Emergency Billing & Coding Services
Typical Issues in getting reimbursed for ED services
Emergency medicine billing services are highly unique compared to other forms of medical billing. The complexity is due to the unpredictable nature of patient intake. It relies heavily on the patient care report prepared when the ambulance picks up the patient from where the need arises
Medical Billing & Coding Services Expertise in ED Billing & Coding
At XyberMed, we have a client base that spans across all 50 states, covers a wide range of hospitals, physician practices, and medical billing companies. We employ our experience and knowledge acquired through a decade of working with ED doctors in fixing & improving your revenue cycle. Our coders are proficient in ICD-9/10, CPT, HCPCS coding guidelines provided by CMS and AMA, and are certified by the American Academy of Professional Coders (AAPC).
Applying best practices for ED Billing & Coding Services
At XyberMed, we recognize ED billing & coding challenges, such as high out-of-pocket expenses and the prudent layperson rule. We work with your group to solve them as a business partner.
Our certified coders work with you 24/7 to prevent problems caused by incorrect use of modifiers, as well as educate your in-house billing specialist on how to avoid them. We also look for discharges not fully billed to identify unbilled procedures and improve reimbursements. Our services cost is often covered many folds by the additional reimbursements for services that Emergency Departments leave on the table. We do this by focusing on efficient, streamlined processes that decrease the amount of time needed to bill emergency department services correctly.
We have built our approach using modern technology, and the team focuses on providing data-driven solutions that help reduce denials and increase revenue.
Research and Analyze Historical Data for Maximum Reimbursement
Our XyberMed Services also include proper research on historical payments data. We research and analyze historical data from the area to find proper pricing and rates. All our research is based on locality to make sure we are providing patients with the best rates and you with the best reimbursement.
This is because the supply and demand are different for each area. By researching the historical data of the area, we are better able to meet the expected price for both the patient and for you.
When it comes to the emergency room and special out of network billing, it is all about the connections with claims pricing companies. Out of network claims can be challenging for many staff members for maximum reimbursement. Since Right Medical Billing has developed a strategy and a database for out of network claims, we are able to provide you with the best rates.
Benefits of our ED Billing and Coding Services
We bring excellence, knowledge, and accuracy to ED billing and coding services while building a revenue cycle devoid of defects for your practice. With patient demographics entry, insurance verification, insurance authorizations, coding, billing, and reconciling of accounts, our medical billing process can add value to your organization. Our team strives to introduce a friction-free billing, coding, claim submission, and payment posting process. We ensure consistent accounts receivable follow-up and prior authorization to avoid claim denials. Our denial management team’s #1 priority is shifting your focus from denial management to denial prevention. We bring you a group of specialists who are:
Certification from The American Association of Professional Coders (AAPC)
Familiar with medical billing software such as Lytec, Medic, Misys, Medisoft, NextGen, and many more
Coders trained in coding software such as EncoderPro, FLashcode, CodeLink, etc.
Being able to apply standard CPT, HCPCS procedure and supply codes, and ICD-CM diagnosis coding as per CMS guidelines
Successful track-record of processing medical bills with leading commercial carriers such as United health, WellPoint, Aetna, Humana, HCSC, Blue Cross Group, etc.,
Ability to negotiate successfully with Medicare and state-specific Medicaid policies
Ability to identify DNFB cases and educated physicians on unbilled procedures as well as improve clinical documentation