Stop Losing $$$ on Well Woman Exam Claims — CPT Coding Best Practices for Gynecology Practices

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Well-woman exams sound simple. They’re not. Gynecology practices lose thousands every year because payers deny, downcode, or bundle these visits due to coding errors, missing documentation, or confusion between preventive vs. problem-oriented care . If your practice is seeing unpaid or underpaid Well Woman claims, here’s the reality: It’s not the payer. It’s not the patient. It’s your coding workflows—and they’re costing you real money. Below is the no-nonsense breakdown of how to stop revenue leakage immediately. Why Gynecology Practices Keep Losing Money on Well-Woman Exams Most losses happen because of wrong CPT/ICD pairing , incorrect use of preventive codes, and failure to separate problem visits from preventive services. Top revenue killers: 1. Using the wrong preventive CPT code Common mistakes include: Billing 99381–99397  is incorrectly based on age Missing counseling or preventive components that justify higher-level codes Treating a preventive exam...
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Basic Billing Tips for New Medical Practice Start-ups

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You were putting up your own medical practice! This means you have probably done your research on the pros and cons, and are aware of the benefits and risks factors. The crucial question now is how to deal with the one and only daunting task – Medical Billing. To be able to maintain that balancing act of funding your practice and continuing to provide quality patient care, an effective practice management cycle is essential. For a successful Revenue Cycle Optimization, given that each component is interdependent right from eligibility checking, charge coding, and claims reimbursement, to accounts receivable and denial management, the state-of-the-art approach is required. Here are 5 essential billing tips that can help you get started to avoid the pitfalls in your new venture:

Basic Billing Tips for New Medical Practice Start-ups

1. Be informed: Your clinical and administrative staff should be trained to collect all insurance details from the patient before the patient–physician engagement is initiated. This includes the name of the insurance provider and the patient’s policy number.

2. Confirm: Your office staff should always confirm the kind of services that the insurance covers for the patient and what disease or ailment  the insurance coverage is for, thus avoiding later misgivings and the high rate of denial of claim reimbursements that may follow

3. Keep updated: With the economic challenges that the world is facing, and new health plans rolling out every year, rules keep changing. It is necessary that you know the fine print when dealing with insurance-covered patients so that claim reimbursements are high and the process of denial management is kept at abeyance

4. Automate: What most physicians have now realized is that automation of the Medical billing cycle is the key to transforming the physician revenue cycle, increasing efficiency, and decreasing claim denials. When you automate, denied claims can be easily routed through to the specialists, thus decreasing the wait time and increasing claim reimbursements much quicker than via the manual route of back and forth, causing unnecessary burdens on your staff.

5. Partner: The real key to building a successful revenue organization is Outsourcing. When you outsource your medical billing services via practice management vendors who can double up as clearing house vendors, the physician can concentrate on the core challenge- quality patient care, rather than on the cumbersome administrative process for medical billing. The reason is simple, the vendors can handle changes in software updates more easily, are updated about the intricacies involved in various kinds of insurance coverage, can verify details much more easily through their networks, are more aware of financial policies, insurance policies, compliance requirements, coding standards, and billing technology and can immediately fix the errors, thereby decreasing the waiting time for claim reimbursements.

To learn more about the Basic Billing Tips for New Medical Practice Start-ups, click here: https://bit.ly/3RqPkMe, Contact us at info@medicalbillersandcoders.com/ 888-357-3226.

Location: United States

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