Wound Care Billing Services
MedEx MBS enables wound care specialists to concentrate on patient care by taking the stress of medical billing off their shoulders.
Wound Care Is Complex for Various Reasons
Outpatient wound care coding is complex for several reasons. For instance, a single patient’s wound may be treated in various facilities, such as a hospital and then an outpatient center after discharge. Each encounter must be accurately billed, with codes specifying the location where the care was provided.
Rising Cost And Budget Cuts
In the current financial climate, with rising costs and shrinking budgets, effective medical billing is crucial for ensuring full reimbursement of claims. Practices that lack specialists in coding and billing often miss out on substantial revenue.
Key Reasons to Outsource Wound Care Billing
Medical codes are intricate and updated annually, making it challenging for in-house staff to stay current, often leading to costly errors. Outsourcing to a professional revenue cycle management (RCM) company like MedEx MBS ensures optimal reimbursement. Here are three key reasons why wound care centers particularly benefit from outsourcing their medical billing.
Referrals
Most wound care patients are referred by another physician’s office, which typically checks their insurance coverage for your services. However, it’s important not to assume coverage is guaranteed. Each time a new patient schedules an appointment, the wound care center must verify their insurance coverage.
Increasing Costs and Reduced Reimbursements
Wound care supplies, including costly items like cellular and tissue-based products for skin wounds, are seeing decreased reimbursements. This makes it crucial to ensure that every service is accurately coded and billed to avoid revenue loss from claim rejections and denials.
Prior Authorization
Many insurers and payers require prior authorization for treatments and will reject claims that are not pre-approved in their system, even if the services would have otherwise been covered. Therefore, it is crucial to verify authorizations when confirming that an exam or visit is covered. Additionally, since wound care often involves ongoing treatment over time, which may necessitate further authorizations, staff must be proactive and vigilant about these requirements.
