How Outsourcing ENT Billing Services Can Avoid Common Coding Issues

ENT is a medical specialty that is complex by itself and ENT billing is no exception to it. Otolaryngologists not just bill for office visits but also for the various surgical procedures related to the head and neck disorders. In addition to this, they have the challenging task of figuring out and applying the right CPT codes while submitting bills and claims for reimbursement to insurance carriers. Asides this, the HIPAA 5010 standards compliance and the frequent changes that are being made to ICD 10 guidelines have made coding and reporting even more difficult. All of these can take their time and focus away from their primary concern – the patient. Well, in order to free physicians from the onerous task of medical billing comes in the Otolaryngology billing services. They help ENT physicians focus on their practice without having to worry about losing money due to improper billing.

Problems encountered by ENT practices and how outsourcing can help

While trying to streamline the complexities related to coding and keeping pace with insurance industry trends, it so happens that small independent ENT practices overlook crucial operations. What could be done? Well, such complexity can be handled only by a professional medical billing company that has an experienced team of billing and coding staff who have deep expertise across all facets of Otolaryngology billing. Moreover, for ENT practices the chances of incorrect coding is higher due to the wide range of procedures and treatments involved. Asides from this, there are a few other issues that are commonly encountered by ENT practices. They are as follows.

• Ineffective and outmoded procedures: It is the medical coder’s responsibility to code to the highest degree of specificity. This entails extracting as much information as possible from the medical reports provided by the Otolaryngologists. This also implies that they should have a solid grasp of medical terminology for both procedures and diagnoses. Failing to provide enough diagnostic specificity can lead to rejected or denied claims. Outsourcing companies have experienced coders who know the importance of coding to the highest level of specificity. Rest assured.


• Incorrect medical reports: Sometimes Otolaryngologists miss to provide enough information or may leave out important details of the procedure in their report. This usually happens when they are swamped with patients and unable to effectively communicate with their billing team. This problem can invariably lead to rejected or denied claims. Certified coders from professional billing companies make every effort to clarify reports and do the best with what they can under such circumstances.


• Failure to use updated code sets: Every year, medical codes are either added, discontinued or existing codes may be replaced. If your billing team doesn’t stay current with the code sets and revised guidelines they cannot use them properly. This can result in increased chances of claim rejections and denials. Hiring outsourced certified coders who keep themselves updated with the changing trends in the medical industry helps to avoid claim denials and rejections.


• Under and overcoding: Whether intentional or unintentional both these are regarded as fraudulent practices and can trigger audits and investigations. If your in-house team isn’t adequately trained and prepared they will find it difficult to keep your practice running smoothly. Outsourcing your medical Otolaryngology billing services to a team of skilled billers and coders helps to avoid such risky coding practices.


• Unbundling: This is more of a fraudulent practice where an in-house billing team may charge a patient separately for procedures instead of bundling it under one in order to collect a greater reimbursement. It may be done without any fraudulent intent due to the complexity of the rules governing whether to bundle services or to bill services separately. Outsourcing to professional ENT billing services helps to avoid such mistakes that are caused by inexperienced coders, as they have a team of certified coders who are adept in bundling basics.

As a busy Otolaryngologist running a successful medical practice as well as maintaining proper documentation and coding for optimal reimbursement can be quite challenging. We at Scribe4Me provide high quality Otolaryngology billing services according to the latest compliance and industry trends to provide top notch results. Our expertise lies in resolving most of the common issues associated with billing while considerably reducing claim rejections and maximizing reimbursements. Get in touch with us today and avail customized Otolaryngology billing services at affordable prices.