5 Major Challenges that A Gynecology Billing Company Helps You Avoid

 

Managing the nuances of medical billing is a challenging affair and your gynecology practice is also not an exception to it. Each step in your billing process must be accurate and performed efficiently to keep your overall revenue foundation robust. Your administrative team should always assign the latest CPT, ICD-10, DRG codes efficiently and adhere to all the payer-specific guidelines. A single mistake in your billing process can lead your practice to face expensive claim denials and compliance issues. Unfortunately, most gynecology practices and hospitals lack a professional team that can stay updated and double-check every claim, thus ending up facing some vital challenges that are mentioned below. 

Know how a professional gynecology billing company helps you avoid the frequent challenges: 

Managing gynecology billing in a hospital environment: 

Gynecology practices often need to coordinate care across inpatient units, outpatient centers, and affiliated providers, making billing an overwhelming affair. Things always become difficult for you to manage when several entities are involved in the same line of care. A professional gynecology billing company always leverages a centralized method to track all the maternity services provided. Experts in a professional billing company also offer accurate modifiers like -24,-25 and -59 to distinguish separately billable services and split technical and professional components.   

Coding challenges for gynecological surgeries and inpatient procedures: 

Most gynecology practices have inexperienced professionals who do not know how to assign accurate codes and complete documentation for gynecology procedures like deliveries, hysterectomies, laparoscopies, etc. A professional company always keeps its staff members trained on the latest coding guidelines so that they can assign the right surgical codes based on approach, laterality, and procedure intent. They also use NCCI edits to avoid unbundling services done in the same session and monitor DRG shifts to ensure proper documentation. 

Inconsistency in the billing process:  

Always remember that payer rules for fetal testing, infertility evaluation, and high-level ultrasound processes change based on the contract you have. Gynecologists often face denials because of not obtaining prior authorization, assigning wrong codes, or making wrong diagnoses. A professional gynecology billing company uses payer-specific billing guides and leverages an advanced workflow to perform PA and other pre- and post-billing steps to improve your end-to-end RCM process. 

Difficulties in ensuring the right billing process for preventive and diagnostic gynecology care: 

You often need to provide preventive and diagnostic services on the same day and your team always need to use the right modifiers and documentation process to bill both correctly. An experienced billing professional knows what it takes to use modifier -25 to help separate E/M services from preventive care, and document the medical necessity and details of each service to ensure accuracy. The team also strictly follows CMS and commercial payer rules for coding well-woman exams and screenings. Professional billers help hospitals capture full reimbursement while staying compliant with all preventive billing guidelines. 

Your billing practice always needs precise documentation, accurate coding and an expert team that clearly understands your revenue cycle. The truth is that you cannot afford to face billing gaps, denials and compliance problems in your practice. Fortunately, you can always overcome all the billing hurdles by hiring an expert gynecology billing company. Make sure the billing company offers you an end-to-end RCM solution as well as a la carte solutions like PA, coding, AR and denial management, virtual assistance and scrubbing services within a super competitive rate like $7/hour. A reliable company also offers you a free transitional period with a dedicated account manager at your disposal. There is no point in wasting your valuable time and money. Give your practice a solid financial boost and contact an expert today to schedule a consultation.