For a lot of medical practices, Medicare payments make up a large percentage of accounts receivables. For maximized reimbursements, providers are required to take proactive measures. Following are few simple ways to enhance your Medicare payments.
1. Use Accurate Diagnosis: While billing Medicare, you must report the appropriate ICD-9 diagnosis medical codes that match the patient's symptoms, complaints, conditions, illnesses as well as injuries detailed in the patient's medical record. Correct diagnosis coding reduces the risk of claims denying for not supporting medical necessity. You must always list the primary diagnosis code initially and then list any additional diagnosis codes in order of importance.
2. Provide the Medicare Patient an ABN: As per Medicare guidelines, a provider must give the Medicare Patient an ABN or cannot bill them for the service in case Medicare doesn't cover the service.
3. Medicare Eligibility: It is essential that the providers validate their patient's insurance eligibility each and every time services are provided. Verifying Medicare coverage is just as vital as verifying coverage for any other payer. Verifying Medicare eligibility will offer information for instance active coverage, commencement and termination of coverage.
4. Avoid Duplicate Claims Submission: Medicare will reject claims as duplicate in case the same claim has been earlier billed. In case a claim is being submitted owing to the changes to the patient account, ensure to wait until the claim has been received and processed by Medicare prior to submitting a corrected claim. Then you should file the claim using the proper frequency code “7 - Replacement of Prior Claim or Corrected Claim” to avoid a duplicate claim denial and include the Medicare DCN (document control number).
5. Use suitable Modifiers: Choose and report the accurate modifiers with the CPT or HCPCS medical codes on the claim as per the Medicare guidelines. Improper coding of procedure code modifiers can cause a delay or reduction in payment.
Visit AudioEducator for more information on recent Medicare guidelines and appropriate medical codes for maximized reimbursements.
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