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Time Business News
30-05-2025
- Business
- Time Business News
Optimizing Practice Revenue: The Role of Physician Medical Billing Services
In the intricate landscape of healthcare, physicians face the dual challenge of delivering exceptional patient care while managing the complexities of medical billing. Navigating insurance claims, coding regulations, and reimbursement processes can be overwhelming. This is where physician medical billing services come into play, offering specialized solutions to streamline billing operations and enhance financial performance. Physician medical billing services encompass the comprehensive management of billing processes for medical practices. These services handle tasks such as patient registration, insurance verification, coding, claim submission, payment posting, and follow-ups on denied or unpaid claims. By outsourcing these functions, physicians can focus more on patient care, leaving the administrative intricacies to experts. Improved Revenue Cycle Management: Professional billing services ensure accurate and timely claim submissions, reducing the likelihood of denials and accelerating reimbursements. This leads to a more efficient revenue cycle and improved cash flow for the practice. Expertise in Coding and Compliance: Staying updated with the ever-evolving medical coding standards and compliance regulations is crucial. Billing services employ certified coders who are well-versed in ICD-10, CPT, and HCPCS codes, ensuring that claims are compliant and reducing the risk of audits and penalties. Reduced Administrative Burden: Managing billing in-house requires significant time and resources. Outsourcing these tasks allows medical staff to allocate more time to patient care and other critical functions, enhancing overall productivity. Access to Advanced Technology: Many billing services utilize state-of-the-art software that integrates with electronic health records (EHRs), providing real-time analytics and reporting. This technology aids in tracking financial performance and identifying areas for improvement. Scalability and Flexibility: As a practice grows, its billing needs become more complex. Billing services can scale their operations to accommodate increased patient volumes, ensuring consistent and efficient billing Talent When selecting a physician medical billing service, consider the following factors: Experience and Specialization : Choose a provider with a proven track record in handling billing for your specific medical specialty. : Choose a provider with a proven track record in handling billing for your specific medical specialty. Transparency and Reporting : Ensure the service offers detailed reports and maintains open communication regarding financial performance and claim Billers and Coders (MBC) : Ensure the service offers detailed reports and maintains open communication regarding financial performance and claim Billers and Coders (MBC) Compliance and Security : Verify that the provider adheres to HIPAA regulations and employs robust security measures to protect patient data. : Verify that the provider adheres to HIPAA regulations and employs robust security measures to protect patient data. Customer Support: Opt for a service that offers responsive and knowledgeable support to address any concerns promptly. Physician medical billing services play a pivotal role in enhancing the financial health of medical practices. By entrusting billing operations to specialized professionals, physicians can mitigate errors, ensure compliance, and focus on delivering quality patient care. In an era where efficiency and accuracy are paramount, leveraging the expertise of medical billing services is a strategic move toward sustainable practice growth. TIME BUSINESS NEWS
Time Business News
19-05-2025
- Business
- Time Business News
How Medical Billing Services Help Improve Revenue Cycle Management (RCM)
