Owning and managing a busy medical practice and keeping an eye on its medical billing can make it challenging. This is where medical practices might find medical billing outsourcing an option that allows them to focus on their core business, patient care. With constant pressure to reduce cost, improve care, and prepare for changes that seem to be everchanging it can be hard to keep a good grip on your revenue cycle management. As an experienced medical billing outsourcing company, Outsource Strategies International (OSI) can help keep your reimbursement on track and improve the health of your practice.
WHY OUTSOURCE MEDICAL BILLING WITH OSI?
It’s our experience and customer service that makes us special. We want you to remain in control; working as an extension to your practice while providing accurate HIPAA-compliant medical billing and coding service.
Our Medical Billing Outsourcing Service Covers Most Medical Specialties
Being one of the top medical billing outsourcing companies committed to client satisfaction, we serve all major specialties including:
- General Surgery
- Internal Medicine
- Pain Management
- Physical Therapy
Why Choose OSI?
- Dedicated managers with years of outsourcing experience in the US
- We have been in business for over 15 years
- We will save you money
- Increase your revenue
- 30-day AR follow up. Increased follow-up through our outsourced team
- Keep up with healthcare changes
- Experienced in many specialties
- We can handle all your insurance verification and authorizations
- We have experienced and certified coders.
- Follow-up on patient payments
- Focus on what you do best
- Dedicated billing manager
- Keep your practice ahead of your schedule
- We will work on your software
- We can handle small and large practices
- 30-day agreements
- No start-up fees
- No long-term yearly contracts
Knowledge in Many Practice Management Software
Our billing team has experience working in many practice management software. Access can be through a VPN, or directly to the web-based software. We have worked on many software such as
- Practice Admin
- Advanced MD
- Athena health
Frequently Asked Questions
We have been in business since 2002.
Though we did not start off with medical billing service, we got into medical billing very quickly and started providing medical billing outsourcing from 2002 onwards.
Yes, we do. Our eligibility verification and authorization team can make sure that each patient you see is someone you will get paid for. Need authorization for your procedures? We do that as well. We can keep your patients verified 5 days ahead of their visit. Know your copayments and deductibles.
Not necessarily. We can work on your software as well. With high-speed internet and HIPAA-compliant protocols that are in place we can easily be in your system and work as an extension to your business.
We are presently providing a complete practice management suite to our clients.
- Patient scheduling and rescheduling
- Insurance verifications
- Charge entry
- Claims processing
- Payment posting
- AR follow up
- Patient billing
- Patient collections
Yes, they are. We have coders who specialize in several specialties. They are either AAPC certified or AHIMA certified.
Great question. We are very particular about going through the EOB and checking by line items. Since we post payments by line item, we can identify low payments and denials. Our AR team will follow up on claims by the 30th day of claim submission and act in a timely manner. We realize that the payment time frame for each insurance might be different and they might need a different time frame of follow-up. That is what makes our AR management efficient. We do not write without proper follow-up and discussion with our customers.
Yes, we can. We can compare your billing and then make sure that you are billing the best codes that allow for you to maximize your reimbursements.
Yes, we do.
We provide full support from our US and offshore offices. Being fully HIPAA-compliant, we follow all standards and requirements in electronic transmission and storage of health information.
Contact us today to find out how our medical billing services can improve your bottom line. To request information regarding our medical billing outsourcing services, call: 1-800-670-2809.
Key Strategies To Prevent E/M Mistakes And Denials
PODCAST by Meghann Drella, CPC: Senior Solutions Manager: Practice and Revenue Cycle Management, Healthcare Division
Hello and Welcome to our Podcast series. My name is Meghann Drella and I am a Senior Solutions Manager here at Outsource Strategies International. Today, I will be discussing - Strategies to Prevent E/M Mistakes and Denials.
The key to maximizing payment and avoiding risk of audits is proper documentation and coding of E/M patient visits. The main reasons for the denial of E/M claims are assigning the wrong codes and reporting codes that do not support the services provided. Here are the top strategies to prevent E/M mistakes and denials –
Choose the code that best represents E/M services rendered: There are different levels of E/M codes, which are governed by the complexity of the visit and documentation requirements, and certain other factors. According to CMS, the main variables that need to be taken into account when selecting E/M codes are:
- The Patient type (new or established) - New patients are those who have not received any professional service from the healthcare provider within the last three years; and established patients are those who have received professional services from the healthcare provider within the previous three years.
- The Setting/place of service - The physician-patient encounter could take place in an office or outpatient setting, a hospital inpatient, an emergency department, or a nursing facility.
- The level of service provided based on the extent of the history, the extent of the examination, and the complexity of the medical decision making. Typically, the higher the complexity of the encounter, the higher the level of the code reported. Unless coding based on ‘time’, these three key components are enough to meet E/M documentation requirements.
Starting January 2020, evaluation and management (E/M) has new codes for e-visits that Medicare will reimburse.
Provide clear documentation for Level 4 Office Visits: When time is the main element in the patient’s visit, the appropriate time-based service code needs to be captured. However, choosing a , Level 4 E/M code based on time, proper documentation that clearly describes what was done and why is crucial, according to a 2018 Medical Economics article. The reason is that Level 4 E/M codes come under payer scrutiny as they are associated with higher payments. The report notes that if the physicians choose a Level 4 E/M code based on time, their documentation must clearly describe what was done and why. In the absence of proper documentation, the physician could come under the microscope if the payer suspects up coding. The article notes that focusing on diagnosis codes can help justify the basis for E/M level selection based on time. Another point to note is that time spent on extent of the counseling and coordination of care should also be documented. These services are above and beyond the E/M code and documentation must really reflect this fact.
Ensure services rendered are “reasonable and necessary”: According to CMS, when assigning an E/M level, medical necessity means “the services furnished in accordance with accepted standards of medical practice for the diagnosis or treatment of the patient’s condition.” Medical necessity is determined by the severity of the patient’s problem. To prevent claim denial, it should be ensured that the service provided was reasonable and medically necessary.
If it wasn’t documented, then it wasn’t done. Physicians should ensure clear and legible documentation in the medical record. New documentation guidelines for office- and outpatient-based E/M services came into effect on January 1, 2019. According to these rules, the provider can reference previous information and document an update from the last visit. However, physicians should know the documentation guidelines followed by their non-Medicare payers as these may differ from CMS guidance.
Stay informed about updates: The AMA recently released CPT errata and technical corrections and knowing these changes is necessary to ensure correct coding. The E/M section, under the Non-Face-to-Face Services heading, the Remote Physiologic Monitoring and Treatment Management Services introductory guidelines has been revised to specify that codes 99457, 99458 should be reported for the first completed 20 minutes and each additional completed 20 minutes, respectively, of clinical staff/physician/other qualified healthcare professional time in a calendar month. Other changes include:
- Deletion of the second instructional parenthetical note following 99458 that states: “Report only 99457 if you have not completed 20 minutes of additional treatment regardless of time spent.” Do not report 99457 for services of less than 20 minutes.
- Revision of the third instructional parenthetical note following 99458 to read: “Do not report 99458 for services of less than an additional increment of 20 minutes.” These became effective Jan1, 2020.
I hope this helps, but please remember that documentation as well as a thorough knowledge of payer regulations and guidelines is critical to ensure accurate reimbursement for the procedures performed.
Thanks for joining me and Stay Tuned for my next Podcast.
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