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Medical Billing and Coding in Connecticut

Healthcare practices in Connecticut operate in a dynamic environment where regulatory complexities, insurance demands, and patient expectations continually evolve. To navigate this complex landscape, practices increasingly rely on expert medical billing and coding services.

That’s where Practice Support becomes a valuable asset for healthcare practices seeking this type of professional assistance. We pride ourselves in providing quality medical billing and coding solutions for your Connecticut practice, helping you provide efficient and reliable care for your clients.

Benefits of Hiring Our Medical Billing and Coding Services in Connecticut

Guided by Clinical Experts

Our leadership team, made up of seasoned clinicians, offers invaluable knowledge and extensive industry expertise. This foundational knowledge enhances our medical billing and coding services, establishing us as a dependable partner for your Connecticut practice.

Optimize Claim Tracking

Our state-of-the-art tracking system gives you full transparency and timely updates on claim statuses, reducing delays and minimizing denials. This proactive approach guarantees that administrative obstacles do not impede your cash flow, setting us apart as a preferred choice among Connecticut medical billing and coding companies.

Boost Revenue

We work to maximize your financial returns by eliminating errors and refining the claims process. Our medical billing services in Connecticut focus on lowering claim denials and increasing reimbursement rates, ensuring you gain every dollar you’re entitled to.

Enhance Efficiency

Our innovative solutions streamline the billing process, allowing your staff to focus more on patient care—a benefit that many medical billing companies usually don’t offer. Utilizing advanced technology, we reduce manual tasks to boost your practice’s operational efficiency.

Ensure Regulatory Compliance

We remain at the forefront of regulatory changes to help your practice meet billing requirements and avoid costly penalties. Our expertise in medical coding provides a strong grasp of healthcare regulations, allowing your practice to operate efficiently and legally within prescribed boundaries.

Get to Know Our Medical Billing and Coding Process

 

1. Verifying Patient Insurance

  • Insurance Details Collection. Acquire detailed insurance information from patients, including images of both sides of their insurance cards and any additional pertinent data.
  • Eligibility Confirmation. Verify the plan’s active status and specific coverage details through phone or online platforms.
  • Benefit Clarification. Determine co-pays, coinsurance, deductibles, and any required pre-authorizations or referrals.
  • Documentation. Record all verification information in the patient’s file for future reference.

 

2. Arranging Provider Appointments

  • Patient Information Gathering. Confirm or collect demographic and medical history details from the patient.
  • Appointment Coordination. Schedule an appointment based on the provider’s availability using practice management software.
  • Reminder Notifications. To minimize the risk of no-shows, send appointment reminders via phone, email, or text message.

 

3. Initial Patient Care Delivery

  • Check-In Process. Update the patient’s personal and insurance information during check-in.
  • Diagnosis and Planning. The healthcare provider evaluates the patient to develop a diagnosis and treatment plan.
  • Activity Documentation. Accurately document all services and procedures performed during the visit.

 

4. Updating EMR Details

  • EMR Entry. Input visit details into the Electronic Medical Records system, including medical history, diagnoses, and procedure notes.
  • Coding Preparation. Ensure documentation is accurate and comprehensive for coding purposes.

 

5. Code Assignment by Practice Support

  • Professional Coders. Certified coders review EMR information to assign appropriate ICD, CPT, and HCPCS codes.
  • Verification of Codes. Ensure the assigned codes accurately reflect the services provided and comply with payer requirements.

 

6. Subsequent Care Delivery

  • Follow-Up Scheduling. Arrange any necessary follow-up appointments for ongoing treatment.
  • Continued Documentation. Maintain thorough records of follow-up visits to document all services rendered.

 

7. Claims Submission

  • Claims Preparation. Compile detailed patient and service information needed for submitting claims.
  • Error Checking. Utilize claim scrubber tools to identify and rectify potential errors before submission.
  • Electronic Submission of Claims. Submit claims electronically through EDI or a clearinghouse.
  • Confirmation Recording. Document receipt confirmations for each claim submission.

 

8. Claims Processing

  • Claim Evaluation. The insurance provider reviews the claim for accuracy and eligibility.
  • Decision Making. The payer determines whether to approve, partially deny, or reject the claim.
  • Explanation of Benefits. Receive and log the Explanation of Benefits (EOB) that outlines the payer’s decision regarding the claim.

 

9. Managing Payments

  • Payment Collection. Receive payments from insurance payers and address any outstanding patient balances.
  • Posting Payments. Enter payment information into the practice management system and update patient accounts.
  • Account Adjustments. Make necessary adjustments based on agreements and update any outstanding patient balances.

 

10. Follow-Up Activities

  • Resolution of Claim Denials. Investigate the reasons behind denied or underpaid claims and take steps to resubmit or appeal when necessary.
  • Patient Billing. Send invoices for overdue balances and follow up on unpaid accounts.
  • Customer Support. Respond to any inquiries from patients or payers about billing or the services provided.

 

11. Reporting and Evaluation

  • Generation of Financial Reports. Create reports detailing the status of claims, denials, payments, and accounts receivable to evaluate financial health.
  • Review of Efficiency. Examine the efficiency of coding, billing, and collection processes to find areas for enhancement.
  • Conducting Compliance Audits. Perform regular internal audits to ensure adherence to billing and coding regulations, keeping your Connecticut practice compliant.

Learn More About the Medicaid Program in Connecticut

Efficient Billing With the ASO Model

Connecticut’s Medicaid program, known as HUSKY Health, operates without traditional managed care organizations but utilizes an Administrative Services Organization (ASO) model. This system streamlines billing and care coordination, reducing administrative burdens for providers while ensuring timely reimbursements and maintaining financial stability.

Expanding Care Access With Telehealth Integration

HUSKY Health has embraced telehealth, allowing providers to offer virtual consultations, remote monitoring, and telemedicine services. With Medicaid reimbursement for these services, providers can expand their reach across both urban and rural areas in Connecticut, offering greater flexibility and access to care.

Comprehensive Billing for Behavioral Health Services

Connecticut Medicaid provides extensive billing options for behavioral health services, including mental health counseling, substance abuse treatment, crisis intervention, and community-based mental health care. This supports providers in addressing the state’s growing demand for mental health services while ensuring consistent revenue through Medicaid reimbursements.

Supporting Essential Care Through HCBS Waivers

Connecticut Medicaid supports various HCBS through waivers, enabling providers to offer in-home care, personal assistance, and community-based support for individuals with disabilities, the elderly, and those with chronic conditions. These services are critical in a state with an aging population, ensuring consistent Medicaid funding and helping providers meet essential care needs.

Improving Patient Outcomes With HUSKY Health’s Preventive Measures

HUSKY Health places a strong emphasis on preventive care, reimbursing providers for services such as immunizations, well-child visits, cancer screenings, and routine health check-ups. This focus on early detection and prevention improves patient outcomes and allows providers to establish long-term relationships with patients, ensuring regular Medicaid reimbursements.

Improve Operations Within Your Healthcare Practice in Connecticut—Contact Practice Support Today!

Don’t let your healthcare practice fall behind your competitors by hiring Practice Support’s expertise. Working with different practices gave us the needed knowledge and skills to provide quality services to each client. We also study each practice we work with to determine how we can offer our solutions optimally.

Schedule a consultation right away to speak with our expert medical billers and coders.

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