In the constantly-evolving world of medical billing, neurology medical billing can be one of the most complex and challenging types of medical billing. With the unique and complicated nature of neurology practices, it’s critical to make sure that accurate and timely reimbursements for services rendered are received. We’re going to take a comprehensive look at the world of medical billing for neurology and look at some of the key elements that set this billing specialty apart from others. Additionally, we’ll look at some of the best practices that can keep your revenue cycle optimized.
Overview of Neurology Medical Billing
Neurology is a field of medicine that focuses on the diagnosis and treatment of various disorders of the nervous system, including the brain, spinal cord, and countless peripheral nerves. With the sheer complexity of the conditions diagnosed and treated, neurology medical billing involves multiple intricate requirements for both coding and billing.
Key Elements Of Medical Billing For Neurology
It’s important to understand the basic elements of any neurology medical billing process. Here are some of the most significant points to take into account.
1. Procedure and Diagnosis Codes
One of the most important things to remember for accurate reimbursement is the correct assignment of ICD-10 and CPT codes. In neurology, many different codes are used to cover the range of diagnostic and therapeutic procedures, including but not limited to neuroimaging, neurophysiology tests, and nerve conduction studies. This means it’s critical to be familiar with the latest coding guidelines, updates, and changes, to minimize the potential for claim denials.
In many cases, the codes that are used will need to have specific modifiers applied to them, to convey additional information about the service, process, or procedure that was used. Using modifiers correctly is an important part of preventing underpayment and overpayment.
3. Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs)
LCDs are policy documents that are issued by Medicare Administrative Contractors that lay out the medical necessity guidelines and coverage specifics for healthcare services and procedures inside of their respective jurisdictions. LCDs can vary between contractors, which means it’s essential for neurology practices to be intimately familiar with the LCDs applicable to their region.
NCDs are standardized policy documents that are issued by the Centers for Medicare & Medicaid Services, which outline the coverage and medical necessity for specific services, but on a national level. NCDs apply to all Medicare beneficiaries no matter what region they are in.
Best Practices for Medical Billing in Neurology
To give your practice the best chance at full optimization of its revenue cycle, try to implement these best practices:
1. Invest Heavily In Staff Training
In the neurology medical billing field, continuous training is crucial to keep your billing staff apprised of all changes and updates in the ever-changing neurology billing requirements. Provide ongoing education and support for their professional development, and help ensure everyone in your billing department is kept up-to-date and compliant with the latest changes and updates.
2. Utilize Technology
Leverage modern medical billing software that can help streamline your billing process and your day-to-day operations. Specialized neurology medical billing software can help drastically reduce manual tasks, as well as human-related errors, which commonly cause claim denials or rejections. Implementing an electronic health record system can also help ease documentation woes and facilitate seamless integration with your billing system.
3. Implement Regular Audits
Periodically, you’ll need to conduct internal audits of your medical billing processes. This is a critical component of keeping your billing department streamlined and running smoothly. Audits will help you find potential process breakdowns, errors, and inconsistencies, highlighting areas that need improvement, and frequently giving you actionable ways to improve them. Any issues found should be addressed quickly to minimize potential revenue loss.
4. Ensure Timely and Accurate Claims Submission
Submitting claims on time and without errors is the best way to minimize delays in your revenue cycle. Delays in submission can lead to delays in reimbursement or even denials. To prevent your revenue from being delayed, and that any errors are corrected, implement a suitably efficient claim denial management system that proactively seeks out claim denials to address the errors and get the claims resubmitted. Also, ensure that the issue behind the initial error is rectified.
5. Outsource When Prudent
In many cases, it may be more prudent to simply outsource your neurology medical billing needs, rather than invest the time, resources, and more to have in-house staff tasked with them. There are many benefits to this approach, and often those who operate or work in small to medium neurology practices find that outsourcing their medical billing services holds more benefits than simply taking some work off of their shoulders. We’ll take a look at the benefits of outsourcing medical billing for neurology next, and dig into any potential drawbacks there may be.
Advantages of Outsourcing Medical Billing
There are several significant benefits to outsourcing your neurology medical billing, including but not limited to:
- Compliance: Outsourced billing providers stay current with all of the latest coding updates, changes, and regulatory requirements. This means effortless compliance on your end, without massive financial investment into annual or semi-annual training.
- Expertise: When you outsource your billing and coding, you’re delegating those tasks to providers that have extensive knowledge and significant experience, allowing them to navigate even the most complex billing scenarios with ease. This also translates to greatly reduced errors and as a result, far greater claim acceptance rates.
- Time & Cost Savings: Outsourcing takes a massive amount of work off of the shoulders of your in-house staff. This frees up their time to provide a much higher level of care and patient focus and eliminates the need for hiring and training in-house billing personnel and keeping them updated and compliant.
- Instant Accountability: You will have a dedicated team of billing and coding professionals, often with a single point of contact to simplify communications. This means that in rare situations where an error is encountered, the source can be rapidly identified and subsequently corrected. This provides a means of continual improvement and process evaluation that means your numbers get better every single day.
Choosing the Right Medical Billing Partner
If you think your practice may be ready to outsource its neurology medical billing needs, finding the right medical billing partner can be challenging unless you partner with AMS. AMS Solutions can provide industry-leading coding and billing outsourcing services while maintaining the highest level of data security and patient privacy. Reach out today to learn more.