- June 16, 2020
- Posted by: Thomas Anderson
- Category: Orthotics and Prosthetics
There are multiple challenge areas in billing especially if your Orthotics supplies company. With the changing regulations and mandates, there are a number of issues right from coding for common fractures to taking stock of a bundling of issues.
Reporting of inaccurate codes especially if they are related to fracture and their types can lead to loss of revenue and even denial of claims in the longer run. You have to stay sharp especially as a coder when it comes to fracture care coding by knowing the intricacies involving the terminologies.
Understanding TPI’s by payers and using the appropriate Observation codes
Also knowing the descriptor and having it updated for the observation services of the payers can be a complication. For instance, if you report hospital observation codes 99217 and 99218-99220, not overlooking the verbiage change effective from Jan1 2018 of CPT and adding the phrase “outpatient hospital “in the phrase “outpatient hospital observation status”.
Also perfecting your trigger point injection claims (TPI’s) even though these services are reported with only two TPI codes, it does not mean reporting the diagnosis codes for TPI’s are simple. One of the main things to remember in orthotics billing is that covered or non-covered diagnosis for TPI’s will always differ by locations, payers and also by encounter specifics.
Also, a lot of payers may have limited policies of payments for TPI’s. Hence checking the policies before applying for claims saves time & money. It all boils down to having the right resources in place that can handle all your process loopholes with Orthotics billing.
Finding a team that balances your operational stress
Surely, it might be quite hectic to find a reliable team, handling all your pre and post DME billing work with excellence. Having 100% HIPAA compliance and finding someone that works diligently on your Rx order entry, patient demographic creation, collection the documents from the physician office, getting the eligibilities and authorizations done on time.
It gives you the much needed boost to improve your post Orthotics billing process and rely better on developing processes to improve on your rate of denials and accounts receivable collections.
To conclude, a dedicated team handling all your Orthotics billing challenges will immediately understand what it takes to improve on financial viability by working as a reliable operational arm. It helps in reducing operational costs immediately and also eliminate proven pain areas in your RCM requirements.