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Our service is backed by a team of expert billers and coders certified by the American Academy of Professional Coders (AAPC) and the American Medical Association (AMA). They have a stringent quality audit process in place to ensure correct code usage for various sleep medicine procedures. Banking on their service accuracy and advanced billing tools, we streamline and improve billing services for all types of sleep medicine conditions. Here's how our services help you streamline the process:
- Leverage sleep medicine-specific billing software integrated with digital systems such as EMR, EHR, and EDI to facilitate electronic claims submission and payments for an end-to-end digital billing workflow.
- Verify patient information (demographics, medical history, physical referrals, Coordination of Benefits details) and insurance provider information (name, policy number, group number, coverage details, effective dates, expiration dates) to ensure accurate claims documentation.
- Check whether any treatment requires prior authorization from the insurance payer and obtain approval before the healthcare provider delivers the service.
- Rigorous training and refresher programs for our team to stay on top of the fee schedules, billing guidelines, claims filing procedures changes, etc., for payers, including government-aided programs such as (Medicare and Medicaid), private insurance payers (Aetna, UnitedHealthcare, Cigna), Employer-Sponsored Health Plans, Tricare, Veterans Affairs (VA) Health Care, and others.
- Maintain code specificity while billing for various sleep medicine procedures such as Continuous Positive Airway Pressure (CPAP), Oral appliance therapy, Cognitive-behavioral therapy for insomnia (CBT-I), Polysomnography (PSG), Multiple Sleep Latency Test (MSLT), Maintenance of Wakefulness Test (MWT), Light therapy, etc.
- Align claims filing documentation with the mandated ICD-10, HCPCS Level II codes, and CPT codes for procedures ( 95800-95811 for polysomnography (sleep study), 95805-95811 for multiple sleep latency testing (MSLT), and 95812-95813 for home sleep apnea testing (HSAT)).
- Adhere to regulatory requirements for different billing models for sleep medicine, including fee-for-service, value-based payment, episode of care, global, and capitation.
- Reconcile EOBs against services rendered and inform patients of their out-of-pocket expenses (deductibles, copayments, coinsurance) to avoid unpaid bills.
- Examine EOBs to summarize patients’ out-of-pocket expenses, including copayments, deductibles, and services not eligible for insurance coverage.
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