In the rapidly evolving U.S. healthcare industry, Revenue Cycle Management (RCM) is at the heart of every successful practice. From patient registration to final payment, every step must be accurate, compliant, and streamlined to ensure healthy cash flow. This is where medical billing services in the USA play a pivotal role. Outsourcing medical billing not only improves operational efficiency but also significantly boosts the financial performance of healthcare organizations. Here's how. Revenue Cycle Management refers to the financial process healthcare facilities use to track patient care episodes—from initial registration to the final payment of a balance. It includes: Insurance verification Patient eligibility checks Accurate medical coding Claims submission Denial management Payment posting AR (Accounts Receivable) follow-up A minor error in any of these stages can lead to delays, denials, or even revenue loss. That's why efficient RCM is essential—and that's where professional medical billing services in the USA make a real difference. Medical billing companies employ certified coders who use the correct ICD-10, CPT, and HCPCS codes, reducing the risk of rejections and denials. This ensures faster reimbursements and less revenue leakage. With automated tools and billing software, outsourced billing providers optimize the entire workflow—from scheduling and verification to claims processing—helping healthcare providers focus on patient care rather than paperwork. Professional billing teams continuously monitor claim trends and reasons for denial. Their expertise helps reduce denial rates by proactively addressing issues before submission, improving collections and cash flow. A dedicated team follows up on unpaid claims, handles resubmissions, and ensures timely payments. This reduces AR aging and enhances financial performance. Medical billing service providers in the USA strictly follow HIPAA guidelines, ensuring that patient data is handled securely and that all claims meet federal and payer regulations. Most billing companies provide real-time dashboards, monthly performance reports, and claim summaries, helping practices make informed financial decisions. Outsourcing medical billing is no longer just a cost-saving strategy—it's a strategic move to maximize reimbursements, reduce overhead, and ensure compliance. Benefits include: Access to trained billing experts Reduced administrative burden Improved RCM efficiency Enhanced focus on core healthcare delivery Scalable solutions for practices of all sizes If you're looking for a reliable, cost-effective, and compliant billing partner, GenMediTech stands out as a leading provider of medical billing services in the USA. Their customized approach to RCM, medical coding, and denial management has helped numerous clinics, hospitals, and solo practices increase their revenue and reduce billing errors. Why GenMediTech? Certified billing professionals HIPAA-compliant processes Transparent reporting High claim acceptance rate End-to-end RCM solutions Efficient revenue cycle management is critical to the survival and growth of any healthcare practice. By outsourcing to trusted medical billing services in the USA, providers can ensure faster reimbursements, fewer denials, and better cash flow. Partnering with an experienced firm like GenMediTech can transform your billing operations, letting you focus more on patient care and less on administrative tasks. TIME BUSINESS NEWS
Time Business News
18-05-2025
- Business
- Time Business News
Avoiding Common Compliance Pitfalls in DME RCM
Durable Medical Equipment (DME) providers face a complex landscape when it comes to managing revenue cycle operations. With stringent regulatory requirements, evolving payer policies, and increasing scrutiny from auditors, maintaining compliance is both critical and challenging. Avoiding common compliance pitfalls in DME RCM (Revenue Cycle Management) is essential for safeguarding revenue, reducing claim denials, and ensuring long-term operational success. In this article, we'll explore the most frequent compliance challenges DME providers encounter, practical strategies to mitigate risks, and how to optimize your revenue cycle while staying aligned with regulatory demands. Before diving into pitfalls, it's important to understand why compliance matters so much in the DME space. DME suppliers must adhere to regulations from Medicare, Medicaid, and private insurers, which govern: Documentation requirements Medical necessity Billing accuracy Supplier standards Non-compliance can result in claim denials, financial penalties, audits, and even exclusion from federal programs. One of the most common compliance issues is the failure to maintain proper documentation that supports medical necessity and claim submission. Documentation must include: Physician's order with detailed product descriptions Proof of delivery Patient eligibility verification Patient's medical records demonstrating need How to Avoid: Implement standardized documentation protocols and regularly audit records. Using electronic health records (EHR) systems integrated with your billing software