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Why Using a Nationally recognized Midwife Billing Company is Important

4/28/2023

 
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Using an expert medical billing company is important for a number of reasons, including:
  1. Increased revenue: Expert medical billing companies have extensive knowledge and experience in navigating complex billing processes, regulations, and insurance requirements, which can help ensure accurate and timely reimbursement. This can help healthcare providers and facilities increase their revenue by minimizing billing errors, denials, and delays.
  2. Improved cash flow: By outsourcing billing to a medical billing company, healthcare providers and facilities can focus on providing quality patient care while the billing company manages the administrative tasks of billing and collections. This can improve cash flow by reducing the time it takes to receive payments and decreasing the amount of staff time spent on billing.
  3. Cost-effective: Outsourcing billing to a medical billing company can be a cost-effective solution for healthcare providers and facilities. Rather than hiring and training in-house billing staff, providers can utilize the expertise of a specialized billing company at a fraction of the cost.
  4. Increased compliance: Expert medical billing companies stay up-to-date with the latest billing regulations and requirements, helping providers and facilities avoid costly compliance violations and penalties.
  5. Access to technology and data analysis: Medical billing companies often utilize advanced billing software and data analytics tools to help identify areas for improvement and optimize revenue cycle management. Providers can benefit from this technology and analysis to improve their billing practices and maximize revenue.
Overall, using an expert medical billing company can help healthcare providers and facilities save time, money, and resources while ensuring accurate and timely reimbursement. It can also help providers focus on what they do best - providing quality patient care.

Billing Codes Commonly Missed for Midwifery Practices

4/14/2023

 
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Most midwives know about basics when it comes to billing health insurance plans. If you work for a large practice, many providers don’t do anything with billing and have a whole department handling that aspect of care. When you start a private midwife practice (whether small or large), it is essential to know what the billing guidelines and coding system is like.
Revenue, particularly from insurance companies, is the bread and butter for most midwife business. Some choose to do cash, but that is getting harder and harder to keep a midwife business going when health care costs are soaring. Families depend on their insurance plans to cover midwifery services. What I am focusing on today isn’t typical maternity care and office codes. I am discussing commonly missed revenue codes that create additional cash flow to the business for care already being done.
The guidelines for maternity coding is based on hospital obstetrical care (office visits, deliver in hospital, nurse provides most of the labor support and doctor comes into catch baby at the end, etc). Use high quality care and all the extra things midwives in community based setting to your advantage when billing insurance companies. Home visits during maternity and postpartum care are outside typical maternity care billing codes. The codes are based on complexity and time spent with patient.
First visit with nurse is billable as nurse visit for time utilized. If a patient sees a midwife for visit, confirmation of pregnancy with urine pregnancy test is separate for routine prenatal care. Use new or established office visit depending on complexity and time spent with patient. Urine pregnancy tests, lab draws, finger sticks for blood samples, wet mounts, and other office procedures are separate billable codes during pregnancy.
If a women schedule office visit outside of routine pregnancy or comes in for prenatal visit with additional primary concerns (not discomforts of pregnancy) like flu, depression, ear infection), it is a separate office visit charge.
Don’t forget about education and prevention. Affordable Care covers 100% for preventable services. Childbirth education, breastfeeding support, and tobacco counseling are common in pregnancy visits and needs to be documented in chart in order for billing codes to be reimbursed. Always put time spent with patient on your summary notes. Midwives are great at spending lots of time with patients and additional revenue is lost for not putting it into your notes. Your notes have many purposes: communication with staff of care recommendations, liability protection, and billing audits.
Most hospital based midwives don’t do baby care first month of life even though it is part of our training and scope. That is where community based midwives shine with full family care. Newborn care is usually covered 100% by insurance plan if billed as such. If a home visit code is used for care, may be a deductible or co-payment aspect of insurance reimbursement. There are specific codes for newborn care that some insurance plans will pay for in home setting versus office.
Remember a doctor and traditional hospital based practice spends limited time at the beside during birth. Home birth and birth center midwives can use prolonged labor codes if more than two hours continuous with women during labor. Some insurance plans do require this code be used if medical emergency is occurring like postpartum hemorrhage or newborn resuscitation (others don’t). Birth assistants (whether another midwife or assistant), birth supplies, water use during labor and birth, medications like Rhogam, Pitocin, Cytotec, Vitamin K, and IV fluids are sometimes covered. Aetna, BCBS, and United Health Care typically cover more of these midwifery community based codes.
Below is an extensive list of billing codes and their descriptions used for midwifery care. Please use as many codes for care you are providing. Midwives are valuable assets to health care and all the quality, personalized care we provide needs to be counted for. Billing and coding is not part of midwifery education, but running a successful practice requires these skills to be known.

Birth Center Billing Insurance Tips

4/7/2023

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​If you operate a birth center and bill insurance, here are some tips to help you streamline your billing process and increase your chances of getting paid:
  1. Verify insurance coverage: Before a patient's visit, verify their insurance coverage and benefits for birth center services. This will help you avoid any surprises or disputes down the road.
  2. Create a clear fee schedule: Create a clear fee schedule that outlines the charges for different birth center services, including prenatal care, delivery, and postpartum care. Make sure your patients are aware of these fees upfront.
  3. Keep detailed records: Keep detailed records of all services provided, including dates, times, and any relevant notes or observations. This will help you provide accurate and comprehensive invoices to insurance companies and patients.
  4. Bill insurance promptly: Submit claims to insurance companies promptly to ensure you receive payment in a timely manner. Delays in submitting claims can result in delays in payment or even denials.
  5. Follow up on outstanding balances: Keep track of any outstanding balances and follow up with patients and insurance companies to ensure you receive payment for all services rendered.
  6. Consider contracting with insurance companies: Contracting with insurance companies can help ensure timely payment and streamline the billing process. You can also negotiate rates with insurance companies to increase revenue.
  7. Use electronic billing software: Electronic billing software can help streamline the billing process and reduce the likelihood of errors. Some software can also automate claim submissions and track outstanding balances.
  8. Stay up-to-date on billing codes and regulations: Keep up-to-date with billing codes and regulations to ensure you are billing correctly and avoid any potential issues with insurance companies.
Overall, effective billing practices require attention to detail, good communication with patients and insurance companies, and a willingness to stay organized and up-to-date with changing regulations and requirements.
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