Pain Management Billing
Pain management encompasses a range of services to alleviate and manage chronic or acute pain and covers various aspects of comprehensive assessment, medication management, interventional pain procedures and more. Added to this complexity, the challenges of medical coding and billing significantly impact financial health, especially due to numerous regulations and restrictions imposed by payers. Pain management involves a wide range of procedures, interventions, and medications, each requiring specific coding.
We, at RCM Workshop, understand the challenges of pain management coding and billing, and our dedicated coders and billers specially trained on pain management work in perfect collaboration with you to ensure correct reimbursement and healthy cash flow. Our optimized medical billing process starting from eligibility & benefits verification, prior authorization to accurate coding and quick submission of claims. Our post billing process encompassing denial management and AR follow-up ensures timely payment and reduces denial rates.
Unbeatable Service, Quality & Price
ACCURACY
0
%
TURNAROUND TIME
<
0
Hours
COLLECTION
0
%
PRICE
Starting from $
6
/Hour
Challenges
Challenges in Pain Management Billing
In addition to issues pertaining to billing operations, challenges in documentation & coding for pain management are key factors of lower reimbursement. Documentation of medical necessity with coding that correlates with multiple components of the patient’s medical record, operative report, and billing statement is extremely important.
Because of the complexity of treatment, assignment of most specific ICD-10 codes that accurately represent the patient’s diagnosis, use of appropriate CPT codes for pain management procedures performed and proper use of modifiers as necessary to provide additional information or indicate specific circumstances are essential to avoid underpayment or denials. All codes used must be supported by medical necessity documents.
Limits on number of procedures, exclusion for some alternative therapies, restriction on certain drug combinations along with frequent changes of billing regulations for pain management are some of the factors that hinder appropriate reimbursement.
OUR PROCESS
Our Pain Management Billing Process Workflow
Our expert coders and billers are fully updated with pain management coding and billing guidelines and payer specific rules to comprehensively address the challenges and ensure swift and accurate payments. Our billing experts work diligently and follow industry standard best practices for revenue cycle management to minimize errors and reduce claim rejection rates, resulting in better turnaround time and higher revenues for your practice.
Our stringent review and audit activities are part of our standard operating procedure to ensure quality and compliance. Our standardized process for denial management and AR follow-up ensures timely payment and eliminates payment delay. Our pre-service workflow ensures clean claim submission and reduces denials significantly. Our metrics driven reporting tool captures and reports every aspect of process performance – productivity, quality and $ collections in a transparent way and gives you full control over your billing process.
Scheduling & Registration
Well coordinated appointment Scheduling, update insurance details and handle inbound outbound calls from/to patients.
Eligibility & Benefits Verification
Confirm patient primary and secondary insurance and benefits coverage and verify the patients’ coverage, co-pays, co-insurance and deductibles
Prior Authorization
Initiate request for prior authorization with the payer, follow-up to check Auth status till closure and finally update the system with Auth approval reference number.
Medical Coding
Check accuracy of codes and modifier according to specialty and assign corresponding and appropriate charges to the codes.
Charge Posting
Audit the claims thoroughly to check for accuracy and edit if necessary and submit claims – both EDI and paper format.
Claims Edit & Submission
Audit the claims thoroughly to check for accuracy and edit if necessary and submit claims – both EDI and paper format.
Payment Posting
Carry out both auto as well as manual posting for payments received and conduct reconciliation against claims.
Denial Management
Analyse and categorize denial claims according to denial codes, $ amount and payers, and resubmit claims after correction.
AR Management
Follow-up with payers to gather status for unpaid claims, and their resolution.
Patient Collection
Sending patient statements and follow-up with patients for final and outstanding payment.
Tailored to your specific needs, you have the flexibility to entrust us with either your entire billing requirements or select any combination of our Urgent Care billing services. Our seamless integration ensures smooth operations without causing any disruption to your billing operations.
BENEFITS
Outcomes Guaranteed
Our industry standard best practices, analytics driven approach and metrics based performance measurement helps us in optimizing revenue cycle process to ensure a superior quality outcome consistently. We deliver you a much-improved financial outcome – maximized revenue, steady cash flow and reduced operational cost.
Efficient benefits verification
>99% clean claim submission
Efficient authorization management
<24 hours turn-around time
Efficient coding & code review
>25% increased reimbursement
Efficient denial management
<5% claims denials
Proactive accounts receivable follow-up
<40 days AR & reduced aging
Better coordination & documentation
improved patient satisfaction
WHY US?
Why partner with us
Our revenue cycle service encompasses all facets of your pain management billing needs, seamlessly integrating into your existing billing infrastructure. By following medical coding and billing best practices and regular update on regulatory guidelines and compliance requirements, our dedicated team provides a superior and improved billing service. We are committed to delivering unparalleled support and productivity, while helping you optimize your revenue cycle. Partner with us today for a superlative outcome and transform your billing process.