Hospital Medical Billing
Optimize Your Hospital’s Revenue with Seamless Medical Billing Solutions
Hospitals offer emergency care for complex surgeries, so special treatments need to be focused on hospital medical billing. The process of hospital billing is very complex due to its broad spectrum of care, such as inpatient and outpatient services, diagnostics, surgeries, and long-term treatments, among other benefits. In addition, hospitals deal with a large number of patients and also have many departments. This makes the medical billing very complex and requires sharp coordination with regard to appropriate coding and timely submission of claims and effective revenue cycle management.
Hospital medical billing has endless procedures, which have separate billing codes in the case, and it has DRG diagnosis-related group codes for inpatient stays and CPT codes for any kind of outpatient services. Hospitals need to track services across various departments of the hospital, like radiology, laboratory, pharmacy, and surgery departments, which may need to send separate billing components. Coding for packaged services, such as those in surgical procedures or longer inpatient stays, requires accurate accuracy to prevent loss in revenue and maintaining compliance with all the payer guidelines.
The breadth of insurance payers’ requirements is very challenging in hospital medical billing, including everything from Medicare, Medicare, and private insurance, each with unique rules surrounding coverage, pre-authorizations, and documentation. Often, they then also have to account for out-of-network care as well as other audits and compliance with healthcare regulations. If coding was either applied wrongly or not at all documented, then there is a huge possibility that the claim would be denied, or worse, delayed, which will badly affect the revenues and operational efficiency of the hospital.
Our professional hospital medical billing service offers you access to our experts who have expertise in the technicalities of hospital billing and coding. They manage everything from claiming for patients who visited the emergency room to coordinating the billings for inpatient patients who are under the hospital for a long time. It allows your staff to understand the critical issues in such a facility, such as having a large volume of claims, bundling, and negotiation with the payer, allowing our billing team to deliver accurate coding and efficient claim submissions for potential cash flow and denial reduction.
Optimized Hospital Medical Billing for Your Practice.
Thorough, Accurate Hospitalist Coding
Our certified hospitalist coding experts ensure all services are accurately captured using up-to-date coding guidelines. By carefully reviewing documentation, we assign the correct codes that reflect the complexity of care provided, preventing underpayments and audit risks.
Streamlined Claim Submission
Every claim undergoes a thorough review process to eliminate errors before submission. We customize each claim to meet payer preferences, resulting in quicker approvals and fewer denials, ensuring timely payments.
Detailed Revenue Cycle Analysis
With customized reports and dashboards, we provide insights into key performance indicators such as coding trends, denial rates, and aging accounts. These metrics allow for data-driven decisions that enhance efficiency and profitability.
Ongoing Regulatory Compliance
Our team stays current with evolving regulatory requirements from CMS, OIG, and other governing bodies. We implement necessary policies to keep your billing compliant and protect your practice from potential penalties.
Immediate Collections and Practice Management
We streamline the collection of patient details and ensure treatment information is accurately recorded. This reduces time spent on unnecessary billing steps, and patients are promptly informed about insurance and payment requirements.
Hospitalist Electronic Claims
Our billers ensure that patient treatments align with their insurance coverage, minimizing claim errors. We rigorously cross-check claims for accuracy before submission, ensuring a smooth and error-free reimbursement process.
Accounts Receivable Management
We manage the entire claims process, from submission to payment tracking, ensuring timely reimbursements. In the case of claim denials, our team swiftly identifies and resolves issues, resubmitting for successful payment without delays.
Increased Efficiency
By employing proven billing strategies, we enhance the efficiency of your hospital. Our team identifies potential gaps in patient information early, preventing claim denials and ensuring a seamless billing experience.
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Frequently Asked Questions
1. What is the billing code for a hospitalist consult?
CPT codes 99251-99255 are used for initial inpatient consultations. These codes vary based on the complexity of the consult, time spent, and medical decision-making involved.
2. What CPT codes do hospitalists use?
For inpatient evaluation and management (E/M) services, hospitalists frequently use:
- 99221-99223: Initial hospital care, based on the complexity of the patient’s condition and the physician’s time.
- 99231-99233: Subsequent hospital care, reflecting different levels of service complexity.
- 99238-99239: Hospital discharge day management.
- 99291-99292: Critical care services.
3. What codes are used for inpatient billing?
Hospitalists typically use E/M codes 99221-99239, which cover everything from initial evaluations to follow-up care and discharges, tailored to the level of service complexity, time involved, and the nature of the patient’s health issue.