Billing and Collections

Comprehensive physician consulting coders certified in ICD 10 proficiency can help with your ICD 10 coding questions.

One of the largest problems following the Oct 1, 2015 implementation date for ICD-10 will be the insufficient documentation to support the specificity required for the new ICD-10 code sets. Accurate coding and proper payment will not be possible without clinical documentation improvement. A behavioral change in documentation habits for most providers is necessary, and time is of the essence. Accurate documentation is vital to a successful ICD-10 transition. 

Many surgery centers find it challenging to consistently manage billing with in house staff, due to such factors as staff turnover and varying availability of qualified billing professionals in local labor markets.

As a Billing and Collections provider, CPC functions as a seamless extension of your team, focused on maximizing your cash flow—giving you the assurance of consistent, accurate processing by highly qualified professionals using state of the art billing software and hardware.

CPC’ Billing Staff are available to provide an ICD-10 assessment:

  • Evaluate your current documentation in preparation for ICD-10.
  • Identify the deficiencies and education needed to improve.
  • Avoid denied or un-billable claims and reduce the risk of interruption in revenue.

CPC’ Billing and ICD-10 implementation. 

  • Identify the ICD-10-CM codes (unspecified and specific codes) that correlate with your specialty’s top ICD-9-CM codes
  • Reduce ICD-10 coding errors by choosing only accurate and applicable ICD-10 code(s) for each ICD-9 code
  • Locate the most applicable ICD-10-CM codes for your specialty in the shortest possible time
  • Quickly view ICD-9-CM and ICD-10-CM code descriptors
  • Spend less time and save on overtime expenses by implementing the right ICD-10 code

CPC’ Billing Services include:

  • A designated CPC account representative to handle billing calls from patients and payers with courtesy, professionalism, and accuracy.
  • Charge Entry— Expert ICD-10 transition and CPT coding, with charge postings submitted daily after careful review for quality control and complete revenue capture.
  • Daily claims submission to support continuous cash flow, electronically or on CMS 1500 forms when warranted.
  • Payment processing—with daily entry of payments and denials after careful review for correct processing and payment, and prompt review of writeoffs, coinsurance, and deductibles to ensure proper calculation and allocation.
  • Accounts receivables—prompt, effective followup on all unpaid claims and denials, and continuous monitoring of receivables to identify trends.
  • Appeals—our expert appeals department responds immediately to denied and underpaid claims, to maximize captured revenue. With our “No Claim Left Behind” approach, claims are never written off until all appeals have been exhausted.
  • Patient statements and collections—CPC manages all of your patient billing interactions, including weekly review and mailing of statements; collections calls at 30/60/90 days; and, on client approval, payment plan arrangements, referral for collection escalation/credit reporting, and writeoffs.
  • Monthly meetings with surgical center management to review summary of charges, current aged trial balance, summary of payments, summary of adjustments, and totals for a monthly “snapshot” of profitability.
  • Claim/chart analysis to ensure proper coding and documentation.