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Wound Care Billing Services

Swift Bizz lets wound care specialists focus on patient care without the stress of medical billing.

Wound Care Is Complex For Several Reasons

Outpatient wound care coding is complex for several reasons. One is that it may take place in different kinds of facilities, even for a single patient, treating the same wound, such as when a hospital patient is released and wound care continues at an outpatient center. Each encounter must be billed correctly, including the code details indicating which location was used.

Rising Cost And Budget Cuts

In today’s financial climate, with costs rising and budgets being cut, it is especially important to have effective medical billing so that all claims are properly reimbursed. Most practices that don’t have specialists managing their coding and billing are losing significant amounts of revenue.

Top Reasons to Outsource Wound Care Billing

Medical codes are complicated and on top of that, they change every year, making it extremely difficult for staff in medical practice to keep up, which results in expensive errors. Outsourcing to a professional revenue cycle management (RCM) company like Swift Bizz ensures that you receive the highest possible reimbursement. These are three of the reasons it is especially beneficial for wound care centers to outsource medical billing.

Referrals

Most wound care patients come in on referral and the referring physician’s office will usually have checked to see if their insurance covers your services—but you can’t assume that is the case. When each new patient makes an appointment, the wound care center must verify insurance coverage.

Rising Costs And Lowered Reimbursements

Wound care supplies include some very expensive products, such as cellular and/or tissue-based products for skin wounds, but reimbursements are going down. This means it is vital that every service delivered is properly coded and billed so there is no lost revenue due to claim rejections and denials.

Prior Authorization

Many insurers and payers require prior authorization for treatment and will reject a claim that isn’t authorized in their system, even if it is something they would have authorized and paid, so it is important to find out about authorizations when confirming that the exam/visit is covered. Wound care also may be ongoing over a period of time and require additional authorizations, so staff must be proactive and attentive to such limitations.

 

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