Medical Billing for Subsequent Hospital Care

A confusing medical billing situation can occur when the ED physician provides subsequent hospital care to a patient. Interpreting the level of eval and management services provided can be a challenge when the coder only has the notes.

Many medical billers often err on the side of caution and under-report subsequent hospital care services which results in a much lower reimbursement rate and that hurts the overall revenue flow of the practice.

This could occur if a coder fails to realize that she need not satisfy all of the E/M components to report the subsequent care codes. Documentation in the code choices needs to be included as well to insure proper reimbursements.

If this is a common dilemma in your practice, instead of having your staff tearing their hair out trying to ascertain the correct coding, simply outsource your medical billing to the pros who make it their sole job to get you the maximum reimbursements on all your services. Did you know you could raise your revenue by an average of 25% by simply outsourcing? A medical billing firm has the checks and balances in place to catch possible situations in your coding or billing that could cause denials and will always submit your claims with full medical necessity and documentation.

Medical billing will always be tricky, if you’re ready to leave the headaches of medical billing behind and simply grow your practice; it’s time to outsource your medical billing to the professionals that can get your practice the best reimbursements for your services.

View all Articles by: Melissa Clark, CCS-P