PULMONOLOGY BILLING SERVICES
Stands to Lose Greater Amounts
As a relatively high-cost medical field, pulmonology stands to lose greater amounts of revenue when billing and coding errors are present. The complexity of the ever-changing pulmonary billing codes means that there may be errors—however, a coding and billing team that is experienced in pulmonology billing will minimize them and will be able to efficiently handle rejected and denied claims, unlike a less experienced office staff, who may spend hours sorting out each claim and may never get the more complicated ones resolved in the required time frame, resulting in significant losses of revenue.
Challenges Associated with Pulmonology Billing
The medical billing process starts in the scheduling phase when insurance coverage and payer requirements have to be confirmed. Pulmonology frequently includes rescheduling appointments due to coordination with other specialists and hospital procedures and annual processes that need to be tracked and accounted for.
Seasonal Services Must Be Part Of The Cycle
Flu shots, vaccines and other preventive practices that need to occur on a seasonal or annual basis have to be tracked and scheduled, adding another set of coverage and coding questions that have to be addressed.
In general medical practice, there may be hundreds of patients through the doors daily, resulting in an enormous number of low-dollar claims being filed daily, but in pulmonology billing, examinations and treatments are of a different, more in-depth, and time-consuming, nature. A physician may see 10 or 15 people on a normal day, meaning the loss of revenue for a single unpaid claim can be substantial.
Complicated Procedures And Treatments Involve Complex Coding
An important part of coding is the modifiers, which are required to give the pertinent details needed to be reimbursed for all services delivered. Inexperienced coders can look up the general code for a procedure, but often do not know how many levels they need to go down and all the numerically coded details that need to be added.