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Ensuring Compliance and Revenue Growth through Specialized Ophthalmology Billing!
Streamline your billing process get paid accurately and on time with our reliable home health care medical billing services.
Ensuring Compliance and Revenue Growth through Specialized Ophthalmology Billing.
Are you tired of dealing with the complexities of medical billing for your ophthalmology practice? Look no further! Our professional team specializes in providing comprehensive medical billing services tailored specifically for ophthalmology practices. With our expertise and industry knowledge, we can streamline your billing processes, maximize revenue, and ensure compliance with ever-changing regulations.
Opthalmology Medical Billing Services:
- Registration of patients.
- Insurance verification and patient eligibility check.
- Patient encounter.
- Prepare Medical Claims.
- Medical Coding Compliance.
- Claim Scrubbing and Submission.
- Payer Adjudication.
- Patient Statements.
- Follow ups.
- Payment Postings.
- Reporting and Insights.
- Accounts receivable management
- Denial management and appeals
Home Health Billing vs Hospice Billing
Home health care billing and hospice billing are both important aspects of healthcare billing, but they differ in several ways. Here are some key differences between home health care billing and hospice billing:
Services offered: Home health care billing typically covers services such as skilled nursing, physical therapy, occupational therapy, speech therapy, and medical social work, among others. Hospice billing, on the other hand, covers end-of-life care, palliative care, and support services for patients and their families.
Length of care: Home health care services can last for several weeks or months, depending on the patient’s needs. Hospice care, however, is designed to provide care for patients who have a limited life expectancy, usually six months or less.
Medicare coverage: Both home health care and hospice care are covered by Medicare, but there are some differences in the coverage criteria. For home health care, the patient must be homebound and require skilled care, whereas for hospice care, the patient must have a terminal illness and a life expectancy of six months or less.
Billing codes: Home health care billing and hospice billing also use different billing codes. Home health care billing uses codes such as Current Procedural Terminology (CPT) codes and Healthcare Common Procedure Coding System (HCPCS) codes, whereas hospice billing uses codes such as the Hospice Medicare Benefit Codes.
Reimbursement rates: The reimbursement rates for home health care and hospice care also differ. Home health care services are typically reimbursed at a higher rate than hospice care services.
While both home health care billing and hospice billing are important aspects of healthcare billing, they differ in terms of the services offered, length of care, Medicare coverage, billing codes, and reimbursement rates.
Guide to CPT & HCPCS Codes
CPT Code: 99500-99600 – Home Visit Services
CPT Code 99501: A home health provider, such as a registered nurse, visits a patient and her newborn at home to review plans of care and provide additional resources to the patient.
CPT Code 99502: A home health provider, such as a registered nurse, visits a patient and her newborn at home to evaluate the newborn and provide newborn care education to the patient.
CPT Code 99503: A licensed respiratory therapist or other nonphysician provider provides respiratory therapy in the patient’s home.
CPT Code 99505: The provider makes a home visit to a patient with a stoma, an artificial opening in the abdomen for the passage of stool or urine.
CPT Code 99511: The provider visits a patient at home to manage treatment for and remove the patient’s fecal impaction.
CPT Code 99512: The provider visits the patient at home to provide hemodialysis, which removes waste from the blood in a patient with kidney failure.
CPT Code 99600: Use this CPT code to report a home visit service or procedure that does not have a specific code.
CPT Code: 99601-99602 – Home Infusion Procedures and Services
CPT Code 99601: The provider visits the patient at home to provide an infusion or administer a specialty drug. Use this code for up to the first two hours of a visit.
CPT Code 99602: The provider visits the patient at home to provide an infusion or administer a specialty drug. Use this code for each additional hour of the visit after the first two hours.
HCPCS Codes for Home Health Services:
The HCPCS codes range Home Health Services is T1019-T1022. It is a standardized code set necessary for Medicare and other health insurance providers to provide healthcare claims.
T1019-T1022 Home Health Services
T1019: Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, ICF/MR, or IMD, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant)
T1020: Personal care services, per diem, not for an inpatient or resident of a hospital, nursing facility, ICF/MR, or IMD, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant)
T1021: Home health aide or certified nurse assistant, per visit
T1022: Contracted home health agency services, all services provided under contract, per day
Other HCPCS codes for Home Health:
S9122: HCPCS Code for Home health aide or certified nurse assistant, providing care in the home; per hour
Home Health Care Billing Guidelines
Home health care billing guidelines can vary depending on the specific insurance plans and regulations in your area, but here are some general guidelines that may be helpful:
Verify patient eligibility and coverage: Before providing any home health care services, it is important to verify the patient’s eligibility and coverage under their insurance plan. This may involve contacting the insurance company directly to confirm coverage and obtain any necessary authorizations.
Obtain all necessary documentation: Home health care billing requires accurate and complete documentation of all services provided. This may include physician orders, patient assessments, care plans, progress notes, and other relevant documentation.
Code services correctly: Home health care services must be coded accurately in order to ensure proper reimbursement. The coding system used for home health care billing is the Healthcare Common Procedure Coding System (HCPCS), which includes codes for various services and supplies.
Follow billing requirements: Each insurance plan may have specific billing requirements, such as the use of certain forms or submission of claims within a certain timeframe. It is important to understand and follow these requirements to ensure timely and accurate payment.
Monitor reimbursement and address any issues: Keep track of payments received and monitor reimbursement rates to ensure that you are being properly reimbursed for services provided. If there are any issues or discrepancies, address them promptly with the insurance company.
Stay up-to-date on regulations: Home health care billing regulations can change over time, so it is important to stay up-to-date on any changes or updates to ensure compliance with current regulations.
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Frustrated with decreased revenue, staffing issues, and technology costs?
At Everest A/R Management, we offer a full range of medical billing and coding services. We understand that all medical offices and practices are not the same. We work with our clients to design a customized solution that not only meets your needs, but exceeds them. We optimize customer service and efficiency to build a seamless process. Let us focus on the billing, A/R, and administrative challenges while you focus on patient care and clinical quality.
Do you have a backlog of aged insurance claims?
Are you contemplating a system conversion and are concerned about the old A/R? Perhaps you’ve realized your staff just doesn’t have the time to work the aged claims due to the volume. Maybe you want to wipe the slate clean and start fresh whatever your reasons for considering a clean-up project, Everest can relieve you of your burden.
With our extensive background in patient financial services, we can help guide your staff and internal processes to be more efficient and effective.
This translates to higher revenue for your organization.
Anticipating a staff member’s leave of absence? Has one of your staff been in an accident?
Don’t allow your business process to get bogged down because of a staff shortage! Because of our background in administration, hiring quality employees is quite familiar to us.
Let us help you sail smoothly through your personnel shortage!
Our clients are at the heart of our organization. Extraordinary services for extraordinary clients.
Specialty Billing Services Florida
Our medical billing services in Florida can help you increase your revenue by reducing the number of denied and unpaid claims. Our billers in major cities like Gainesville, Jacksonville, Miami, Tampa, St. Petersburg and Orlando can provide you with less paperwork and more accurate medical claims to improve the efficiency of your practice.
Specialization
- Family Practice
- Internal Medicine
- Nephrology
- Oncology
- Physical Therapy
- Radiology
- Mental & Behavioral Health
- Urgent Care
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