Medical Billing & Coding Services for Virginia Providers
Medical Billing in Virginia for Providers & Practices
Our medical billing & coding services are provided to practicing providers and groups in Virginia 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 Virginia, 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 Virginia Providers choose is Outsource Management Group, LLC.
Medicare: Medical Billing in Virginia, What Providers Should Know.
Medicare is a federal-funded social insurance program that benefits seniors, people below the age of 65 with certain disabilities, and patients with end stage renal disease. It is different from Medicaid, which is for those with limited income and resources, though it is possible to qualify for both programs simultaneously.
This federal program may cover hospital insurance (Part A), medical insurance (Part B), prescription drugs (Part D), or a prearranged combination of all these through advantages plans administered through approved private companies (Part C).
In Virginia in 2012 1,203,462 people, or 14% of the population, were enrolled in the program, and this number is expected to continue to grow. While this insurance is funded at the federal level, state-run programs help qualifying beneficiaries with the rest of their medical expenses through Virginia Medicaid and the Department of Aging.
For providers, there are three Medicare participation options. A provider may be a participating (PAR) or non-participating (non-PAR) provider, or may opt out of the program entirely. PAR providers agree to accept the program’s allowed fee as the maximum payment for their treatment of beneficiaries. As incentives, they receive a rate that is 5% higher than that for non-PAR providers; their names are included in a directory made available to beneficiaries; and their claims are processed faster. Non-PAR providers can charge more than the approved fee, but receive only 95% of the fee participating providers get for treating beneficiaries.
Opting out of the program is a tedious process, but an estimated 23% of Virginia providers did so in 2012, citing revenue loss and inadequate treatment for beneficiaries because of the limited services that the program covers.
The program pays providers for their services based on a standardized fee schedule that is derived from a resource-based relative value scale (RBRVS). The RBRVS is updated yearly and takes into account a provider’s work and expenses while treating a patient, as well as geographical differences in resource costs. A guide to the current scale is available from the American Medical Association.
While the services covered and a provider’s reimbursement for them are decided by the Centers for Medicare and Medicaid Services (CMS), there is no reason for providers to earn less than they should under the system. The key to getting proper reimbursement is correct coding and billing.
The CMS employs a system of numeric and alphanumeric codes to categorize services rendered to beneficiaries and what should be paid for them. Doctors should familiarize themselves with these codes as it is easy to lose money through undercoding or failing to provide the correct documentation when filing a claim. The CMS provides information on coding and other useful manuals and documents on their website.
Partner with the leading medical billing firm & increase your revenue now!
By utilizing our medical billing for Virginia 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 Virginia 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!
