In this article, we talk about the difference between in-house and outsourced billing, discuss the pros and cons of each and give you a look at the cost and savings associated with an outsourced solution. If you aren’t ready to hand over 100% of your billing operations, you can start with a hybrid approach, such as seeking assistance with collections and simplifying your billing system.

Whatever you decide, OmniMD has solutions that can help your front desk and back-office crew minimize mistakes, improve efficiency and increase patient satisfaction.

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You can prevent your loyal patients from changing service providers by eliminating common pain points. By addressing the following issues, you can provide convenient, seamless, and quality medical care that delights your clients:

• Billing concerns
• Inefficient appointment setting
• Lack of automation for new patient registration
• Poor communications of diagnostic, treatment, and medication information

Let’s start with some high-level goals.

High-Level Goals to Improve Patient Satisfaction

As you formulate a plan to tackle each of the challenges below, keep the following high-level goals in mind:

• Strive to improve access to care and meet patients online for critical communication.
• Listen to what your patients tell you when diagnosing problems with satisfaction at your practice, and conduct regular customer satisfaction surveys to keep on top of your client’s changing needs.
• Talk to your healthcare professionals to find out what they need to access information and streamline the treatment process.
• Adopt technology, such as OmniMD, that allows your team to create an effective virtual experience during treatment, appointment setting, follow-up care, and other touchpoints.
• Offer training for medical professionals new to virtual communication.
• Place your patient at the center of your business and work everything us around them.

Billing Concerns and Solutions

Efficient billing practices help you enter claims to payers quickly for a faster revenue turnaround. They also make life easier for patients, who ultimately want to know how much the service will cost. Too often, patients are unable to get a straight answer regarding billing prior to a visit. In many ways, this is driven by unknown factors that come up during an examination. However, there are still several things you can do to address billing concerns.

To improve patient satisfaction when it comes to billing, consider the following suggestions:

• Adopt technology that includes a patient portal. This technology gives patients access to their information, sends appointment reminders, and allows you to communicate with clients efficiently. By including an FAQ section and glossary describing billing codes, you can help them understand the billing without calling your office.
• Add a chat feature to make it easy for patients to ask questions about their procedures. Patients often have questions about their financial responsibility since bills typically contain multiple payment amounts. Giving them a lifeline as they examine the bill can help your patients remain calm and cool while working to understand the billing process.
• Train your billing team to promptly answer customer questions and politely address complaints.
• When it comes right down to it, patients tend to be more trusting of medical procedures than the billing process. You can maintain consistent pricing and educate each patient on the cost of service while they’re still in the office. This approach avoids misunderstandings and hard feelings.

OmniMD Medical Billing Software and Medical Billing Services offer a comprehensive solution that makes it easy to verify insurance eligibility, simplify your billing template, send bills and accept payments electronically, and improve your patient satisfaction rates through an effective billing process.

Patients also need understanding and better communication when it comes to appointment scheduling, discussed in the next section.

Appointment Scheduling Pain Points and Solutions

Taking an appointment may seem simple. However, there are several factors that make the process complicated. It only takes one emergency visit to derail appointments for the rest of the day for one or more providers. With the right scheduling software, you can set better expectations for wait times and move things around more easily when necessary.

If your front desk still uses an appointment book to manage appointments, you’re missing out on the functionality of automated appointment setting software.

Here are a few questions to help you determine whether your appointment setting technology meets the needs of your front desk team and patients:

• Does your system allow patients to schedule their own appointments online?
• Does your appointment software automatically schedule reminders that reach clients via text, email, or their preferred communication channel?
• Can your staff see appointments for each provider at a glance?
• How easy is it to create an appointment in your current appointment scheduling system?

Automation does more than make it easier to set appointments and check patients in. Patients can choose the right professional to help them with their particular condition. Combined with a call center that can manage appointments after hours, appointment setting software can streamline the front desk experience.

Best of all, you can customize your settings to allow for same-day appointments for emergencies and access reporting that shows counts for various procedures and appointment times by day, week, or month.

Medical appointment software adds a ton of value to your practice, including:

• Setting and managing recurring appointments
• Printing schedules for physicians and other practitioners
• Tracking activity to improve wait times and other metrics that boost patient satisfaction
• Accessing one-click co-pay acceptance to improve your revenue stream

So, making the right choice when it comes to your medical appointment software can mean the difference between a waiting room full of annoyed patients and efficient appointment-setting practices that make your patient’s loyal customers.

New Patient Registration Improvements

Patients often complain about the new patient registration process for the following reasons:

• Too many forms
• Duplicate information on forms
• Takes up too much time during the office visit

With the right automation tools, you can streamline the new patient registration process by moving it online. Patients should not have to re-enter their name, insurance information, and contact information on multiple forms.

Paper-free new patient processing makes sense. It can also help you save time and money and alleviate patient dissatisfaction. Explore the solutions offered by OmniMD, such as pre-visit data capture, context-aware forms, and data validation for consistent data.

Making Diagnostics, Reports, and Medication Information Available

Implementing a patient portal allows your clients to retrieve prescription information, diagnostics results, and other reports impacting their health. Making this information available online can also help healthcare providers prioritize urgent cases. By improving medical care and outcomes, online diagnostic tools, reporting, and medication management further improve customer satisfaction.

Providing immediate access to lab results can help practitioners come to a conclusive, accurate diagnosis faster. This means that the patient receives the right treatment earlier in the progression of diseases and disorders.