can help ensure consistency and completeness. Coding errors can lead to improper billing, triggering claim denials or overpayment allegations. Common mistakes include: Using outdated or incorrect HCPCS codes Billing for non-covered items or services Duplicate billing How to Avoid: Train billing staff continuously on the latest coding updates and conduct routine billing reviews. Leveraging coding software with built-in compliance checks can reduce human error. Submitting claims without verifying patient insurance coverage or eligibility often results in denials and delays in payment. Eligibility issues are especially prevalent with secondary insurance and Medicaid. How to Avoid: Integrate real-time eligibility verification tools in your billing process to check patient coverage before claims submission. Medicare enforces strict supplier standards under the Competitive Bidding Program (CBP) and accreditation rules. Failure to meet these can lead to penalties or exclusion. How to Avoid: Stay updated with Medicare's supplier standards and ensure your accreditation and licensing are current. Regular internal audits and staff training on Medicare requirements are vital. Many DME providers underestimate the importance of being audit-ready. Audits by Medicare and other payers can be disruptive and costly if documentation or compliance is lacking. How to Avoid: Develop an audit response plan, maintain organized records, and perform mock audits periodically. Engaging external consultants specializing in DME compliance can provide an objective review. Efficient DME revenue cycle management depends on leveraging technology to reduce compliance risks and enhance operational efficiency. Automated billing systems, electronic document management, and real-time reporting tools provide visibility into compliance status and financial performance. Providers who integrate technology solutions benefit from: Reduced manual errors Faster claim processing Enhanced compliance monitoring Adopting a comprehensive revenue cycle management platform tailored for DME can help streamline workflows and ensure adherence to regulatory requirements. Compliance is not a one-time effort. Regular training programs for clinical and administrative staff keep everyone informed about regulatory changes and best practices. Topics should cover: Coding updates Documentation standards Audit readiness Fraud, waste, and abuse prevention Investing in ongoing education helps create a culture of compliance and reduces the risk of costly errors. Avoiding common compliance pitfalls in DME RCM requires a proactive approach combining accurate documentation, proper coding, eligibility verification, adherence to supplier standards, and audit preparedness. Leveraging technology and investing in continuous education are critical to managing these challenges effectively. By focusing on these strategies, DME providers can minimize compliance risk TIME BUSINESS NEWS
Business Wire
28-04-2025
- Business
- Business Wire
CMS Grants Fresenius Kabi Permanent, Product-Specific Q-Code for Otulfi ® (ustekinumab-aauz)
LAKE ZURICH, Ill.--(BUSINESS WIRE)--Fresenius Kabi, an operating company of Fresenius, announced today that the Centers for Medicare and Medicaid Services (CMS) issued a permanent, product-specific billing code for Otulfi ® (ustekinumab-aauz). Under the Healthcare Common Procedure Coding System (HCPCS), the Q-code Q9999 is for 'Injection, for subcutaneous use or intravenous use, ustekinumab-aauz (Otulfi), biosimilar per 1.0 mg.' Otulfi (ustekinumab-aauz) is FDA-approved for subcutaneous and intravenous formulations to treat the same conditions as the reference product Stelara ® (ustekinumab), including Crohn's disease, ulcerative colitis, moderate to severe plaque psoriasis and active psoriatic arthritis. 'This designation is an important milestone for broadening use of this biosimilar that supports quality patient care while reducing costs,' said Molly Benson, Senior Vice President, U.S. Biopharma at Fresenius Kabi. 