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Specialized Billing Solutions for Hematology Practices
< 30
Days in AR
10-15%
Revenue Increase
97%
First Pass Ratio
96%
Collection Ratios
98%
Clean Claims Rate
Hematology Billing Services We Offer
Hematology is one of the most complicated yet rewarding medical specialties in the vast and dynamic healthcare landscape. The study focuses on blood-related diseases and disorders. However, the complexity of hematology services and procedures is not limited to the crossovers with other disciplines. Be it a bone marrow transplant, a leukemia treatment, or a blood transfusion, each procedure on its own is multi-step and requires precise documentation and coding. A single misstep can trigger denials, bringing your entire revenue cycle to a standstill.
Outsourcing hematology billing services to professionals like MediBillMD safeguards your practice from revenue loss. You can cherry-pick the solutions based on your needs and spending capacity to secure specialty-specific knowledge and efficient finance management at a percentage of your net collections.
Common Hematology Medical Billing & Coding Challenges
You are proficient at removing blockages in the patient’s bloodstream, but what about the blockages in your income stream? Like other medical specialties, hematology, too, is plagued by several billing challenges. Errors and oversights like inaccurate coding, missing documentation, a lack of coverage verification, and untimely claim submission can result in denials, causing an adverse impact on the revenue cycle.
Being aware of the complications that are likely to arise during hematology billing is the first step toward successful mitigation. Understand the factors that most frequently disrupt the billing workflows of hematology practices across the country to prepare counter strategies and sustain your revenue growth.
Complicated Coding Requirements
Coding requirements for government and commercial insurance payers often vary across states. Moreover, these rules and guidelines are regularly revised to keep up with the innovations and developments in the healthcare space. Hematology practices may have a hard time complying with the frequent policy changes, such as separate vs panel coding.
Shortage of Expert Billers & Coders
The industry-wide shortage of experienced and skilled medical billers and coders amplifies when we zoom in on hematology billing. Due to the complexity of hematology treatment procedures, strict payer requirements, and a high denial rate, only a few choose to specialize in hematology medical billing, making their availability almost nil.
Concurrent Diagnoses & Treatments
Quite often, blood disorders and diseases develop or occur concurrently with another medical condition. For example, hematopoietic dysplasia (a disorder of the marrow stem cells) develops into leukemia, thereby requiring the involvement of a hematologist as well as an oncologist. Billing these overlapping diagnoses and treatments can create confusion.
Specialized Procedures & Services
The field of hematology is ever-evolving. This has led to the development of specialized and costly tests, treatments, and supplies. So, when the claims are denied for these products or services, either due to coverage issues, coding errors, or documentation discrepancies, hematology labs and centers lose a large chunk of their income.
Benefits of Outsourcing Hematology Billing
Handling hematology medical billing in-house can be a hassle, especially when you have to spend thousands of dollars upfront to set up a space, purchase the right tools and software, and hire coding and billing experts. Even with the right resources, there is no guarantee that your in-house billing team will be able to navigate all the challenges associated with billing specialized hematology services and procedures.
But when you outsource hematology medical billing services to us at MediBillMD, you get the promise of clean and accurate claim submission, reduced AR days, improved collection ratios, and a significant revenue boost. By combining human expertise and technological capabilities, we deliver hematology billing excellence at one-third of the cost of in-house billing.
Unlock years of industry experience and coding and billing expertise with MediBillMD. We only hire, train, and retain top talent to ensure coding accuracy and seamless billing for our clients. Our AAPC-certified coders and skilled billers can efficiently handle your practice’s administrative workflow to file clean claims each time.
Leverage cutting-edge tools and software like integrated EHRs and EMRs to improve billing efficiency. At MediBillMD, we use advanced technology to automate repetitive tasks, create backups, and ensure data security. Our premium tech infrastructure is designed to streamline the hematology billing processes so that every claim is filed on time.
Assure industry compliance and high quality with MediBillMD’s carefully created systems and processes. We adhere to federal and state laws and vigilantly stay updated with revisions in rules and regulations to prevent non-compliance. Moreover, we perform quality checks at every step of the process to meet ISO 9001 quality standards.
Access round-the-clock dedicated support for all your hematology billing-related questions and queries. Our communication lines are open 24/7 to help our clients with their billing emergencies. Moreover, a project manager is assigned to each client who monitors KPIs and implements strategies to improve the practice’s financial performance.
