Medical Billing and Coding Arizona

Healthcare practices in Arizona are increasingly reliant on the expertise of medical billing and coding companies to smooth out operations and ensure financial viability. As the healthcare landscape evolves, with a growing emphasis on regulatory compliance and reimbursement processes, efficient billing and coding become vital.

Practice Support is one company that provides this type of service, standing ready whenever healthcare organizations need excellent and reliable services. Our expertise reduces billing errors and ensures patients receive the correct charges for their medical services.

 

Why Hire Practice Support in North Dakota

Increased Revenue Cycle Efficiency

Our team streamlines the billing process, reducing the time from patient care to payment, which leads to improved cash flow for your practice.

Extensive Knowledge of Regulations

Like other medical billing companies, we stay updated on the latest healthcare regulations and coding guidelines, ensuring compliance and minimizing the risk of audits or penalties.

Reduced Administrative Burden

By outsourcing your billing and coding needs, your staff can focus more on patient care than administrative tasks.

Accurate Claims Submission

Our proficiency minimizes errors in coding, resulting in higher claim approval rates and faster reimbursements.

Ran By Clinicians

Veteran clinicians founded our company. This enables us to understand the medical industry and its challenges better.

Our Medical Billing and Coding Process

 

1. Confirm the Validity of the Patient’s Insurance

Before scheduling the appointment, we verify the patient’s insurance details to check if they have active coverage and understand their benefits. We contact the insurance company through an electronic verification system to confirm eligibility, plan details, and pre-authorization requirements.

 

2. Schedule an Appointment With the Provider

Once insurance coverage is confirmed, the patient’s appointment with the healthcare provider can be scheduled. This involves coordinating with the patient to find a suitable time and completing all necessary pre-appointment paperwork.

 

3. Delivery of Care (First Occurrence)

On the appointment day, the healthcare provider delivers the necessary medical care or service during the patient’s visit. This care is thoroughly documented for coding and billing purposes.

 

4. Details are Updated on the EMR (Electronic Medical Record)

We enter the specifics of the patient’s visit, including diagnoses, treatments, and services provided, into the Electronic Medical Record (EMR) system. The accuracy of this data is crucial for coding and billing.

 

5. Practice Support Identifies the Codes

Using the information documented in the EMR, our medical coders assign appropriate codes for diagnoses (using ICD codes), procedures (using CPT codes), and supplies or medications (using HCPCS codes). These codes are essential for the billing process.

 

6. Delivery of Care (Second Occurrence, if Needed)

If follow-up care is needed, another appointment is scheduled, and the process from service delivery to updating the EMR is repeated.

 

7. Claim Submission

Once we complete the coding, a medical bill or claim is prepared and submitted to the patient’s insurance company electronically through a medical billing software system. The claim includes all relevant codes and patient information.

 

8. Claim Processing

The insurance company reviews the submitted claim to determine the accuracy of the codes, verifies patient coverage, and applies any applicable co-pays, deductibles, or co-insurance. They may request additional information or corrections if needed.

 

9. Payment Posting

After the claim is processed, the insurance company sends back an Explanation of Benefits (EOB) detailing what was covered and the payment amount. The payment is posted in the practice’s billing system, and any remaining balance is billed to the patient.

 

10. Follow-Up

If discrepancies, denials, or unpaid claims exist, our billing staff follows up with the insurance company to resolve issues. This may involve appealing denied claims, correcting errors, or providing additional documentation.

 

11. Reporting and Analysis

The final step involves generating reports and analyzing the billing and coding process to identify trends, ensure compliance, and improve efficiency. This could include reviewing accounts receivable, tracking claim denials, and evaluating the practice’s overall financial health.

What You Need to Know About Arizona’s Medicaid Program

 

Streamlined Billing Process

Arizona’s Medicaid program, called the Arizona Health Care Cost Containment System (AHCCCS), functions via managed care organizations (MCOs) to simplify billing processes. This approach reduces administrative tasks for providers and guarantees prompt reimbursements, supporting the financial stability of healthcare businesses.

 

Fully-Integrated Telehealth

AHCCCS has seamlessly incorporated telehealth into its reimbursement system, enabling providers to deliver virtual consultations, remote monitoring, and telemedicine services. This integration is particularly beneficial for Arizona’s rural and underserved areas, allowing healthcare providers to extend their reach and improve access to care without needing more infrastructure.

 

Extensive Support for Behavioral Health Services

Arizona Medicaid offers extensive billing codes for various behavioral health services, including therapy, crisis intervention, substance abuse treatment, and community-based mental health care. This lets providers tackle the growing demand for mental health services while generating consistent revenue through Medicaid reimbursements.

 

Home and Community-Based Services in Arizona

Arizona Medicaid supports a vast range of HCBS, which allows businesses to offer in-home care, personal assistance, and community support services. These services will help individuals with disabilities and the elderly, ensuring consistent Medicaid funding and enabling providers to offer the community excellent, quality care.

 

Reimbursements for Preventive Care

Arizona Health Care Cost Containment System (AHCCCS) focuses on preventive care, offering reimbursement for services like immunizations, well-child visits, and routine health screenings. This approach improves patient outcomes by catching health issues early and allows providers to build long-term relationships with patients, ensuring regular Medicaid reimbursements.

Two Types of Medical Coding in Arizona

 

Hospital Coding

Hospital coding is specifically tailored for inpatient and outpatient services that hospitals or health systems provide. It requires various coding systems, the primary one being the ICD (International Classification of Diseases) coding system, which reports diagnoses and the severity of the patient’s condition.

Additionally, hospitals employ CPT (Current Procedural Terminology) codes to denote the specific procedures and services rendered, alongside HCPCS (Healthcare Common Procedure Coding System) codes, which cover non-physician services, such as durable medical equipment.

A crucial aspect of hospital coding is assigning DRG (Diagnosis-Related Group) codes for payment purposes. These codes group patients based on clinical similarity and resource use, allowing hospitals to manage billing and reimbursements from Medicare and Medicaid effectively.

 

Professional Coding

Professional coding relates to services rendered by individual healthcare providers, such as physicians and specialists. Professional coders primarily use CPT codes to detail the evaluation, management, and treatment services provided during a patient visit. An essential component of professional coding is the proper application of modifiers, which provide additional details about the service performed, such as whether it was a bilateral procedure or the provider managed multiple procedures during a single encounter.

Contact Practice Support for Accurate Medical Billing and Coding Services

You can always trust Practice Support when providing services like medical billing in Arizona. We have catered to numerous healthcare practices, ensuring we never miscalculate even the tiniest number. Our medical coders and billers are ready to assist your healthcare business.

Contact us now if you need more details about our medical coding in Arizona or what practices we have serviced in the past.

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