'As a recent addition to Fresenius Kabi's biosimilar product offerings in the U.S., Otulfi is a key part of our company's commitment to advancing biopharma to deliver enhanced care options.' The drug received FDA approval in September 2024 and was launched in the U.S. in March 2025. Developed by Formycon AG, a leading independent developer of biosimilars, this ustekinumab biosimilar is part of a global commercialization partnership that began in February 2023 between Formycon and Fresenius and covers key global markets. A Q-code is a CMS reimbursement code used by healthcare providers and payers to process claims for drugs administered through injection, infusion or other means. Commercial insurers and government payers use them to standardize claims submissions and reimbursements. Pass-through payments are used by hospital outpatient department services through the Hospital Outpatient Prospective Payment System (OPPS) to support use of new devices, drugs, and biologicals that meet eligibility criteria for a period of at least two years but not more than three years. To learn more about how Fresenius Kabi provides patient support, please visit the KABICARE™ patient services hub. About Otulfi Otulfi (ustekinumab-aauz) is a human monoclonal antibody that targets the cytokines interleukin-12 and interleukin-23 which play an important role in inflammatory and immune responses. The FDA approval of Otulfi (ustekinumab-aauz) was based on a thorough evaluation of a comprehensive data package including analytical, pre-clinical, clinical and manufacturing data. Otulfi (ustekinumab-aauz) demonstrated comparable efficacy, safety, pharmacokinetics and immunogenicity to the reference drug Stelara® in patients with moderate to severe plaque psoriasis. Otulfi (ustekinumab-aauz) was approved for both subcutaneous and intravenous formulations which will offer a comprehensive, alternative treatment solution for health care professionals and patients treated with ustekinumab in the U.S. Otulfi (ustekinumab-aauz) is the fourth Fresenius biosimilar commercialized in the U.S., following the approvals and launches of adalimumab-aacf, Tyenne ® (tocilizumab-aazg) and Stimufend ® (pegfilgrastim-fpgk). Fresenius's growing pipeline of autoimmune and oncology biosimilars has several molecules in early and late-stage development. Indications Otulfi (ustekinumab-aauz) is an IL-12/23 antagonist indicated for treatment of adult patients with moderate to severe plaque psoriasis who are candidates for phototherapy or systemic therapy; active psoriatic arthritis; moderately to severely active Crohn's disease; moderately to severely active ulcerative colitis. Otulfi (ustekinumab-aauz) is also indicated for pediatric patients ≥6 years of age with moderate to severe plaque psoriasis who are candidates for phototherapy or systemic therapy and active psoriatic arthritis. IMPORTANT SAFETY INFORMATION Otulfi (ustekinumab-aauz) is contraindicated in patients with clinically significant hypersensitivity to ustekinumab products or to any of the excipients in Otulfi (ustekinumab-aauz). Infections Ustekinumab products may increase the risk of infections and reactivation of latent infections. Serious bacterial, mycobacterial, fungal, and viral infections were observed in patients receiving ustekinumab products. Serious infections requiring hospitalization, or otherwise clinically significant infections, reported in clinical trials included the following: Plaque psoriasis: diverticulitis, cellulitis, pneumonia, appendicitis, cholecystitis, sepsis, osteomyelitis, viral infections, gastroenteritis, urinary tract infections. Psoriatic arthritis: cholecystitis. Crohn's disease: anal abscess, gastroenteritis, ophthalmic herpes zoster, pneumonia, Listeria meningitis Ulcerative colitis: gastroenteritis, ophthalmic herpes zoster, pneumonia, listeriosis. Avoid initiating treatment with Otulfi(ustekinumab-aauz) in patients with a clinically important active infection until the infection resolves or is adequately treated. Consider the risks and benefits of treatment prior to initiating use of Otulfi (ustekinumab-aauz) in patients with a chronic infection or a history of recurrent infection. Instruct patients to seek medical advice if signs or symptoms suggestive of an infection occur while on treatment with Otulfi (ustekinumab-aauz). Discontinue Otulfi (ustekinumab-aauz) for serious or clinically significant infections until the infection resolves or is adequately treated. Theoretical Risk for Vulnerability to Particular Infections Individuals genetically deficient in IL-12/IL-23 are particularly vulnerable to disseminated infections from mycobacteria (including nontuberculous, environmental mycobacteria), Salmonella (including nontyphi strains), and Bacillus Calmette-Guerin (BCG) vaccinations. Serious infections and fatal outcomes have been reported in such patients. It is not known whether patients with pharmacologic blockade of IL-12/IL-23 from treatment with ustekinumab products may be susceptible to these types of infections. Consider appropriate diagnostic testing (e.g., tissue culture, stool culture, as dictated by clinical circumstances). Pre-Treatment Evaluation of Tuberculosis (TB) Evaluate patients for TB prior to initiating treatment with Otulfi (ustekinumab-aauz). Avoid administering Otulfi (ustekinumab-aauz) to patients with active TB infection. Initiate treatment of latent TB before administering Otulfi (ustekinumab-aauz). Consider anti-TB therapy prior to initiation of Otulfi (ustekinumab-aauz) in patients with a past history of latent or active TB in whom an adequate course of treatment cannot be confirmed. Closely monitor patients receiving Otulfi (ustekinumab-aauz) for signs and symptoms of active TB during and after treatment. Malignancies Ustekinumab products are immunosuppressants and may increase the risk of malignancy. Malignancies were reported among subjects who received ustekinumab in clinical trials. In rodent models, inhibition of IL-12/IL-23p40 increased the risk of malignancy. The safety of ustekinumab products has not been evaluated in patients who have a history of malignancy or who have a known malignancy. There have been reports of the rapid appearance of multiple cutaneous squamous cell carcinomas in patients receiving ustekinumab products who had pre-existing risk factors for developing non-melanoma skin cancer (NMSC). Monitor all patients receiving Otulfi (ustekinumab-aauz) for the appearance of NMSC. Closely follow patients >60 years of age, those with a medical history of prolonged immunosuppressant therapy, and those with a history PUVA treatment. Hypersensitivity Reactions Hypersensitivity reactions, including anaphylaxis and angioedema, have been reported with ustekinumab products. If an anaphylactic or other clinically significant hypersensitivity reaction occurs, institute appropriate therapy and discontinue Otulfi (ustekinumab-aauz). Posterior Reversible Encephalopathy Syndrome (PRES) Two cases of posterior reversible encephalopathy syndrome (PRES), also known as Reversible Posterior Leukoencephalopathy Syndrome (RPLS), were reported in clinical trials. Cases have also been reported in postmarketing experience in patients with psoriasis, psoriatic arthritis and Crohn's disease. Clinical presentation included headaches, seizures, confusion, visual disturbances, and imaging changes consistent with PRES a few days to several months after initiating ustekinumab products. A few cases reported latency of a year or longer. Patients recovered with supportive care following withdrawal of ustekinumab. Monitor all patients treated with Otulfi (ustekinumab-aauz) for signs and symptoms of PRES. If PRES is suspected, promptly administer appropriate treatment and discontinue Otulfi (ustekinumab-aauz). Immunizations Prior to initiating therapy with Otulfi (ustekinumab-aauz), patients should receive all age-appropriate immunizations as recommended by current immunization guidelines. Patients being treated with OTULFIOTULFI (ustekinumab-aauz) should not receive live vaccines. Avoid administering BCG vaccines during treatment with Otulfi (ustekinumab-aauz), or for one year prior to initiating treatment or one year following discontinuation of treatment. Caution is advised when administering live vaccines to household contacts of patients receiving Otulfi (ustekinumab-aauz) because of the potential risk for shedding from the household contact and transmission to patient. Non-live vaccinations received during a course of Otulfi (ustekinumab-aauz) may not elicit an immune response sufficient to prevent disease. Noninfectious Pneumonia Cases of interstitial pneumonia, eosinophilic pneumonia, and cryptogenic organizing pneumonia have been reported during post-approval use of ustekinumab products. Clinical presentations included cough, dyspnea, and interstitial infiltrates following one to three doses. Serious outcomes have included respiratory failure and prolonged hospitalization. Patients improved with discontinuation of therapy and in certain cases, administration of corticosteroids. If diagnosis is confirmed, discontinue Otulfi (ustekinumab-aauz) and institute appropriate treatment. Most Common Adverse Reactions The most common adverse reactions (≥3%) seen in patients treated with Otulfi (ustekinumab-aauz) are: Psoriasis: nasopharyngitis, upper respiratory tract infection, headache, fatigue; Crohn's disease, induction: vomiting. Crohn's disease, maintenance: nasopharyngitis, injection site erythema, vulvovaginal candidiasis/mycotic infection, bronchitis, pruritus, urinary tract infection, sinusitis. Ulcerative colitis, induction: