Medical Billing and Coding New Mexico
It’s important that healthcare practices hire the services of medical billing and coding companies to ensure timely and accurate payment for the services they provide. If your healthcare business in New Mexico needs this type of service, you have Practice Support to hire. We have worked with numerous healthcare practices around New Mexico, so we know how to handle that area’s unique billing and coding needs.
Why Hire Our Billing and Medical Coding in New Mexico?
Expertise in Local Regulations
Increased Revenue Cycle Efficiency
Outsourcing your billing and coding to us can streamline your revenue cycle, reduce claim denials, and improve your practice’s cash flow.
Veteran Clinician Management
Focus on Patient Care
With our billing and coding specialists handling the administrative tasks, your team can concentrate on what truly matters—providing high-quality care to your patients, thereby improving overall patient satisfaction.
Cost-Effective Services
Our Medical Coding and Billing Procedure
1. Confirm the Validity of the Patient’s Insurance
Our administrative staff verifies the patient’s insurance coverage and eligibility. This includes checking the patient’s insurance card, contacting the insurance provider if necessary, and confirming that the provided services are covered under the patient’s current plan. Any copayments or deductibles are also determined during this stage to ensure transparency in patient responsibility.
2. Schedule an Appointment With the Provider
Once the insurance validity is confirmed, the patient is scheduled for an appointment with the appropriate healthcare provider. Scheduling typically considers the patient and provider’s availability, aiming for a convenient and timely visit. Additional pre-appointment confirmations and reminders might be sent to the patient to minimize no-show rates.
3. Delivery of Care (First Occurrence)
During the initial medical visit, the healthcare provider examines the patient, diagnoses any conditions, and administers the proper treatments or interventions. This could range from a routine check-up to more complex consultations where diagnostics and treatment plans are discussed.
4. Details Are Updated on the EMR
After the patient visit, detailed notes and provider observations are entered into the Electronic Medical Records (EMR) system. This includes patient history, findings, diagnoses, prescribed treatments, and follow-up care instructions. The EMR serves as a comprehensive and secure digital patient record.
5. Practice Support Identifies the Codes
Practice support’s staff of medical coders and billers review the detailed EMR entries and identify the appropriate diagnostic and procedure codes. These codes come from standardized code sets like the ICD (International Classification of Diseases) and CPT (Current Procedural Terminology). Accurate coding is critical as it directly affects claim processing and reimbursement.
6. Delivery of Care (Second Occurrence, if Needed)
If further treatment or follow-up visits are needed based on the initial assessment, the patient returns for extra care. Each subsequent visit follows a similar examination, documentation, and coding process.
7. Claim Submission
After the medical codes are determined, a claim is prepared and submitted to the patient’s insurance company. This submission includes all the relevant codes, patient details, and a bill for the rendered services. Modern systems often allow electronic submission, which can expedite the processing time.
8. Claim Processing
The insurance company reviews the submitted claim to determine its validity and whether the services are covered under the patient’s policy. This review can involve scrutiny of the codes, patient eligibility, and the necessity of the services provided. They will then approve or deny the claim and inform the provider’s office of the decision.
9. Payment Posting
The insurance company processes the payment for approved claims, which is then posted to the provider’s billing system. This step guarantees that patient accounts are updated correctly, reflecting any payments received from insurance and outstanding amounts possibly owed by the patient.
10. Follow-Up
If there are any issues with claim processing, such as denials or underpayments, our billing team will follow up with the insurance company. This may require resubmitting claims, providing additional documentation, or appealing denied claims to ensure proper compensation for services rendered.
11. Reporting and Analysis
Finally, consistent reporting and analysis are performed to review the efficiency and effectiveness of the billing and coding process. This includes tracking metrics like claim approval rates, turnaround times, and payment discrepancies. These insights can identify areas for improvement and ensure the practice’s financial health.
How New Mexico’s Medicaid Program Works
Streamlined Billing Process
New Mexico’s Medicaid program, known as Centennial Care, is largely managed through several managed care organizations (MCOs). This setup streamlines the billing process, making healthcare providers navigate the system easier and receive timely reimbursements, which is also crucial for maintaining financial health.
Wide Focus on Telehealth Services
In New Mexico, Medicaid has embraced telehealth as a critical service, especially given the state’s rural expanses. Providers can leverage telemedicine to offer consultations, follow-ups, and other services remotely. This not only improves access to care for patients in remote areas but also broadens the scope of services that providers can bill for under Medicaid.
Billing Opportunities for Pediatric Support
Providers in New Mexico who specialize in pediatric care can benefit from Medicaid’s support for services aimed at children with special healthcare needs. Billing opportunities are available for therapies, early intervention services, and extensive care plans, giving children their needing care.
Specific Billing Codes for Chronic Disease Management
Medicaid in New Mexico encourages providers to offer chronic disease management, with specific billing codes available for managing conditions like diabetes, asthma, and heart disease. These services maintain consistent care and guarantee patients receive ongoing support, which in turn provides a steady revenue stream for providers.
Incentives and Higher Reimbursement Rates
Recognizing the unique hurdles faced by rural healthcare providers, New Mexico Medicaid offers incentives and higher reimbursement rates for services provided in rural and underserved areas. This support lets providers extend their services to patients in remote locations.
Need Expert Medical Billing in New Mexico? Hire Practice Support Today!
Your healthcare practice should never suffer just because you have difficulty with the billing and coding tasks. That’s why you have reliable medical billing companies like Practice Support, as we provide top-tier services that produce excellent results. We can also give you a breakdown of our medical coding systems because we always stay transparent with any client we work for.
Call us today with more questions about our medical billing and coding services.
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