We do not submit claims just because they are generated in the software. Before submitting claims, we make sure proper patient information is reflected on the form and we also check for correct provider information and health information of patients. Our billing team audits all exams and billing codes to make certain all coding is done correctly and coded for the highest reimbursement. We also review all exams for appropriate level of coding. We review exam documentation to make sure it supports codes that have been billed. Our comprehensive scrubbing process is put in place to send proper information to the insurance companies and maintain highest integrity in patient health documentation. When we find conflicting information on a claim, we immediately report this to the provider and wait on provider’s written directions before submitting claims.
Our work toward submission of claims begins as soon as the provider finalizes the exam. We review exams for supporting documentation. We check all documentation for Doctor’s notes on testing, and details or operative notes. We make sure all services provided by the doctor are billed according to individual insurance rules and regulations. Every single claim form narrates a patient’s visit to the doctor. One single form has the burden of carrying immense amount of information. The claim form tells the insurance, who was treated by the doctor, why did the patient come in to see the doctor, where did the patient see the doctor, how long was the visit, what were the special circumstances for the visit, what was done, and why was it done. Once claims clear our scrubbing process, they are then submitted to insurance and followed carefully for expedite processing.
MBS takes a holistic approach to billing. Successful billing takes a well organized team. We keep updated on all eye related news and updates. We also attend CME courses for billing and coding and HIPAA throughout the year. We research on any revision proposed or enacted for CPT codes and diagnosis codes. We keep doctors and staff updated on new rules and regulations as well. We study billing patterns and give regular feedback to providers. MBS helps doctors code efficiently by equipping them with latest information on the ever-changing world of billing codes. We attend all Academy meetings to stay current on billing and coding. We also have established communication with AAO coding experts for research on billing issues. We check each claim to make sure diagnosis codes support the billed CPT codes before submitting claims.
Our Billing and Coding Research Center is Available to You for all Your Billing Questions. Contact us for insurance related Inquiries.