After treatment, patients may have questions regarding symptoms, complications, and other concerns that come up during the recovery process. Allowing patients to send a message directly in the patient portal can provide updated information for physicians looking to recommend additional treatment or alleviate patient concerns. Alternately, limited engagement can slow recovery periods and put the patient at risk.

Find out how vigorous engagement with patients through a patient portal facilitates care transitions such as diagnosis, treatment, and aftercare.

Request a demo today!

OmniMD offers numerous tools that can help your practice retain patients through improved engagement. Contact us today for a free consultation on how our tools can streamline your practice.

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If you run a healthcare organization from a small physician’s office to a large hospital, your billing department uses codes to document procedures, medication and techniques used to treat clients. Entering the wrong code can result in improper billing and claims denials. Even if you get it right, the codes themselves often don’t accurately reflect the level of care provided.

Medical codes transform services, procedures and equipment into a universally understood language. However, your billing clerk may need to include more information to ensure that your organization receives the proper compensation. In addition, modifiers help clarify the services provided to insurance companies and billing personnel.

A medical modifier consists of two numbers or letters added to CPT or HCPCS Level II codes. Modifiers provide essential information about the service or procedure without impacting the main code. This blog provides guidance on using modifiers 59, 25 and 91.

When Should You Use Modifiers?

Tack on a modifier to the appropriate CPT code when you need a better description of services provided to clients. It’s important to avoid adding modifiers merely to increase reimbursement. You also cannot use modifiers to bill for procedures bundled with other services.

Working with modifiers requires care and due diligence. The descriptions aren’t always as clear as you might hope. Also, using the wrong modifier can result in suspicion or claim denials on the part of an insurer.

However, modifiers are critical to proper billing for your organization’s products and services. They further clarify a CPT code to document important information. These supplemental descriptions paint a more detailed story regarding services. In this blog, we’re concentrating on three of the most commonly miscoded ones.

CPT modifier 59: Distinct Procedural Service

Medical practitioners use modifier 59 to distinguish distinct procedural services. This commonly misused modifier indicates multiple procedures on different parts of the body during a single visit. Unfortunately, coders often use it to separate services bundled in another code. When used to prevent bundling and increase the total bill, adding modifier 59 becomes part of fraudulent billing practices.

Coders should also avoid using modifier 59 to bypass controls on the insurer’s claims processing system. Therefore, it’s important to use 59 only when there’s no more appropriate code to describe multiple procedures.

Example:

1. A dermatologist performs a Photo Dynamic Therapy session on a patient’s scalp and face.
2. Then, the machine is used to treat other parts of the body.
3. The coder enters 9656796567 – 59 into the claim system.
4. Modifier 59 indicates the second procedure, which required new positioning on a unique body region.

This is a valid use of modifier 59.

Modifier 25: separately Identifiable Evaluation and Management

Modifier 25 is a separately identifiable evaluation. Further, it’s performed by the same doctor or caregiver on the same day. Therefore, medical professionals can use modifier 25 to amend applicable CPT codes when the patient’s condition requires multiple evaluation and management (E/M) services.

Avoid using modifier 25 in the following circumstances:

Avoid using the 25 modifier to bill for postoperative E/M related to a prior surgery.

• Don’t add modifier 25 for an E/M service not followed by a procedure.
• Instruct coders not to append 25 for minimal same-day procedures unless you can show the service was “significant, separately identifiable.”

Example:

1. A patient attends a cardiac appointment complaining of chest pain while exercising. The patient is hypertensive and has high cholesterol. The cardiologist orders a stress test on the same day.
2. The billing clerk enters an E/M visit (99214) and a cardiovascular stress test (93015).
3. Usingmodifier 25 with the E/M code accounts for the significantly separate procedures.

Modifier 91

Use modifier 91 to indicate a test performed multiple times on the same day. If you use the tests for separate specimens for unique results, apply modifier 91 to clarify the billing.

When to avoid using modifier 91:

• Don’t append 91 if re-running lab tests to confirm previous results.
• Avoid modifier 91 if retesting due to problems with the equipment or specimen.
• Don’t use the 91 modifier when another code includes a test series or for procedures that require a one-time result.

Example:

1. A high blood pressure patient takes a plasma renin activity test (84244 Renin) while lying down.
2. The doctor performs the same test in multiple positions to determine whether the position contributes to hyperaldosteronism or other conditions.
3. Repeat renin tests are scheduled for the afternoon, but the patient is standing up this time.
4. The 91 modifier can be added to the second renin (84244) procedure.
5. This results in two sets of lab tests for the same day on the same patient.

Understanding how to use modifiers correctly can help ensure that your claims are processed smoothly and without incident. Refer to the CPT code book for information on other modifiers.

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But, what is modifier 22? It is described in the CPT guidelines as a benchmark that classifies increased procedural service. The CPT code book’s Appendix A explains that a modifier comes to play when the work needed for a particular procedure goes beyond what is typically required.

Using it correctly helps in reimbursing a physician and ensures this group of professionals is compensated for any additional time they are involved in tackling unseen difficulties and other unanticipated complications.

But it is imperative to note, proper reimbursement goes beyond just integrating a modifier to a service code. According to professional coders, there are many other factors and requirements that come into play.

In this regard, this guide seeks to explore how procedural coding works and when to use modifier 22.

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