New York Family Practice Billing: Capture Transitional Care Management Revenue in the 30-Day Window

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Family practices in New York are missing significant Transitional Care Management (TCM) revenue because services are not properly documented, tracked, or billed within the required 30-day window. When workflows are not aligned with TCM guidelines, eligible services go unbilled or are denied, resulting in preventable revenue loss. Transitional Care Management is designed to reimburse providers for coordinating care after a patient is discharged from a hospital or facility. While the opportunity is substantial, execution is where most practices fail. This is why many providers rely on specialized primary care billing services and medical billing services in New York to ensure compliance and maximize reimbursement. Why the 30-Day TCM Window Matters TCM billing is strictly tied to 30 days following patient discharge. To qualify for reimbursement, providers must meet specific requirements, including timely patient contact and follow-up visits. The first interaction must occur within...
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Enhance Pathology Revenue with a Smooth Billing Process

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The constant change in the healthcare industry has impacted timely reimbursement for medical practices over the past few years. Pathology Medicare and Medicaid have gone on a reduction spree as far as physician reimbursements are concerned. Most third-party payers like Cigna and Aetna are keener on signing up contracts with physicians that focus on fee-for-service, where the reimbursement is less than 100% more often than not.

Here are a few ways to enhance revenues and have a perfect billing process in place.

Be Familiar with your LCDs

Pathology billing companies need to be familiar with Local Coverage Determinations (LCDs) and know the ins and outs of how they are related to various specialties and other frequently billed services. LCDs give a crystal clear picture of the instances when some procedures are covered by Pathology Medicare. They will also indicate the specific circumstances under which a procedure is considered appropriate and absolutely necessary. One can also find details on coding guidelines that facilitate reimbursement faster and without any hitches. 

Be thorough with your Electronic submission reports

Submission reports can come in very handy for a Pathology Billing Services provider while verifying various claims that are submitted. They can easily track the claims received by the payers. The reports also help keep track of the rejected claims and know about the reasons why they were rejected. Pathology billing companies can intensely review such reports to ward off probable denials, make necessary corrections and resubmit the claims immediately. Claims that did not reach the payers can also be investigated and scanned for errors, which can be corrected before resubmission.

To know more about our Pathology Billing Process click here: https://bit.ly/3V9TBDf Contact us at info@medicalbillersandcoders.com/ 888-357-3226.

Location: United States

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