Pulmonology Billing Service

Outsource your Medical Billing services for Pulmonology medical practice.

When providing inhalation treatment for acute airway obstruction, Medicare will not pay for both 94640 and 94644 if they are billed on the same day for the same patient. The coder must decide which of the two codes to submit for payment. Generally, it would be the code that has the greatest volume/quantity. Also, Medicare covers pulmonary rehabilitation programs for patients who have been diagnosed with moderate, severe, or very severe COPD as established by the GOLD guidelines. No more than two one-hour sessions may be billed in a single day and the services are only covered if provided in a physician’s office or hospital outpatient department.

Pulmonology medical billing is complex and ever-changing. Confronting declining payments, increasing patient responsibility and increased operational costs require efficient and accurate medical billing procedures. Our team of certified medical coders and billing experts will manage all aspects of your medical billing, including common documentation shortfalls, which help to ensure your practice receives maximum compensation for services rendered.

Experienced Pulmonology 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.

Pulmonology 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 Pulmonology 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.

Data Analytics

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
Payer 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
Prior-authorizations
Non-covered services and medical necessity management
Eligibility and benefits coverage
Clinical documentation quality
Coding
Claim editing
Payor rules & mandates