Medical Billing & Coding Services for New Jersey Providers
Medical Billing in New Jersey for Providers & Practices
Our medical billing & coding services are provided to practicing providers and groups in New Jersey by utilizing the latest in information transfer technology!
The medical billing company you choose to handle your medical billing and management functions should be experts at what they do, and more importantly, experts at increasing provider revenue… not just a company that is close to your practice in New Jersey, but someone who genuinely cares about you, your revenue and your practice.
With successful and satisfied clients all over the United States… the medical billing company that most successful New Jersey Providers choose is Outsource Management Group, LLC.
New Jersey’s Medicare Part B Carrier is Novitas, formerly Highmark Medicare Services, Inc. There is a plethora of information located within the Novitas website. A provider or provider’s staff can find some valuable information on how to correctly code and bill practically anything navigating through the website.
A very valuable tool on the New Jersey Novitas website is the link to Evaluation and Management Services E/M: Complying with Documentation Requirements. The fact sheet describes common comprehensive Error Rate Testing (CERT) Program errors related to Evaluation and Management (E/M) services and provides information on the documentation needed to support a claim submitted to Medicare for E/M services.
The Centers for Medicare and Medicaid Services (CMS) developed the CERT Program to produce a National Medicare-Fee-For-Service (FFS) error rate, as required, by the Improper Payments Information Act. CERT randomly selects a small sample of Medicare FFS claims and reviews those claims and medical records from providers/suppliers who submitted them for compliance with Medicare coverage, coding and billing rules.
In order to accurately measure the performance of the Medicare claims processing contractors and to gain insight into the causes of errors, CMS calculates both a National Medicare FFS paid claims error rate and a provider compliance error rate. The results of the reviews are published in an annual report and semi-annual updates. CMS strives to eliminate improper payments in the Medicare Program to maintain the Medicare trust funds and protect patients.
E/M services are grouped into several different categories and subcategories of services based on the setting as an example, hospital or physicians office, and type of service, initial or a subsequent care visit. Within each category or subcategory, there are three to five levels of services that are specific to the category or subcategory of service. From April 2009 to May 2010 E/M professional services accounted for an estimated $28 billion in Part B payments on a national level. Based on the most recent data from the CERT Program, 8.4% of those E/M payments were identified as being billing at the wrong code level-either too high or too low.
The components of an E/M Service are broken into three key components. The first is history, the second is the examination and the third is the medical decision making. There are also three contributory components which are the nature of the presenting problem, counseling and coordination of care. Finally – Time. Time may be the primary component used to determine the level of service if more than 50% of the E/M encounter includes counseling and or coordination of care. In these cases, the time must be clearly documented; as well as more than 50% of the time was spent in counseling/coordination of care and a brief summary of counseling and/or coordination of care provided.
New Jersey’s Novitas is a great resource for finding correct coding methods for billing and what the expectations are in billing those certain levels.
Partner with the leading medical billing firm & increase your revenue now!
By utilizing our medical billing for New Jersey physicians you are taking the first step to increasing your revenue. As your business partner, we become a seamless part of the daily function and overall financial health of your practice. We take great pride in continually verifying that our New Jersey providers are being reimbursed for everything they deserve. Contact us today if you’re working long, hard hours and tired of needing more revenue. We will become your partner and guide you to a better bottom line!
