Medical Billing Services

Intro to medical billing services

At NovaMed we offer comprehensive medical billing services designed to streamline the financial and administrative processes of medical practices. Our expertise ensures that all aspects of billing, from claims submission to patient support, are handled efficiently and accurately. By outsourcing these critical tasks to us, medical practices can focus more on patient care and less on administrative burdens.

Service includes:

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Understanding ICD10 codes

ICD-10 codes are an essential component of the medical billing process. These codes classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease. Medical coding extracts billable info from the medical and clinical records, creating claims is where medical billing and coding intersect to form the backbone of the medical revenue cycle.

Accurate use of ICD-10 codes is crucial for claims submission as it ensures that medical services are appropriately documented and reimbursed. Our team understands the importance of ICD10 codes in medical billing, our team is proficient in the application of ICD-10 codes, ensuring that each claim reflects the correct diagnoses and procedures, which minimises the risk of claim rejections and maximises reimbursements.

PMBs - Prescribed Minimum Benefits

PMBs are a set of defined benefits that ensure that all medical scheme members have access to certain minimum health services outlined by the Council of Medical Schemes, regardless of the benefit option they have selected. PMBs cover a wide range of conditions and are designed to provide members with continuous care to improve their health and well-being. Medical schemes are required by law to cover the costs related to the diagnosis, treatment, and care of any emergency medical condition*, a limited set of 270 medical conditions, and 25 chronic conditions. These benefits are crucial for maintaining a basic standard of healthcare and preventing significant health deterioration.

*An emergency medical condition is marked by its sudden and unexpected onset, necessitating immediate medical intervention to avoid serious health consequences.

Benefits of partnering with us

1. More Time for Patients: Outsourcing billing and administrative tasks allows medical staff to focus on providing excellent patient care, thereby increasing the time available for patient interactions.
2. Cost Reduction: Outsourcing can be more cost-effective compared to hiring and training in-house staff to manage billing and administration, leading to significant cost reductions.
3. Revenue Maximisation: Practices without the right resources and capacity are often at risk of losing revenue; however, outsourcing ensures that claims are submitted accurately, and payments are collected efficiently, minimising the chances of lost income.
4. Risk Reduction: Outsourcing helps medical practices comply with complex billing and administrative regulations, thereby reducing the risks of fraud and bad debt.
5. Improved Claims Management: By outsourcing claims submission and management, practices ensure that claims are processed accurately and promptly, reducing delays and maximising reimbursements.
6. Expert Billing and Coding: Specialised billing and coding services minimise errors and optimise revenue. Accurate coding ensures that practices receive the correct payments for the services provided.
7. Reduced Rejection Rates: Thorough analysis and resubmission of rejected claims help reduce revenue loss and improve overall cash flow. This proactive approach ensures that fewer claims are denied.
8. Accurate Patient Verification: Verifying patient eligibility with medical aid schemes before appointments ensures coverage and reduces financial risk, preventing unexpected costs for both the practice and patients.
9. Timely Payment Collections: Following up on outstanding payments ensures that practices receive timely collections, reducing bad debt and improving financial stability.
10. Comprehensive Reporting: Detailed reporting and analysis provide valuable insights into financial and operational performance, helping practices identify areas for improvement and make informed decisions.

By choosing NovaMed for your medical billing services, you can be confident that your practice’s administrative operations are in capable hands, ensuring smooth and efficient functioning of your practice.