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Specialized Billing Solutions for Geriatrics Practices
< 30
Days in AR
10-15%
Revenue Increase
97%
First Pass Ratio
96%
Collection Ratios
98%
Clean Claims Rate
Geriatrics Billing Services We Offer
Every 1 in 6 people in the USA is above the age of 65 and eligible for geriatric care services. Geriatrics is the branch of medicine that focuses on diagnosing, treating, and managing the unique healthcare needs of senior citizens. It ranges from administering preventive care to managing cognitive impairments and treating chronic conditions like arthritis. Unfortunately, the broad scope of geriatric care complicates its billing as several services must first be checked and marked ‘billable’, then accurately coded, well documented, and finally translated to claims for reimbursement.
At MediBillMD, we help geriatricians avoid all this hassle and more through our professional geriatrics billing services. Designed to streamline the geriatric billing process and optimize revenue cycles, our solutions work in tandem with your existing practice management software, improving claim accuracy, reducing denials, and accelerating reimbursement turnaround times.
Common Geriatrics Medical Billing Challenges
If you think looking after the elderly is demanding, wait till you reach the billing stage. Like all other medical specialties, geriatrics billing comes with its own set of challenges. Whether it is the initial step of patient eligibility and benefits verification, the process of claim submission, or the last step of payment collection, each phase can be overwhelming if you don’t adopt billing best practices.
But how can you overcome the common challenges in geriatric medical billing if you don’t know what they are and what causes them? That is why they say knowing the problem is half the solution. Understand the challenges your geriatrics practice is struggling with and navigate them effectively.
High Claims Volume
The USA’s aging population has increased the demand for geriatric services. On any given day, geriatricians meet and treat dozens of older patients, resulting in a high claims volume. However, due to staff shortages, the claims are either not processed on time or are rushed through, leading to erroneous claim submissions.
Complex Coding Requirements
In geriatrics billing, coding is extremely nuanced. Older adults suffer from a wide variety of chronic conditions, which include physical, psychological, and functional decline, making coding a complicated process. From thousands of ICD-10, CPT, and HCPCS codes, coders must choose the most appropriate one for accurate diagnosis and treatment.
Low Reimbursement Rates
The government’s budget cuts have affected the reimbursement rates for geriatric services. Each passing year, Medicare negotiates the lowest possible rates. Moreover, providers must prove the medical necessity of various products and services rendered to older patients to avoid claim denials and collect what little they can for their efforts.
Different Plans & Coverage Issues
Medicare Part A, Part B, Medicaid, and commercial health insurance plans all cover elderly care to some extent. However, the exact geriatrics services covered by each plan vary across plans and payers. This makes it challenging and time-consuming for providers to verify a patient’s coverage and render timely geriatric care.
Benefits of Outsourcing Geriatrics Billing
Affordable services, compliant solutions, proven results, focused approaches, do you want it all? Then, consider outsourcing geriatrics billing to MediBillMD. With a team of expert medical billers, certified professional coders, and revenue cycle managers, we are resolved to streamline your geriatric billing workflow and maximize your cash inflow. Our strategy involves combining human expertise and technological capabilities to clear your claims backlog, solve payment disputes, and set up efficient practice management systems for your geriatric practice’s sustainable growth.
Outsource geriatrics billing to MediBillMD today and enjoy a 98% clean claim rate, 96% collection ratio, and up to 15% revenue boost. Our ISO 9001-certified quality and HIPAA-compliant data security prove our commitment to providing exceptional geriatrics billing services.
Our 98% clean claim rate lets you submit with confidence. At MediBillMD, we have a proven track record of filing error-free medical insurance claims. We use claim scrubbing tools to detect errors and human quality checkers to verify and fix them before sending claims to insurance payers.
We firmly believe the U.S. healthcare system stands upon 3 Ps - Providers, Patients, and Payers. Our job is to act as a bridge between them. The MediBillMD team maintains effective and transparent communication with all three stakeholders to prevent and resolve payment disputes before they impact geriatric care delivery.
Our cloud-based systems are designed to safely and meticulously store limitless records and information so you can prove the medical necessity of each service you render to your elderly patients. We also follow strict protocols for data security to protect sensitive health information from people with malicious intent.
