Medical Laboratory Billing Services

Specialist Billers for Internal Medicine

Internal Medicine Billing

Introduction

Internal medicine is a medical specialty that focuses on the diagnosis and treatment of adult patients. Internist refers to a physician who specializes in internal medicine. Internal medicine subspecialties include:

  1. Immunology and allergy
  2. Cardiology
  3. Endocrinology
  4. Hematology
  5. Viruses and other infectious disorders
  6. Gastroenterology
  7. Nephrology
  8. Oncology
  9. Pulmonology
  10. Rheumatology

Internal medicine practices having unique billing and revenue cycles, which medical coders are familiar with. Our staff uses their combined experience and attention to detail to ensure that you are reimbursed for the patient care you deliver in a timely and appropriate manner.

Internal Medicine vs. General Medicine

  • Internal medicine professionals specialize in the prevention, diagnosis, and management of disease and chronic disorders in adults. They’ve been educated to identify difficult diseases that only affect grownups.
  • Patients of any gender or age, including children and adolescents, can be treated by general practitioners.

Medical Billing in Internal Medicine

Internal medicine faces unique issues in terms of billing coverage that other medical disciplines may not face. To make the first diagnosis, internists may need to perform a number of tests, which will be followed up by the expert. Internal medicine medical billing is difficult because consultations aren’t confined to certain diseases, body systems, and symptoms, or procedures/treatments. Furthermore, even if a patient does not have a specific problem, internists provide frequent preventive and periodic evaluation services.

As an internal medicine physician or institution, you will undoubtedly require a billing provider that understands the complexities of this medical specialty. The internal medical billing company you’re looking for is undoubtedly ours. We can provide you with focused, dependable, and quick medical billing services at a 30% to 40% discount.

Benefits of Utilizing Our Billing services

Take advantage of this chance to take advantage of internal medicine medical billing services that eliminate the problems of collecting money from patients. For billing, we’ll employ our high-end software and infrastructure to make the process go faster and smoother. We will bring orders to your business and handle all correspondence with payers, ensuring that you receive your money on schedule and without problems.

  • A thorough investigation of all patient accounts
  • Each account is evaluated on a regular basis.
  • Diagnostic and procedural codes are audited on a regular basis.
  • QA checks are performed on a regular basis, and reports are available.
  • Fewer appeals and/or refiles due to cleaner claims
  • Client benefit reports are generated on a daily, weekly, and monthly basis.
  • Weekly meetings and phone calls to discuss progress are held on a weekly basis.
  • For immediate support, use instant messaging, Skype, or the telephone.
  • TAT tailored to your needs
  • There are no yearly contracts that are longer than a year.

Our Working Methodology

  • Provide Us With Information About Your Practice
  • Fill out a form with information about your practice, including any providers and insurance companies you work with.

Initial Step: Send Us Your Documents

  • Become a member of the Claim Submission Program.
  • We will provide you with any insurance clearinghouse forms required to submit claims on your behalf.

Working Step: Signing -up for Claiming Submission

  • We’ll go over the paperwork we’ll need to bill your insurance claims and assist you with any papers you’ll need to provide us with the correct patient and insurance information. We’ll also consult with you or your employees to figure out the best way to get that information to us, as well as how to prepare it so that nothing is overlooked.

Final Step: Provide Us With Your Paperwork

  • That concludes our discussion. You’ll be on your way to getting your Internal Medicine Billing done correctly by expert coders and medical billing professionals in three simple steps. Simply follow these three simple steps to ensure that your practice is successful.

Conclusion

It’s simple to have NixxeMBS start working on your Internal Medicine Medical Billing. We’ll collaborate closely with your current medical billing business or in-house employees to ensure a seamless transition to our service. Internal medicine billing is something we know a lot about. Our team of Certified Professional Coders and Experienced Billers will walk you through the process of establishing you’re practice.

Dealing with rejections and denials is one of the most costly components of internal medicine billing revenue cycle management for practitioners. Each one can take hours to decipher, correct, resubmit, and occasionally follow up on.

Nixxe

Medical and Coding Billing Errors Statistics

In this article, we will try to cover some of the common Medical and Coding Billing Errors Statistics that lead to rejected claims. If your biller lacks the finesse to get the maximum return for you, you may find a lot of this information very useful. A biller for any practice, lab, or hospital must realize the importance of their role in the business model. They must be diligent, thorough, and meticulous with their job or the brunt of tiny mistakes falls on to the medical service provider, leading to funds stuck in AR and the revenue cycle not coughing out decent profits.

Medical and Coding Billing Errors Statistics

Claims card in hands of Medical Doctor

So, these are some very common errors that lead to rejections.

Missing information:

Every missing information may cause denials or rejections. The most common missing items are listed below:

Missing or incorrect member ID

Missing or incorrect patient DOB or gender

incorrect or Missing zip code or patient’s address

Missing date of accident or date of a medical emergency

Missing hospice information or modifier (GW, GV)

Incomplete or Missing documentation

Lack of other insurance information or COB (coordination of benefits) issue

Timely filing

If a claim is submitted outside the time frame set by insurance it may result in a denial. So providers should be aware of timely filing limits as different payers will have different timely filing limits which are listed below.

Medicare – 12 months from DOS

Aetna – 90 days from DOS

Anthem – 180 days from DOS

Cigna – 90 days from DOS

UHC – 90 days from DOS

Coding errors:

Failing to provide information to payers to support claims results in denials or delays.

The problem can occur if billing department members don’t link a diagnosis code with the CPT code or they do not add the 4th or 5th digit to the diagnosis code.

The upcoding error can occur if billing department employee makes a mistake when entering diagnosis and treatment codes or if the employee is confused by the information provided by the physician or if patients are billed for the more complex procedures than they actually received or bills are submitted for services that were never performed.

Telemedicine coding errors:

Incorrect use of modifiers for telehealth services results in denials or rejections. For example, the GT modifier applies to the real-time telehealth services provided by audio or video system, while the GQ modifier covers services provided through asynchronous telecommunication systems such as an emailed x-ray.

Telehealth modifiers are listed below:

  • GQ

    – Modifier GQ is used to code for services delivered via an asynchronous telecommunications system. Asynchronous telecommunication is when a physician collects & stores medical history, images & pathology reports and forwards them to senior or specialist physicians to get an opinion on the diagnoses & treatment. It can be used by providers participating in federal telemedicine demonstration programs

  • GT or 95

    – Modifier 95 can be used to code all of the diagnosis, evaluation, or treatment of symptoms via Telemedicine. 95 can be attached to any CPT codes. Modifier 95 can be used only when the service is offered via an interactive audio & video telecommunication system. Modifier GT is being appended in place of modifier 95 only when directed by the insurance payer

Duplicate billing:

This is a human error wherein the same medical procedure is billed more than once. This can result in resubmitting a claim or delay in payments. These claims are usually categorized into two groups exact duplicate claim and suspect duplicate claim.

If you submit the initial claim to insurance it is counted as the original submission. Later if you need to recheck or go back to make changes such as insurance carrier, subscriber ID, etc. and you resubmit it without mentioning it as a corrected claim with the original ICN number it will be rejected as a duplicate claim.

Inactive or terminated insurance:

This is one of the most common Medical and Coding Billing Errors Statistics reasons for claim rejections or denials. It is advised to check the insurance availability of the service while treating the patient. Changes and modifications can happen with a patient’s insurance at any point. For example at the time of submission or treatment patient’s policy end date was not given but later it was updated in insurance records.

I hope this article helped you in understanding the reasons behind high rejection rates. Feel free to interact with us over our socials and let us know what you think.