Medical billing is a highly complex area that requires extensive knowledge and experience, especially when dealing with infusion billing. As the infusion billing domain is a maze of intricate guidelines, complicated coding, and constantly changing regulations, making it confusing for more than 84% of infusion providers in the healthcare industry. Furthermore, underpayment tracking, preauthorization requests, interpretation, and complicated patient billing add to the complexity of infusion billing even more.
Understanding the infusion Billing and coding Requirements
- Billing requirements for infusion and injection services depend on whether they are reported by a physician/Qualified Healthcare Practitioner (QHP) or a facility.
- Physicians and QHPs should not report these services in the facility setting; instead, they should select the most appropriate Evaluation and Management (E/M) service.
- When an E/M service is performed in conjunction with an infusion or injection service, modifier -25 must be appended to the E/M service. This indicates that the service was significant and separately identifiable.
- For facilities and physicians/QHPs, only one initial service code may be reported unless two separate intravenous (IV) sites must be utilized due to protocol requirements or patient conditions. The additional time and effort required for the second IV site access can be reported using the initial service code with an appropriate modifier.
- Furthermore, in infusion coding, – the Current Procedural Terminology (CPT) guidelines provide detailed direction for the proper coding of Intravenous Injections and Infusions Providers are obliged to adhere to these guidelines when coding infusions and injections.
Though navigating this maze is quite difficult but with the right operational support ensuring careful scrutinization – it can prevent revenue leakage while enhance the financial health of your practice.
The Role of Operational Expert in managing your infusion Billing Services
Sunknowledge Services an operational expert helping many leading names in the industry possesses deep expertise in infusion billing that can generate significant value for your medical practice.
Taking care of all your data management, authorization, submission of timely and cleaner claims and collection of payments from insurance companies and patients, Sunknowledge offers a comprehensive RCM solution at a cost effective rate. Working on ineffective coding and collection tactics which often leave over 20% of a facility’s collectible revenue unclaimed, Sunknowledge with constant follow up and the right checks and balances ensure a 97 % collection rate and an accuracy of 99.9%.
Leaving no money on the table, the Sunknowledge expert in fact helps navigate these challenges further save 80% of your operational expenses.
So if you are looking for a solution to overcome the challenges of infusion billing and coding, consider partnering with medical billing companies like Sunknowledge Services Inc that possess a deep understanding of infusion billing for better consequences.
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