As a Primary Care Practice you have unique billing issues, whether it is how to bill the Medicare Wellness Exam or how to correctly use the new Transition of Care Codes.
At Strategic, we monitor changes in your specialty area that result from CPT-4 changes, new coding edits, or even areas of focus from the Office of the Inspector General.
We communicate with Practices through our one-on-one meetings and through our Billing Alerts to ensure you understand the ever-changing payer rules.
Primary Care is one of the more complex billing areas and has been faced with several challenges over the last few years:
- Billing for preventive and sick care in one visit. Each payer has its unique set of rules for these combined visit types. We understand these rules and work with you to implement processes to optimize reimbursement.
- Ensuring that you are covering the costs of your immunizations. Many payers change their reimbursement quarterly. We can provide you up-to-date payment information so that you can negotiate with your vendor to ensure your costs are covered.
- Thorough denial review process. At times, an insurance company's internal edits result in an inappropriate denial. All denials are reviewed by our certified coders and appealed when needed. Nothing is adjusted off unless the denial is valid, so you can be assured you are getting paid the money you deserve.
- Protection of Patient Privacy to prevent reportable breaches. Our billing staff is routinely trained on HIPAA, which is particularly important with some of the sensitive conditions experienced by your patients. You can be confident that we are continuously working to protect patient privacy.
Strategic Solutions helps Primary Care Practices face today's challenges and achieve financial success in a complex healthcare marketplace. For more information, contact us at 518-348-1276.