Medical Billing and Coding in New Hampshire

In New Hampshire, healthcare practices face complications in their medical billing and coding processes, driven by the intricacies of state and federal regulations, diverse insurance plans, and the continuous updates needed for compliance. The intricacy involved in coding accurately for various services can create costly errors and denials that stall cash flow.

Enter Practice Support, the company that can help alleviate these burdens. Utilizing our team of expert medical billing and coding specialists, we can streamline aspects of your revenue cycle. We guarantee accuracy, enhance reimbursement rates, and maintain compliance, allowing your practice to thrive financially.

Benefits of Partnering With Practice Support

Remain Compliant

Our company keeps up with the latest regulatory updates to help your practice in New Hampshire compliant, avoiding unnecessary penalties. Our skilled medical coders possess a deep understanding of healthcare regulations, instilling confidence in your practice to operate within legal boundaries seamlessly.

Led by Seasoned Clinicians

Guided by a team of experienced clinicians, we provide invaluable insights and in-depth industry expertise. This robust foundation further enriches our medical billing and coding services, making Practice Support a reliable partner for your practice.

Increase Efficiency

Our solutions enable your staff to focus on patient care by automating and streamlining the billing process, a capability not often found with other medical billing companies. We reduce manual tasks by implementing advanced software systems, ensuring your practice operates smoothly and efficiently.

Refined Claim Tracking

Through our state-of-the-art tracking system, we provide transparency and timely updates on claim statuses, minimizing the risk of delays and denials. This proactive approach removes administrative hurdles that may disrupt your cash flow, setting us apart as an optimal choice among New Hampshire medical billing and coding companies.

Maximize Revenue

Dedicated to expanding your revenue potential, our services emphasize reducing errors and refining the claims process. By cutting down on claim denials and improving reimbursement rates, our medical billing services in New Hampshire help your practice gain every dollar it deserves.

The Medical Billing and Coding Process in New Hampshire

 

1. Insurance Validation Process

  • Verification. Gather the patient’s insurance information, including capturing images of both sides of the insurance card and any essential extra details.
  • Eligibility Check. Confirm the policy’s current status and coverage using phone or online tools.
  • Benefits Confirmation. Review the specific elements of the plan, such as co-pays, co-insurance, deductibles, and any required pre-authorizations or referrals.
  • Documentation. Store all collected verification details in the patient’s records for future reference.

 

2. Arranging Provider Appointments

  • Patient Data. Confirm or collect demographic and medical history information necessary for scheduling.
  • Appointment Scheduling. Use the practice management system to arrange appointments according to the provider’s availability.
  • Reminders. Send reminders via phone, email, or text to decrease no-show rates.

 

3. Initial Care Delivery

  • Check-In. Update the patient’s personal and insurance details upon arrival.
  • Consultation. The provider evaluates the patient and formulates a diagnosis and treatment strategy.
  • Service Recording. Document all services and procedures performed during the visit.

 

4. EMR Updates

  • Data Entry. Input detailed visit information into the Electronic Medical Records system, including history, diagnostics, and procedural notes.
  • Coding Preparation. Ensure that documentation is thorough and accurate to facilitate precise code assignment.

 

5. Coding Identification by Practice Support

  • Medical Coders. Certified coders review EMR data to assign the appropriate ICD, CPT, and HCPCS codes.
  • Accuracy Verification. Confirm that assigned codes accurately reflect the services rendered and adhere to payer guidelines.

 

6. Subsequent Care Delivery

  • Follow-Up Scheduling. Arrange any necessary follow-up visits to ensure ongoing care.
  • Documentation of Continuity. Carefully document each follow-up visit, capturing all services provided.

 

7. Claims Submission Process

  • Claim Assembly. Assemble detailed information about the patient and services for claim processing.
  • Error Checking. Use claim scrubber tools to identify and correct potential errors before submission.
  • Electronic Dispatch. Submit claims electronically via electronic data interchange (EDI) or through a clearinghouse.
  • Confirmation Logging. Record submission confirmation once the claim is sent.

 

8. Claims Processing Workflow

  • Payer Evaluation. The insurance payer reviews the claim for accuracy and coverage eligibility.
  • Decision Making. The payer decides whether to fully approve the claim, partially deny, or reject it.
  • Explanation of Benefits. Obtain and record the Explanation of Benefits (EOB) to comprehend the payer’s decision.

 

9. Payment Posting Procedures

  • Payment Reception. Receive payments from the insurance payer and any outstanding patient balances.
  • Payment Entry. Enter payment details into the practice management system and update the patient’s account.
  • Balance Adjustments. Apply necessary adjustments based on contractual agreements and update any additional patient balances.

 

10. Follow-Up Actions

  • Denial Resolution. Investigate reasons behind denied or underpaid claims and initiate resubmission or appeal as needed.
  • Billing Communication. Issue billing statements for any outstanding balances and follow up on overdue accounts.
  • Customer Support. Respond to inquiries from patients or payers regarding billing or services provided.

 

11. Comprehensive Reporting and Analysis

  • Operational Insights. Generate reports that detail claim statuses, denials, payments, and accounts receivable to monitor financial well-being.
  • Performance Review. Evaluate the efficiency of coding, billing, and collection processes to identify areas for improvement.
  • Regulatory Audits. Perform consistent internal audits to ensure compliance with billing and coding regulations.

Understanding New Hampshire’s Medicaid Program

Streamlined Billing Through Managed Care Organizations (MCOs)

New Hampshire’s Medicaid program primarily operates through managed care organizations under the New Hampshire Healthy Families, Well Sense Health Plan, and AmeriHealth Caritas programs. This system streamlines billing processes, reduces administrative burdens, and ensures timely reimbursements, helping healthcare providers maintain financial stability while delivering comprehensive care.

Expanding Access With Telehealth Integration

New Hampshire Medicaid has incorporated telehealth into its reimbursement framework, permitting providers to offer virtual consultations, remote monitoring, and telemedicine services. This development is particularly advantageous for reaching patients in rural and underserved regions of New Hampshire, allowing providers to expand their reach and enhance access to care without significant physical infrastructure.

Diverse Billing Opportunities for Behavioral Health Services

New Hampshire Medicaid provides extensive billing options for behavioral health services, including mental health counseling, substance abuse treatment, crisis intervention, and integrated behavioral health within primary care settings. As the focus on mental health intensifies, providers are positioned to leverage these billing opportunities to satisfy growing demand while ensuring a consistent revenue stream.

Support for Specialized Pediatric Care

New Hampshire Medicaid offers strong backing for specialized pediatric care, particularly for children with developmental delays, chronic conditions, and special healthcare needs. Providers can bill for specialized therapies, early intervention programs, and comprehensive care plans, securing steady funding while addressing the unique needs of New Hampshire’s children.

Support for Rural Health Provides

New Hampshire Medicaid places a strong emphasis on supporting rural health providers, recognizing the unique challenges of delivering care in underserved and remote areas. This includes higher reimbursement rates and incentives for providers serving rural communities, allowing businesses to expand their reach and improve access to care for rural populations.

Improve Your New Hampshire Practice's Operations by Partnering With Practice Support Today!

Utilize your healthcare practice’s full potential with Practice Support, New Hampshire’s premier medical billing and coding partner. Say goodbye to administrative hassles and hello to streamlined processes, timely reimbursements, and unwavering compliance. With our expert team and cutting-edge technology, we’re here to enhance your financial stability and let you focus on what you do best—providing exceptional care. 

Call us now and experience seamless billing solutions that push your practice forward.

Schedule a consultation