nasopharyngitis Ulcerative colitis, maintenance: nasopharyngitis, headache, abdominal pain, influenza, fever, diarrhea, sinusitis, fatigue, nausea. To report SUSPECTED ADVERSE REACTIONS, contact Fresenius Kabi USA, LLC at 1-800-551-7176 or FDA at 1-800-FDA-1088 or Please click to see full Prescribing Information and Medication Guide for Otulfi (ustekinumab-aauz) here. About Fresenius Kabi As a global health care company, Fresenius Kabi is Committed to Life. The company's products, technologies, and services are used for the therapy and care of patients with critical and chronic conditions. With more than 43,000 employees and present in more than 100 countries, Fresenius Kabi's expansive product portfolio focuses on providing access to high-quality and lifesaving medicines and technologies. In Biopharma, Fresenius Kabi offers cutting-edge biosimilars for autoimmune diseases and oncology. With leading market positions in Clinical Nutrition, a broad portfolio of enteral and parenteral products makes a distinct difference in patients' nutritional status – notably as the only corporation offering both product groups. In MedTech, the company provides vital infusion pumps, cell and gene therapy devices, disposables, and more. Fresenius Kabi is a global leader in supplying blood collection bags and devices, supporting blood banks and health care facilities worldwide. The company's I.V. Generics and Fluids for infusion therapy help save millions of lives every year, in emergency medicine, surgery, oncology, and intensive care. Fresenius Kabi takes a holistic approach to health care and uniquely combines experience, expertise, innovation, and dedication – making a difference in the lives of almost 450 million patients annually. With Vision 2026, as part of the #FutureFresenius strategy, the company is developing, producing, and selling new products and technologies and aspires to expand its position as a leading global provider of therapies, improve patient care, generate sustainable value for stakeholders – shaping the future of health care. Fresenius Kabi is an operating company of the Fresenius Group, founded in 1912, along with Helios and Quirónsalud. As ONE team, the companies in the Fresenius Group are committed to providing lifesaving and life-changing health care solutions on a global scale. Otulfi ® (ustekinumab-aauz) is a trademark of Fresenius Kabi Deutschland GmbH in selected countries. Stelara ® is a registered trademark of Johnson & Johnson.
Associated Press
17-03-2025
- Business
- Associated Press
Inga Ellzey Releases All-New 2025 Complete Coder for Dermatology
Inga Ellzey unveils the 2025 Complete Coder for Dermatology, featuring updated CPT, ICD-10-CM, and payer guidelines to minimize denials and boost revenue. 'Dermatology coding is constantly evolving, and if you're not keeping up, you're leaving money on the table.' — Inga Ellzey, Founder and President CASSELBERRY, FL, UNITED STATES, March 17, 2025 / / -- Inga Ellzey, founder of Inga Ellzey Billing Companies and Inga Ellzey Practice Group, is proud to announce the publication of the 2025 Complete Coder for Dermatology —a comprehensive, 1,000+ page reference manual meticulously updated to reflect the latest CPT, ICD-10-CM, and HCPCS changes. Drawing on decades of industry expertise, Inga Ellzey has crafted this essential resource to ensure dermatology practices stay fully compliant and accurately reimbursed. This new edition addresses updates in E/M documentation, telehealth rules, modifier usage, and insurance policy changes—all organized in a streamlined format for faster lookups. Practices will benefit from clear guidelines on coding excisions, repairs, Mohs procedures, and more, ultimately minimizing denials and enhancing audit readiness. In addition to Inga Ellzey's reference manual for dermatology practices, Inga Ellzey Billing Companies offers outsourced billing services nationwide, supporting dermatology practices with claim submission, appeals, and comprehensive reporting to help maximize revenue recovery. 'Dermatology coding is constantly evolving, and if you're not keeping up, you're leaving money on the table,' says Inga Ellzey, Founder and President. 'The 2025 Complete Coder for Dermatology isn't just an update—it's a necessity. We've made sure every change, every detail, and every nuance is covered, so practices can code with confidence, stay compliant, and maximize reimbursement.' To learn more about Inga Ellzey Billing Companies, visit . Jillian Diffoot + +1 800-318-3271 X LinkedIn YouTube Legal Disclaimer:
