Medical Billing & Coding Services for Rhode Island Providers
Medical Billing in Rhode Island for Providers & Practices
Our medical billing & coding services are provided to practicing providers and groups in Rhode Island 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 Rhode Island, 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 Rhode Island Providers choose is Outsource Management Group, LLC.
Medical Billing in Rhode Island: What Providers Should Know About Medicare
For the 188,502 Medicare beneficiaries in Rhode Island, finding a good provider who will take their insurance is an important issue. For providers, however, deciding whether or not to take beneficiaries is almost as much of a problem.
The simple fact is that doctors know they will earn less from Medicare patients. Even those who register as participating physicians can only receive the payment approved by the program – an amount which can be much less than what a doctor would actually charge. Also, the program only covers 80% of the said approved fee: if the patient can’t afford the remaining amount and has no secondary insurance to cover the difference, a doctor must “write-off” or count the money as lost. It does not help that there is a constant threat to cut the budget for physician’s fees.
It actually isn’t that bleak a picture, however. Providers can and should receive adequate compensation from the Centers for Medicare and Medicaid Services (CMS). The key to this often lies in correct medical billing and coding.
In processing claims for reimbursement, the CMS employs a coding system to help classify the different services rendered to beneficiaries. This allows them to evaluate whether procedures were actually necessary and reasonable (and thus counted as benefits), and to decide how much a doctor should receive for administering them. To keep up with current medical trends, the codes are updated every year. The latest version can be found on the CMS website, and becoming familiar its proper use can save a physician up to thousands of dollars a year.
While the program is a federal one, certain decisions regarding what constitutes a benefit are made through Local Coverage Determinations (LCDs). These are policies made by local CMS contractors, which may be contacted by physicians who want to learn how exactly the program works in their area. In Rhode Island, these are the National Heritage Insurance Company (NHIC, Corp.) and the Wisconsin Physicians Service Insurance Corporation.
Physicians should also be aware of incurring accusations of fraud. The CMS has had its share of doctors trying to take advantage of the system, and crackdown on claims deemed to be fraudulent can be harsh and exacting, even if the offense committed was entirely accidental. Activities considered as fraud include billing for unnecessary, negligible, or unperformed services; referrals to service providers in which the physician has a vested interest; and the prescription of drugs or medical devices in return for favors from their distributors.
The Department of Health and Human Services has published guidelines to help doctors and other healthcare providers avoid potentially fraudulent practices. This is available online. There is also a protocol for self-disclosure for doctors who discover evidence of fraud.
Partner with the leading medical billing firm & increase your revenue now!
By utilizing our medical billing for Rhode Island 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 Rhode Island 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!
