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We have designed our services to help streamline billing processes for your hospice practice. We provide end-to-end billing solutions, from insurance verification to claims submission and electronic payments to collections follow-up. Our AAPC and AMA certified experts provide billing services that adhere to various payer guidelines and codebooks. Here is how we do it for you.
- Integrate digital billing systems such as EHR, EMR, and EDI into the hospice-specific billing software to facilitate faster and accurate electronic claims processing.
- Verify patient information (demographics, medical history) and insurance information (insurance coverage, eligibility, effective dates, expiration dates, and claim addresses) to prevent billing errors and reduce claims denials.
- Verify pre-authorization needs and process the documentation accordingly stating the medical necessity of services to get prompt approval from insurance payers.
- Assign specific billing codes for the hospice procedures offered to the patients (pain management, symptom management, emotional and spiritual support, assistance with activities of daily living (ADLs), end-of-life planning, caregiver support, medical equipment and supplies, and more.
- Stay current with the E/M codes, modifiers, HCPCS Level II codes, ICD-10, and CPT codes such as routine home care - 99201 to 99499, continuous home care - 99324 to 99350, general inpatient care 99221 to 99239, etc.
- Adhere to coding and regulatory guidelines while handling diverse billing models for hospice procedures, including Per Diem Billing, Capitated Payment, Fee-for-Service, value-based payment, and more.
- Process clean claims and submit them to the respective insurance providers (Medicare, Medicaid, Veterans Administration (VA), Tricare, Long-term Care Insurance, and private insurance companies (Humana, Aetna, Anthem)).
- Engage with payers to obtain EOBs and review them to understand reasons for denials. Resolve discrepancies and initiate appeals to gain maximum reimbursements.
- Inform patients about their out-of-pocket expenses including copayments, deductibles, coinsurance and more.
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