We ensure you get back every dollar you deserve by deploying our denial management team to your account. Whether it is patient collections or insurance claim rejections, we defend your right to be paid with our effective payment reconciliation techniques. From rework to resubmissions and appeals to follow-up, we handle everything.
Offering geriatrics billing excellence across the country with local expertise! Our results-driven geriatrics billing solutions are available in all 50 states of the USA. From care workers serving rural communities in Arizona to senior living facilities in the metros of Alaska, our services empower geriatrics practices in every zip code. We have mastered state-specific medical billing so that you can be the master of exceptional elderly care.
Overcome Geriatrics Billing Challenges with MediBillMD
Encountering hurdles during geriatrics medical billing is inevitable. From coverage issues to coding confusion and low reimbursement rates to high claim denials, a series of challenges can disrupt your billing workflow and put a spanner in your revenue cycle. However, with MediBillMD’s advanced geriatrics billing services, you can skip over the pitfalls that make your journey toward financial success a hellish path to walk on.
| Common Geriatrics Billing Challenges | MediBillMD Solution | |
|---|---|---|
| Nuanced Coding for a Variety of Chronic Conditions and Cognitive Impairments | Our team of trained and AAPC-certified coders is well-versed in the complex coding requirements for geriatric services. They use accurate ICD-10 and CPT/HCPCS combinations for various conditions and their treatments. . | |
| Geriatric Care is Provided Across Multiple Facilities and Settings (For example, the geriatrics billing requirements for a home care provider are different from the rules an assisted living facility must follow for reimbursements) |
Our team is proficient in tailoring processes case by case. They know the unique billing requirements for each place of service (POS) and ensure that claims comply with each payer’s guidelines. | |
| Limitations on the Frequency of Geriatrics Services (For example, the number of times telehealth and subsequent services can be provided to older adults) |
Our geriatrics billing team thoroughly studies each plan's benefits, limitations, and exclusions during coverage verification to avoid overbilling and resulting claim denials. We file claims in line with payer policies. | |
| Medicare’s Bundled and Reduced Payments for Geriatrics Services (For example, the Advanced Primary Care Management program that combines multiple services under one stacked payment) |
We follow Medicare’s specific rules for bundled geriatrics services, such as combined PCM, TCM, and CCM under the APCM program, to avoid coding and billing mistakes that lead to denied claims. | |
| Detailed Documentation Requirements to Prove the Medical Necessity of Services | At MediBillMD, our team maintains and submits complete and accurate documentation, such as lab reports, clinical notes, and referral letters, to prove the medical necessity of geriatrics services. | |
| Coding, Billing, and Documenting Combination Care for the Elderly (for example, geriatricians must work with other healthcare specialists to ensure their patients are physically, psychologically, functionally, and socially stable) |
We understand that geriatric care spans multiple specialties to ensure the elderly patient’s holistic well-being. We, too, maintain cross-team communication to code, bill, and document geriatrics services accurately. | |
Lowest Prices Guaranteed
Get unmatched quality at unmatched rates! Our geriatrics medical billing services cost a small percentage of your net monthly collections, ensuring you get the greatest returns on your investment. Contact us for a free quote.
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Geriatrics Billing Specialist
Explore your choices, and know your options. Book a free consultation and speak to our geriatrics billing specialists to make an informed decision for the financial well-being of your practice.
FAQs
MediBillMD understands the complex and ever-evolving healthcare landscape. We keep an eye on the changing regulations, varying reimbursement rates, and updated policies/guidelines to offer tailored geriatrics billing solutions.
Our services are designed to tackle unique billing challenges. We employ a diverse team of certified coders and revenue cycle managers who use their skills and expertise to deliver real results, increasing collection rates up to 96%.
We only charge a fraction of your net monthly collections for our geriatrics medical billing services. Our rates vary depending on the size of your practice, workload, and the level of service acquired.
Adhering to the Medicare rules for geriatric medical billing can put even the most seasoned healthcare providers in a tough spot. Medicare frequently changes its policies on elderly care, and these updates are reflected in medical coding, billing, claim filing, and even denial management.
