Rheumatology Billing Services
Are your in-house billers overwhelmed by rheumatology billing complexities? Are they failing to keep up with the varying insurance payer guidelines and dynamic codebook changes? You need certified billers with expertise in rheumatology to overcome such challenges. Our HIPAA-compliant rheumatology billing services help you navigate the billing complexities to ensure timely reimbursements.
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How We Streamline Rheumatology Billing for Your Practice
Our team of certified coders (CPC) and professional billers (CPB) has an in-depth understanding of the intricacies of current rheumatology coding and billing guidelines. Empowered with the right technologies, our team leverages their expertise for accurate claims submissions for rheumatology-relevant medical services like imaging, infusion therapy, laboratory testing, medication management, etc. We customize our approach to assist healthcare providers in various settings to minimize claims denials and maximize reimbursements. Here’s how we do it:
- Use specialized billing software integrated with digital technologies such as electronic health records (EHR), electronic medical records (EMR), and electronic data interchange (EDI) to simplify billing and ensure all codes and procedures are current.
- Employ a checklist-based approach to capture comprehensive patient details (demographic details, physician referrals) and insurance information (primary, secondary, ID numbers, effective date, expiration date, and relevant financial details like co-payments, deductibles, and coinsurance responsibilities for each payer).
- Expertise across various rheumatology billing types, including capitation billing, global billing, episode-of-care billing, telemedicine billing, etc.
- Ensure zero-error claims filing by maintaining code specificity (HCPCS level II codes, ICD-10 codes covering rheumatoid arthritis, osteoarthritis, gout, etc., and CPT codes covering ranges of evaluation and management (E/M) codes (99201–99499), injection and infusion codes (96372–96379, 96401–96549), laboratory and pathology codes (80047–89398), and more ).
- Submit claims using the precise fee schedules and payment regulations set by Medicare, Medicaid, and various private insurance payers like Kaiser Permanente, Cigna, and others, aiming to optimize reimbursements to their fullest potential.
- Appoint a specialized expert in claims status to handle patient inquiries and serve as a liaison with insurance providers. The expert will actively monitor the status of claims to ensure prompt adjudication.
- Engage with payers and verify EOBs to know about services covered and not covered under claims. If needed, we resolve errors and discrepancies to initiate the appeal process.
- Generate a comprehensive report on out-of-pocket expenses such as copayments, deductibles, coinsurance, etc., to inform patients about their payment responsibilities for uncovered services. This helps our clients prevent unpaid claims.
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During the consultation, some of the issues we can discuss are:
- Your current rheumatology billing process, its inefficiencies, and challenges.
- How we ensure accurate coding and billing for your rheumatology procedures?
- Best practices to handle claims denials and claims rejections
- Steps to improve billing KPIs to achieve maximum reimbursements.
Why Choose Invensis as your Rheumatology Billing Company?
We are a leading rheumatology billing company that has been delivering billing services for a diverse clientele for over 24 years. The client list includes multi-specialty clinics, rheumatology practices, outpatient centers, integrated health systems, MCOs, ACOs, and more. Our certified coders and billers adhere to the latest CMS, AMA, and CUC guidelines, with AAPC certification for all coders. The billing and coding team is ably supported by document and credentialing specialists, appeals experts, coding auditors, and CMRSs. This collaborative approach has yielded a near 95% net collection rate, almost 98% clean claims rate, lower AR days of up to 35-40 days, and a reduction in claims denials to less than 8%.
Benefits of Outsourcing Rheumatology Billing
- Improved Revenue Cycle Management:
Healthcare providers often face challenges with revenue cycle management, especially when it comes to billing and coding for specialized services like rheumatology. Incorrect coding, delayed payments, and claims denials can significantly impact a healthcare facility's revenue stream. This is where outsourcing can be of great help.
Invensis has a team of experienced rheumatology billing and coding experts. Their deep understanding of rheumatology codes ensures timely and accurate claims processing, resulting in improved cash flow and reduced claims denials. Our clients have banked on our services to keep their financial health steady. - Access to Specialized Expertise:
Managing the billing and revenue cycle in a healthcare organization, particularly in the field of rheumatology, can be complicated. Healthcare providers who lack specialized knowledge in rheumatology billing can face challenges in getting timely and accurate reimbursements. Outsourcing rheumatology billing services to expert providers can help healthcare providers ensure their billing operations comply with regulations.
At Invensis, we have a team of experienced billing specialists specializing in rheumatology. Our experts stay up-to-date on regulatory requirements and industry trends to ensure complete compliance. - Reduced Administrative Burden:
Healthcare providers, especially those offering rheumatology services, face several administrative challenges. Managing rheumatology billing is a complex task in itself. To top it, providers face delays in reimbursements, claims denials, and compliance issues that can lead to revenue loss.
To alleviate these administrative burdens, healthcare providers can outsource their rheumatology billing solutions to Invensis. Our team of experienced billing specialists have the expertise needed to look after all your billing needs and save valuable time and resources for patient care and front office tasks. - Improved Compliance:
In the healthcare industry, compliance with regulations and laws is crucial. It is especially important to ensure accurate billing and coding practices for rheumatology practices to avoid legal and financial repercussions. However, changing regulations and billing requirements can be daunting, especially for smaller practices.To mitigate compliance risks and improve financial performance, healthcare providers can outsource their rheumatology billing services to Invensis. Our team of expert coders and billers ensures compliance with HIPAA regulations and the ever-changing coding and billing requirements. We also provide regular audits and analyses to ensure your practice complies with all regulations.
Trends in Rheumatology Billing
- Increasing Use of Technology:
The use of technology in rheumatology billing has increased significantly in recent years majorly due to electronic health records (EHRs) and billing software. This trend has resulted in greater accuracy, efficiency, and transparency in billing practices. Invensis leverages the latest technology solutions to optimize revenue cycles and reduce the risk of errors for healthcare providers. We enable them to focus on providing high-quality patient care while we streamline their billing processes. - Greater Emphasis on Value-based Care:
The trend towards value-based care has gained momentum in rheumatology billing. As healthcare providers look for ways to optimize patient outcomes and improve their bottom line. Value-based care focuses on patient-centered, cost-effective care and incentivizes providers for positive health outcomes rather than the volume of services provided. At Invensis, we augment healthcare providers by helping them navigate the complex world of value-based care reimbursement. We ensure accurate coding and documentation for maximum revenue and reduced risk. - Shift Towards Alternative Payment Models:
The shift towards alternative payment models (APMs) in rheumatology billing has become increasingly popular. Healthcare providers worldwide are looking for ways to adapt to this trend. APMs incentivize providers to deliver high-quality, cost-effective care by rewarding them for positive health outcomes rather than volume-based billing. Invensis assists healthcare providers in APMs to better navigate the complex billing landscape. This helps them in meeting the requirements of APMs which in turn helps in improved patient care.
What Our Customers Say
We have been working with Invensis for the past two years, and they have helped us overcome many revenue cycle management challenges. The team often walks the extra mile to ensure that our needs are met.
Invensis has been our revenue cycle management healthcare outsourcing partner for the past 5 years. They have always delivered on their commitments, whether it is meeting our Service Level Agreement (SLA) or improving our billing process.
Invensis has been a great partner providing quality medical coding and billing services. The team is extremely responsive to every query we pose, and the turn-around time for deliverables is always as committed.
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