Get the Money You are Owed for the Services Provided

Correct coding is essential for the proper billing of your business to occur. When the wrong codes are put it, you can be missing out on hundreds of dollars per client every month. If you are struggling to do your own medical billing without the assistance of a professional biller, you may be in over your head as you try to input your billing each month. When you don’t code your patient visits correctly, you will lose money for services that you provided.

Know Your CPT Codes

CPT codes, or Current Procedural Terminology codes, are used to indicate the type of treatment provided. CPT codes are five digits long and will consist of either four digits that indicate the procedure, and the last digit the level of the procedure, or three digits with the two digits indicating complexity of the visit. For example, in the case of an initial patient exam, the first part of the code indicates that an initial patient exam occurred. The last part of the code will show how complex the new patient exam was.

The patient exam could have three different complexity levels, low, moderate or high. Each level has a difference price attached to it. If you are seeing patients for high level new patient exams but billing incorrectly for low level exams, you are missing out on a significant amount of money for each visit.

Know When to Modify Codes

As you go through your billing, you may be providing a number of services at one visit. Insurance companies can be tough when it comes to using a CPT code and various treatments that you provide. To best optimize the billing for each visit, know when you can add on a modifier to the CPT code you are using. For example, if you need to assess a patient two times in one day, you would use a modifier at the end of your CPT code to indicate that the two exams in one day were medically necessary. If you don’t use a modifier, the insurance company will only pay for one exam instead of the two you conducted.

Determine the Codes Each Insurance Company Will Accept

While CPT codes are uniform throughout an industry, each insurance company may pay a different amount for each code. In addition, some companies may require a modifier to be used and then pay the claim, while others won’t pay the claim no matter what type of service modifier you use. It’s complicated to get used to each insurance company and the coding necessary for each patient visit. If you are not a professional medical biller, you are going to miss out on money that is owed to you for services rendered.

If you are trying to do your medical billing on your own, consider how much time you spend on your billing. If you are struggling to get your billing done every month and it is taking you too many hours, it’s time to find a professional billing service to take your billing off of your hands. Professional medical billing is a skill that takes time and patient to learn. For most medical practitioners, it is worth the fee charged for having professional medical biller handle all the billing for you.

With the right CPT coding and billing optimization done for each visit, it is possible to start collecting the money that is due to you for the services you provide to your clients. It’s important that you get your coding right, and the services you bill for include the right modifiers so that the bill will be approved. A professional serviced will be able to keep track of all of this information for you, getting you the most money possible for the services rendered to your clients.


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