From the procedure and operative report to the codes and billing rules, the reimbursement cycle for cardiothoracic surgeries is almost as complex as the procedures. Whether your practice specializes in angiography and endovascular interventions, or open endarterectomies and thoracotomies, accurate coding and billing are essential to keep your business running smoothly and profitably.
Our coding team has extensive experience coding in ICD-10, CPT, and HCPCS code set, and can save you valuable time and effort determining which codes most closely match the procedure performed. Whether you’re creating dialysis access or performing a stent placement, we have the knowledge to correctly code and get you paid.
Our team of certified medical coders and billers collaborate with your practice to help identify problem areas, such as correct modifier usage and educate your practice on best practices and procedures. From angioplasty to office visits and imaging, ebix, Inc. will work with you to manage all aspects of your billing process and help to maximize revenue for services rendered.
Experienced Cardiothoracic Billing Services gets you more
It is important to realize that the key to successful Revenue Cycle Management is understanding all your practice’s revenue sources. Hence, our team will help improve profitability by monitoring, measuring and managing all aspects of your revenue cycle.
Certainly, the ebix team has superior tools and experience. Hence, our Revenue Cycle Management solutions are in place to capture revenue from claims remittances, patients, and evidence-based data. Collecting from all these sources will help secure your practice’s health care payments and enable it to become more profitable.
Cardiothoracic Billing Services for Your Practice
- Initial Credentialing is Free. Our expert staff reaches out to the carriers of your choice to obtain network status. Namely, free at a startup and a very reasonable fee per provider afterward.
- Fee Schedule Analysis. We will help research appropriate change levels. We enter the allowed amounts from the network contracts obtained to track and uncover any improper reimbursements.
- Workflow Consulting. As a matter of fact, our management staff has over 100 years of combined experience. Therefore, we can advise you on the best practices to build a team and processes that ensure results.
- Carrier Contract Advice. Consequently, there are pitfalls to avoid in contracts and situations that may cause you to choose non-network status with challenging carriers. We have additional expert resources to bring help when necessary.
- Coding Expertise. The ebix team offers certified coding staff to “abstract” codes from provider documentation, or review what you’ve coded for accuracy and completeness. Additional revenue opportunities plus compliance and audit survival are the results of our efforts. We offer Chart auditing services and provider/staff education.
- Fees based on Results. We don’t get paid until we’ve obtained reimbursement for you.
- No Surprises. No additional charges for postage, claims, statements or custom report/data analytics needs.
- Fast Claim Submission. Don’t suffer from delays or write-offs from untimely submissions. Your billing will be submitted promptly after receipt.
- Up to 10% Better Reimbursements.
Medical Coding Compliance
The ebix Cardiothoracic Billing Services team has a strong reputation as an expert in medical coding service. By and large, medical billing begins with accurate and complete documentation in the medical record. Hence, coding is the way your intellectual services and labor are translated into a code used to bill insurance and document the value of your service.
Perhaps most noteworthy are the ICD-10 codes. As a matter of fact, the ICD-10 codes are currently the cornerstone of classifying diseases, injuries, health encounters, and inpatient procedures in morbidity settings. Because of this, the ebix, Inc. team has honed medical coding skills and business processes to meet the needs of independent physicians.
Therefore, the transforming of a provider’s narrative or description of the disease, injury, and procedures into universal medical code numbers for the insurance claim is the fundamental purpose of medical coding. For this reason, our team of professional certified medical coders ensures higher reimbursement by properly aligning services with a medical diagnosis. Consequently, this doesn’t just assure you that you’re properly reimbursed. It will also minimize denials resulting from the incorrect association of diagnosis and procedure codes.
Our financial reporting gives you the insight you need to address the root causes of charge issues, resolve process inefficiencies, improve coding compliance, and ensure the integrity of all claims. Office Managers and Administrators can easily review performance and trends, drill down into the data to analyze root cause by reason, evaluate payer performance, and the financial impact of claim denials.
Examples of some of the financial reports we provide (above and beyond the typical month-end reports that give details around charges, collections, and your AR) include:
- Charge & Revenue Analysis – evaluate financial ratios versus MGMA benchmarks
- Coding Analysis – identify potential under, over and incorrect coding scenarios
- Procedure Analysis – analyze top CPT codes for cost-benefit analysis
- Payor Reimbursement Analysis – assess which payers consistently slow up payments through unnecessary denials and “lost” claims
- Provider & Staff Productivity Analysis – evaluate provider and staff productivity based on the specific place of service, revenue and RVU’s
- AR Aging Analysis – velocity of payments per payor and CPT respectively
Minimize Medical Claim Denials
Based on our experience working with physicians and healthcare organizations we understand that the revenue cycle success starts at the patient registration and continues throughout the claims cycle. Accuracy of patient demographics and financial information upfront results in reduced denials, fewer rejected claims, and fewer returned statements. Claim cleanliness is the key component that stops the denial from origination, and it is impacted by the following parameters:
- Patient registration data quality
- Non-covered services and medical necessity management
- Eligibility and benefits coverage
- Clinical documentation quality
- Claim editing
- Payor rules & mandates