highlights of this proposed rule:

•      Starting and until CBP contracts are awarded, it has been proposed that the beneficiaries will be receiving DME items from any Medicare enrolled DME supplier.

•      For DME furnished, CMS has proposed traditional fee schedule amounts.

•      For non-CBAs that are non-contiguous or rural areas, items furnished will be paid at 50/50 rates and for non-CBAs; items furnished will be paid at current payment rates.

•      CMS has proposed new payment classes for portable oxygen and oxygen equipment, new payment rules for ventilators and has improved payment rates for new DMEPOS items.

In 2019, CMS released the proposed rule that included potential changes to the DME payment rates. This long-awaited proposed rule is being considered positive because it includes vital improvements for payment in non-bid areas along with improvements to the CBP (Competitive Bidding Program).

About 247 Medical Billing Services:

We are a medical billing company that offers ‘24/7 Medical Billing Services’ and support physicians, hospitals, medical institutions and group practices with our end to end medical billing solutions. We help you earn more revenue with our quick and affordable services. Our customized Revenue Cycle Management (RCM) solutions allow physicians to attract additional revenue and reduce administrative burden or losses.

Contact: 
247 Medical Billing Services
Tel: +1 888-502-0537
Email: info@247medicalbillingservices.com

Are you doing your HCC Coding Correctly - Check Out Now

It is important for practices to create a workflow so that HCC Coding becomes easy to implement. If your healthcare facility is struggling with HCC coding, then it is time to make necessary changes. Only when coding is done with extreme specificity, it will become easy to get a clear picture of the cost and status of the patient’s health. Specificity and accuracy will be needed for getting claims reimbursed by payers.

So if you feel that your coders aren’t doing HCC Coding correctly, then here are a few tips to consider:

•     Start by educating your physicians as well as coders about HCC Coding and prompt them to ensure that only the latest information gets documented.

•     It is important to encourage physicians and coders to stay abreast of the latest rules and regulations to ensure accuracy in HCC coding.

•     Updating of technologies is equally important because in case there is any issue with the EHR, efficiency of HCC Coding will go down significantly. So your practice needs to invest in the latest technology for improving workflow and ensuring that coding functionality remains high.

•     Physicians at the practice should be given training in time management as well. This is because providers already have enough work to handle in a day. If they are not able to invest some time in accurate and detailed document diagnoses and treatments then the coders won’t have what is needed to complete their job.

•     Another great way of ensuring that HCC Coding is done right and you are getting paid on time is to outsource the service to a third party. A reputed billing company will know the ins and outs of the coding industry. Their teams stay updated on the latest codes and regulations, and hire only the best of coders from the industry.

Your practice can either completely outsource the HCC Coding tasks to the billing company or just handle them the review and audit work to ensure that your in-house coders are on the right track. Irrespective of the services you choose, you can remain assured that a team of expert coders will be working dedicatedly to help you maximize revenue. They will ensure that you receive all the funds for each service you have offered to the patients. So what are you waiting for? Improve your HCC Coding today with the tips and get paid on time.

About 247 Medical Billing Services:

We are a medical billing company that offers ‘24/7 Medical Billing Services’ and support physicians, hospitals, medical institutions and group practices with our end to end medical billing solutions. We help you earn more revenue with our quick and affordable services. Our customized Revenue Cycle Management (RCM) solutions allow physicians to attract additional revenue and reduce administrative burden or losses.

Contact:
247 Medical Billing Services
Tel: +1 888-502-0537
Email: info@247medicalbillingservices.com

HCC Coding - Top 5 Tips to Increase the Practice Revenue

With several changes taking place in the Medicare Advantage industry, it has become extremely important for physicians to capture data in a timely and accurate manner. It has become more critical than ever for them to also track a patient’s care and condition over a period of time. If any provider fails to do so, it will become difficult for their practice to remain profitable or survive in business. Especially providers who are looking after patients enrolled in the Medicare managed care plans need to be careful. They will have to remain prepared for reductions in revenue. Without adapting to the new environment and changes, they will continue to lose significant dollars in revenue.

What is the best solution that they can take up to avoid revenue challenges?

The answer is focus on HCC coding (Hierarchal Condition Category coding). The HCC model is used by Medicare for calculating payments to providers and health plans. But unfortunately, most Medicare Advantage plans and physicians aligned to these plans continue to miss out on opportunities to improve their revenue potential. Can this be changed?

Here are five ways in which physicians can increase practice revenue with focus on HCC coding:

1.  As an independent practice association or a medical group, physicians are most likely to send data to contracted health plans in an electronic manner. If they use EDI (Electronic Data Interchange) vendor for this task, they must speak to them to ensure that the vendor sends them reports on rejected items. They must ask them to verify the number of diagnosis codes they are capturing and transmitting to health plans.

2.  It is necessary for physicians to find out if new patients have already assigned HCCs from their prior health plan. If yes, then they must ensure that those are being maintained, moving forward. This will help them maintain continuity of care and data collection.

3.  Chart reviews need to be done regularly. If the reviews uncover documentation errors, then training guides should be developed to solve this issue. Even one-on-one training with office staff and physicians need to be conducted. 

4.  Member’s conditions need to be documented and assessed every year. This is what CMS expects from physicians. It is necessary to monitor each member’s HCCs for ensuring consistency in reporting.

5.  As new diagnosis codes get added or old ones get deleted every year, physicians must work with an updated codebook.    

About 247 Medical Billing Services:

We are a medical billing company that offers ‘24/7 Medical Billing Services’ and support physicians, hospitals, medical institutions and group practices with our end to end medical billing solutions. We help you earn more revenue with our quick and affordable services. Our customized Revenue Cycle Management (RCM) solutions allow physicians to attract additional revenue and reduce administrative burden or losses.

Contact:
247 Medical Billing Services
Tel: +1 888-502-0537
Email: info@247medicalbillingservices.com