Jirungu
April 25, 2022
The services you provide at your dermatology practice are essential for the health of your community, but you may face challenges when it comes to billing. Billing and coding for your medical and surgical procedures can be more complex for dermatology practitioners, and the extensive documentation required takes up your valuable time.
Working with a billing specialist company can help your practice improve productivity. Along with providing medical billing and credentialing services, you’ll get help evaluating and managing your current billing practices. Creating a more efficient coding and billing system helps your practice avoid common challenges.
Common Medical Billing Challenges for Dermatologists
Understanding the most common dermatology billing and coding problems can help your practice be more prepared to handle them.
Dermatologists use procedure codes to indicate what services and care each patient receives. The dermatologist’s office submits claims for insurance billing and receives reimbursement based on these coding systems.
Providers use two main coding systems to communicate with insurance companies: The International Classification of Disease (ICD) and the Current Procedural Terminology (CPT). Dermatology coding may require the use and understanding of both coding systems. ICD codes are used to classify medical diagnoses.
Dermatology CPT codes are needed for many in-office procedures such as skin biopsies, excisions, and destructions. Your office may also use Evaluation and Management (E/M) codes within the CPT system to bill for office visits and inpatient services.
It’s crucial that your office understands each coding system and knows when to use them to bill for your services and time properly.
Medical billing documentation acts as a legal document to prove what medical services were rendered and why the patient was seen. It is essential for billing dermatology services and serves as evidence in legal courts if necessary.
Many dermatology practices struggle with providing complete and accurate medical documentation. They may not understand modifiers, use the wrong post-op periods, or have other compliance issues.
Modifiers help define E/M medical billing and coding, and a lack of knowledge may cause your practice to overuse the 25 modifier or the 59 modifier.
Modifier 59 is defined as a specific procedural service and may be scrutinized by the Centers for Medicare and Medicaid Services (CMS) and insurance companies. Documentation or compliance errors can affect your reimbursements.
The insurance information for your patients changes from year to year and may change within the year if they get a new job. Patients can move to a new residence and forget to update their address, which could mean they don’t receive your bills. Your practice could waste time submitting claims to the wrong places without the latest patient information.
It also causes your administrative team to spend more time fixing the problem, which delays your ability to receive payments promptly.
Putting specific office policies in place can help your practice avoid common challenges and make the billing process more efficient. Having the right medical billing resources can lead to more accurate coding and higher reimbursements.
When your patients come in for their appointment, verify their information. This includes any updates to their address or insurance information. Consider scanning their insurance card to compare with your current copy and ask them if they still live at their current address on file.
Double-checking each visit is the best way to ensure your office has the most up-to-date and accurate patient information.
Make it your office policy to collect any copay your patient is responsible for during check-in. Collecting the payment in advance prevents problems with patients who are late paying bills or are unwilling to pay.
Since it’s a standard policy, most patients expect a copay transaction at the time of their appointment. Consider collecting cash-based copayments if your office doesn’t want to deal with personal checks or credit card fees.
Your office can prevent errors in documentation or billing by developing a cheat sheet of codes most commonly used in dermatology. This may include codes for skin conditions such as eczema, psoriasis, dermatitis, acne, and warts.
Your office may also include coding for common skin cancers, skin biopsies, and the removal of stitches. You know your practice best, and your cheat sheet should contain your most-used codes for quick reference.
It may be challenging to get full reimbursement from payers. Submitting your billing to companies promptly can increase your practice’s chance of full reimbursement. Submitting claims quickly can improve your clean claims ratio and lead to better reimbursements overall.
Track all your claim submissions. Know if you’re getting paid and what your practice is receiving from the payer. If claims are unpaid for an extended period, try contacting the payer before resubmitting the claim. Often a quick phone call is all that’s needed to get the payer to take action.
How to Avoid Coding and Billing Problems
Your dermatology practice can develop a better billing strategy by hiring an outside company such as Capital Billing Services. We work with a wide range of Atlanta-area medical practitioners, including dermatologists.
Our medical billing services and practice management services are an excellent solution for addressing payment and productivity issues in your practice.
We’ll evaluate your office’s current coding and billing practices and find ways to improve them and make them more efficient. This reduces the stress of running your dermatology practice while increasing your reimbursements and leaving you with more time to see patients. Contact us today to get help increasing your reimbursements.