Are You Missing TCM Revenue After Hospital Discharges? A Primary Care Billing Guide

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A patient is discharged from the hospital, returns to the primary care practice, and the care team spends time reviewing the discharge summary, reconciling medications, coordinating follow-up, answering questions, and managing the next steps. Then the practice bills a regular office visit. That is where some primary care practices may be leaving legitimate TCM revenue unrecognized. Transitional Care Management (TCM) is designed to account for the work involved in managing a patient's transition from an inpatient setting back to the community. Medicare's TCM framework includes communication after discharge, medication reconciliation and management, care coordination, and a required face-to-face visit. For practices handling a high number of hospital discharges, the financial issue is not simply whether the practice knows about CPT 99495 and 99496. The bigger issue is whether the practice has a reliable process for identifying eligible patients, completing the required steps on t...
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Does Outsourcing Hospitalist Billing Sound Expensive?

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Outsourcing Hospitalist Billing Increases Revenue

By outsourcing hospitalist billing, a team of experts will manage the accounts receivables (AR). Billing experts capture denials and accurately report the EoB (explanation of benefits) information, resulting in a considerable drop in the processing time. In the case of an in-house billing system, the claims would have to wait if the biller goes on a holiday or falls sick. Outsourcing billing services take care of such situations and ensures a steady flow of claim submissions.

Accurate and Timely Submissions

Professional billing service providers submit accurate medical bills and file claims on time. This results in an increase in the number of medical reimbursements. With expert billers, there would be minimal coding errors, which ultimately lead to reduced claims denials.

Outsourced billers keep track of the progress of denials and help streamline them and the claims appeal too. They categorize payers as per the respective time frame for denial appeals and then prioritize the appeals process. This helps in maximizing reimbursements.

Keep Abreast with Reforms and Changes

One of the biggest challenges of medical billing is keeping up with the changes in billing regulations and complying with the latest healthcare reforms. Outsourced billers keep themselves up-to-date with the changing regulations and insurance requirements. They keep up with the latest industry regulations, procedures, and annual updates on ICD and CPT codes.

Protects Practice from Upcoding / Unbundling Risks

Outsourcing hospitalist billing ensures that there are no fraudulent activities in practice. It is an important factor because upcoding or unbundling deeply hurts the goodwill of hospitals and deteriorates the relationship with patients.

Reduces Cost and Efforts

Outsourcing hospitalist billing results in a dip in the operating cost of hospitals. They just have to pay for the basic operations and the billing company takes care of the coding and claims filing procedure. They also take care of updating all billing-related software or managing infrastructural maintenance demands. It can change billing expenses from a fixed cost to a variable cost and improves the ability to manage a hospital.

Cost Cutting on Staff Salaries

By outsourcing their billing, hospitals can save thousands of dollars in the form of annual salaries and benefits that an in-house billing team demands. It also means having more room for other purposes, such as patient rooms, which could in turn help increase revenue.

Inexperienced medical billing specialists make errors that can cost money or seriously delay payments. Outsourced billers help save time and money spent on training the in-house staff on various billing updates and revisions in codes. Outsourced hospitalist billing services bring professional efficiency as hospitals don’t have to track the performance of in-house billers.

To know more about Does Outsourcing Hospitalist Billing Sound Expensive?, click here: https://bit.ly/418FZKc Contact us at info@medicalbillersandcoders.com/ 888-357-3226.

Location: United States

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