Why Outsourcing Wound Care Billing Can Help Your Practice?

 

Wound care is all about evaluating, managing, and treating non-healing wounds. Wound Care, a subspecialty in the medical practice, makes sure that the professionals in wound care are equipped with the necessary techniques and tools to fight the challenges they might face due to the new healthcare reforms and ICD-10 coding guidelines. With the new Affordable Care Act (ACA) in place, wound care professionals are finding it a challenge to integrate all these guidelines in their periodical coding and documentation and still care as same as they did to patients.

More than ever, wound care is now being seriously looked at by the RAC (Recovery Audit Contractor), and especially when payer’s and physician’s perspectives differ, debridement documentation may not stand up to the RAC audit. And addition to this, wound care physicians and clinicians face – ever-changing CMS rules & regulations, the coding of modifiers, the presence of co-morbidities that are in an average wound patient, all make a difficulty when it comes to wound care billing services.

Physicians and wound care specialists are always trying to provide clinically eminent and cost-effective wound care. Since every wound care specialist is facing the same challenge, the health industry is struggling with quality and cost issues.

The wound care market is growing day by day but is often overlooked. The statistics show that more than 9 million US citizens experience a chronic, non-healing wound and were in need of good care. Once a clinic realizes the patients are in need of wound care service, they need to first decide if they can arrange the specific capacity and resources for billing services or they need to outsource to wound care medical billing companies. More than half of the physicians and clinics are affiliated wound care centers using a specialized management company. But do you know what are the benefits of wound care medical billing?

This article throws light on wound care medical billing outsourcing.

Why outsource wound care billing services?

Since we know wound care is a specialty service, it is now developing resources and clinical systems are being developed, but along with all this, it is bringing more challenges too. The clinical effectiveness of wound care service is influenced greatly by the professional competency of wound care specialists, medical information systems, resources, outcomes, cost-effectiveness, patient expectations, and research practice.

To establish a wound care billing service, accreditation and certification are important as it is in any other practice. A few wound billing service providers have earned a joint commission’s certificate for excellence in wound care management when it comes to clinical & operational processes. Such wound care billing service companies can save clinics and practicians time and commitment to resources and give superior creditability.

Hiring such a far-reaching wound care billing company, which provides support to the quality stated in the AAWC conceptual framework, can be a big relief to wound care systems and clinics. Many hospitals and clinics know that they cannot possess the core competencies to handle wounds in larger numbers. Developing an internal billing program can be quite a time consuming and laborious to staff, educate the market, and finance. Many other factors are required for the management team can be established separately and assembled in the hospital.

For all these reasons, many wound care specialists have preferred outsourcing their billing services to expert service providers. Wound care billing outsourcing does not focus on the abilities of clinics, but, it allows them to focus on care while their billing is handled by experts.

Wound care billing outsourcing will facilitate:

• Data collection
• Coordinating interdisciplinary care
• Education
• Sequence of care
• Responsive to regulations

Here are 3 strong reasons why you need to outsource your wound care billing:

Presence of statistical inconsistency

The facts say that almost 20% of beneficiaries are remitted within 30 days and 34% in 90 days. Do you such the capability to handle this kind of readmission? Can you complete the documentation of these beneficiaries as per the standards required? When you prefer wound care medical billing outsourcing, the billing company can handle the tracking of potential readmissions and the required coding and billing done appropriately so as not to attract the attention of the RAC in charge.

Focus on your core practice                 

With constantly changing healthcare regulatory practice, one can lose their focus on core practice. Wound care medical billing outsourcing can help you with expert billers and coders who can handle your job of keeping updated and giving you complete relief from hectic processes. As a medical billing company, your outsourcing party needs to be aware that when wound care service is not performed by a therapist, certain therapy modifiers or revenue codes can’t be reported. An expert wound care billing service provider will make you free from every thought related to coding and billing.

Insurance coverage policy complexities

Patients avail of many coverage policies both, Government and private insurance. How much medical & insurance coverage knowledge your staff knows? Do they know if the Centers of Medicare and Medicaid (CMS) will reimburse the wound treatment? If clear national standards and frequent random changes are missing in guidelines by local Medicare intermediaries or private, it allows the independent auditor to determine the medical necessity. By outsourcing wound care medical billing, you let the experts handle the groundwork.

There are a few more reasons why you need to outsource your wound care medical billing. At 24/7 Medical Billing Services, we offer wound care specialists a few unique reasons for which they hire us as their medical billing outsourcing partner.

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