Pan-national hematology medical billing is made easy with MediBillMD! Our unparalleled hematology billing services are available to practices of all sizes in all 50 states of the USA. Whether you own a private hematology lab on the outskirts of Orlando or work at a large hematology center in Buffalo, we have got you covered. With our expertise and technological capabilities, you are on your way to financial success.
Overcome Hematology Billing Challenges with MediBillMD
Challenges in hematology medical billing are inevitable. From coding errors to insufficient documentation, numerous pitfalls can derail the hematology billing workflow and increase the chances of claim denials. Thankfully, at MediBillMD, we employ a systematic approach to patient data collection, insurance verification, and claim creation and submission, proactively preventing payment delays and denials. Explore our customized hematology billing solutions for unique billing challenges experienced at hematology practices nationwide.
| Common Hematology Billing Challenges | MediBillMD Solution | |
|---|---|---|
| Not Using NCCI Edits when Reporting Certain Combinations of Hematology Codes | Our team is well-versed in the Medicare National Correct Coding Initiative (NCCI). They apply the NCCI edits to hematology codes to ensure correct coding and prevent improper payments. | |
| Failing to Prove the Medical Necessity of the Service or Procedure (for example, blood transfusion for leukemia) |
We maintain complete and accurate documentation, including medical history, test reports, clinical notes, and referral letters, to prove the medical necessity of the rendered service or product. | |
| Diagnostic (ICD-10-CM) and Procedural Code (CPT) Mismatch | Our AAPC-certified coders are experts in all standardized medical systems and keep up-to-date with the changing guidelines to prevent coding errors and discrepancies like diagnostic and procedural code mismatches. | |
| Not Using a Single Panel Code for Panel Testing (for example, separately billing all the tests instead of reporting a bundled CBC panel test) |
Most hematology medical claims are rejected because of coding errors. At MediBillMD, we ensure coding accuracy for bundled and unbundled procedures to mitigate claim denials. | |
| Not Appending the Appropriate Modifiers when Needed (for example, modifier XE to denote that the service was rendered in a separate encounter) |
Our team is well-versed in the use of medical modifiers and understands the difference between its overuse, underuse, and correct use. They append it as per the need to submit a clean claim. | |
| Billing High-Ticket Items (like Specialized Tests) that May Not Be Covered by the Payer | Our hematology medical billing team ensures that prior authorizations are obtained from the insurance payer for specialized tests, like genetic blood disorder panels, to confirm their coverage. | |
Lowest Prices Guaranteed
Take the biggest cut home, every time, with MediBillMD’s affordable and customized hematology billing solutions. Outsource hematology billing to our expert team for a small percentage of your net monthly collections and watch your revenue increase effortlessly.
Schedule a Consultation with a
Hematology Billing Specialist
Are you wondering if outsourcing hematology billing is the right move for your practice? Don’t worry. Book a free consultation with our hematology billing specialist and get all the answers to your questions and queries.
FAQs
MediBillMD is the best choice for hematology billing services because we have a separate team for different processes, such as coding and denial management. Our coding experts can accurately code every hematology procedure, including blood transfusions and tests. Moreover, we take a proactive approach to avoid claim denials, including verifying patients’ insurance coverage and obtaining pre-authorizations.
It is quite affordable to outsource hematology billing services to MediBillMD. You only have to pay a small percentage of your total monthly reimbursements to us, which is an insignificant amount compared to in-house billing costs.
Coding and documentation are the biggest hurdles in hematology medical billing. Hematology includes complex treatment procedures for managing a variety of blood disorders, each with specific coding requirements.
Moreover, annual coding revisions add to the difficulty. As a result, it is quite challenging to accurately code different procedures while maintaining proper documentation to justify their medical necessity.
Billing port-related procedures can be challenging and may require special attention. Here is how you can effectively bill port issues:
- Identify the port issue and its solution (e.g., venipuncture, port flush/irrigation, PICC access, or port de-clotting).
- Verify insurance coverage and obtain prior approval if necessary.
- Use the correct CPT or HCPCS code for the appropriate port-related procedure.
- Maintain proper documentation.
- Submit the accurate claim to an appropriate insurance company.
