In a study report, the Office of the Inspector General (OIG) noted that 42 percent of claims for Evaluation and Management (E/M) services in 2010 were incorrectly coded, which included both upcoding and downcoding (i.e., billing at levels higher and lower than warranted, respectively), and 19 percent were lacking documentation. A number of physicians increased their billing of higher level, more complex and expensive E/M codes. Many providers submitted claims coded at a higher or lower level than the medical record documentation supports. Check out the CMS website for resources to bill correctly for E/M services.
About 8.6% of families with older adults experienced problems paying medical bills, and 8.9% had forgone medical care. The most common composition for older-adult families was one older adult living alone (39.7%). Older-adult families consisting of only two older adults were the least likely to have experienced problems paying medical bills (4.0%) and to have forgone medical care (3.8%) compared with other family compositions. — National Health Statistics Reports, Number 144, July 15, 2020, https://www.cdc.gov/nchs/data/nhsr/nhsr144-508.pdf
Numina Medical Billing offers a complete revenue cycle management solution, starting with a complimentary practice performance evaluation. We work with your staff to improve your billing workflow to ensure timely claims submissions with correct coding, minimize denials, and reduce your A/R backlog. In many cases, we can increase your monthly revenue by as much as 10%.
Billing and Collections
Our highly experienced staff includes medical billing professionals and clinicians trained in the latest best practices to ensure proper coding, timely submission, and proactive followup.
Eligibility and Pre-Authorization
We can verify patient eligibility up front before an appointment, and we obtain the pre-auth’s your patients need, limiting future problems with denied requests by payers.
We have a 98% clean claims submission record, ensuring coding and documentation are complete. We manage denials automatically, with proactive, persistent followup. For Workers Compensation claims, the Numina team efficiently manages the manual processing requirements for submission, ensuring timely payment for services.
Get started with a complimentary Practice Performance Analysis so we can identify strengths and weaknesses in your current billing process. Then, expect clear, regular reports so you know the financial status of your practice at any time.
More than two decades of growth and service