Physician
We are here to serve our clients with professionalism and courtesy, while diligently processing their medical claims as efficiently as possible in order to collect all payments due from insurance companies and patients in an ethical, moral, and confidential manner.
Physician coding important?
The differences between medical and ambulance coding are significant. Ambulance coding has its own set of codes and documentation requirements, which differ greatly from those used by physician and hospital coders. For instance, EMS personnel are not licensed to diagnose, so condition codes must be used instead of diagnostic codes—only a physician can provide a formal diagnosis. Additionally, the patient's actual condition upon ambulance arrival may differ from the reason for dispatch, and strict rules dictate which condition should be reported on the claim. In some cases, a patient may have even passed away before the ambulance arrived. These and many other unique factors must be carefully considered by ambulance coders to ensure claims are accurate and compliant.
Physician Billing
Physician billing is also called medical office billing or professional billing. The purpose of physician billing is to bill the claims to get reimbursement for the medical services provided by physicians to insured patients. It is also used to bill suppliers and non-institutional providers for their services.
The billing form used to bill claims is CMS-1500 or 837-P. There is no difference in these forms except that the CMS-1500 is the paper version whereas the 837-P is an electronic version of the same.
This type of billing is an important process to regulate various administrative tasks that are associated with medical practice such as scheduling appointments, greeting patients; check-in and registration, and collecting payment, etc. The services billed under physician billing include on both in-patient and out-patient services. However, the services falling under the domains of in-patient and out-patient services are billed only after insurance verification. It is because only selective in-patient and out-patient services may be billed for claims as per the insurance policy or insurance agreement of the patient.
It is important to note that physician billing may also include coding. This means in a few cases the medical biller is trained to perform both medical billing and coding. However, sometimes hospitals prefer to have both medical billers and coders who are trained to perform billing and coding respectively.
A physician is a medical professional who diagnoses and treats illnesses, provides routine care, and helps patients stay healthy. They are essential to maintaining individual and community health.
Facility coding involves assigning codes for hospital or clinic services like procedures, equipment, and room charges. It ensures accurate billing and reimbursement for the healthcare facility.
Facility coding involves assigning codes for hospital or clinic services like procedures, equipment, and room charges. It ensures accurate billing and reimbursement for the healthcare facility.
An ambulance is a specially equipped vehicle used to transport sick or injured individuals to medical facilities. It provides emergency care on the way, often staffed by paramedics or EMTs.
HCC Risk Adjustment Coding uses diagnosis codes to estimate a patient’s future healthcare costs. It assigns a Risk Adjustment Factor (RAF) score based on medical conditions and demographics, helping ensure accurate reimbursement in value-based care models.
HCC Risk Adjustment Coding uses ICD-10-CM codes to capture a patient’s health conditions and calculate a Risk Adjustment Factor (RAF) score. This score helps determine reimbursement in value-based care by reflecting patient complexity
