Medical Billing & Coding Services for Pennsylvania Providers
Medical Billing in Pennsylvania for Providers & Practices
Our medical billing & coding services are provided to practicing providers and groups in Pennsylvania 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 Pennsylvania, 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 Pennsylvania Providers choose is Outsource Management Group, LLC.
Billing in Pennsylvania for Medicare: What Physicians Should Know
Medicare benefits millions of people nationwide. This federal program covers hospital (Part A) or medical (Part B) insurance, and may even include prescription drug (Part D) and a comprehensive package of all three (Part C) through the administration of an approved private company. While fundamentally geared towards providing seniors with better healthcare, the program also covers people under the age of 65 with certain disabilities or end stage renal disease.
While it cannot be denied that the program greatly helps its nearly 50 million enrollees, a lot of physicians nationwide are dubious about accepting Medicare patients. This stems largely from the fact that, in addition to expecting less revenue from beneficiaries, they could very easily be accused of fraud when filing claims for reimbursement. Even when unintentional, federal fraud can result in severe penalties, from the non-payment of claims to criminal liability. Partially for this reason, some physicians limit the number of beneficiaries they see, or even decide to opt out of the program entirely.
As of 2012, the state of Pennsylvania was home to 2,350,558 beneficiaries. This is not a number to sneeze at! It is thus well worth a physician’s time and effort to familiarize themselves with the program and how to file claims for reimbursement.
Medical coding forms a large part of how claims are evaluated. The Centers for Medicare and Medicaid Services (CMS) employ coding to determine how much reimbursement a physician should receive based on the complexity of procedures, how necessary they were for a patient’s well-being, and the time expended on a service, and difficulty of decision-making on the part of the physician.
Guidelines on how to use these codes and their latest versions are available on the CMS website, as well as manuals, forms, and other materials that can guide doctors on their way to making a claim.
While the program is federally run by the CMS, many of the decisions regarding the benefits it covers are made by Local Coverage Determination (LCD). These policies are overseen by local contractors, and can thus vary from state to state. In Pennsylvania, the pertinent contractors are Novitas Solutions, Inc., CGS Administrators, and NHIC Corporation. Physicians may apply to these for more information regarding coding and billing in the area.
Mistakes can be unavoidable, however, even for the most well-informed of doctors. Should errors be discovered in a practice’s coding and billing, they should be reported as soon as possible so as to avoid disruptions and bad publicity. The Department of Health and Human Services Office of the Inspector General has a Self-Disclosure Protocol that allows physicians to voluntarily disclose potential fraud without incurring investigation by the Federal Government and the penalties that come with it.
Partner with the leading medical billing firm & increase your revenue now!
By utilizing our medical billing for Pennsylvania 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 Pennsylvania 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!
