Hospital Affiliated Specialties

Posted by mgsionline on July 23rd, 2013

Medical billing and collections for Hospital affiliated specialties is a major challenge that most Healthcare Facilities and Medical groups confront in their day-to-day operations. Even as they try to tackle this problem confidently, several complications arise when the Healthcare Facility is contracted with outside Medical Groups to provide those specialty services at their Facility and the procedural components in billing have to be segregated into separate units for medical billing and collections. Hospital affiliated specialty services such as Radiology, Anesthesia, Hospitalists, Emergency Room (ER) and Pathology require appropriate additional skills to perform billing. Let’s take a look at the problems involved in billing hospital affiliated specialties:

• Accessing Patient Information: Several hospital contracted medical groups carry out medical billing and collections independently. They take care of the professional component billing while the Healthcare Facility bills the technical component. To do so, hospital contracted medical groups must have proper access to patient demographics and other information stored in the Healthcare Facility’s database system. In addition, they should also keep up with the updates on patient information for precise billing.
• Physician Billing Responsibility: The Healthcare Facility and hospital contracted medical groups should first decide about the part of billing they are going to handle individually. Once this decision is made, there would hardly be any confusion in carrying out the billing process. On the contrary, if there is a miscommunication, then the whole process, including anesthesia billing and radiology billing collapses resulting in duplicate claims and denials.
• Learning Billing Nuances: Medical billing specialists must learn certain nuances, especially while performing anesthesia billing. To get proper reimbursement on the anesthesia services rendered, it is advisable to submit anesthesia claims after surgery claims get reimbursed. Processing surgery claims before anesthesia claims has yet another advantage during the first 3-4 months of the year – patient deductibles will get adjusted for the surgery claim which has a higher value and the anesthesia billing gets full reimbursement.  There are such similar nuances for each of the Hospital affiliated specialties.

Learning the do’s and don’ts of hospital affiliated specialty billing and carrying it out internally would be quite challenging for a contracted Medical Group. The best solution would be to outsource medical billing, including for specialties like anesthesia billing and radiology billing to a well-experienced medical billing company like MGSI.

About MGSI:

MGSI, a leading medical billing company based in Florida, has been rendering radiology billing, anesthesia billing and billing services for other specialties with a dedicated team of professionals. This outsourced medical billing company has over 20 years of experience and thus knows the nuances in medical billing and collections. To know more details, log on to www.mgsionline.com.