Healthcare practices in every specialty, including dermatology, provide critical services for patients. Dermatologists care for patients by diagnosing and treating concerns related to the health of the largest organ in the body, the skin. Every day, dermatologists perform a multitude of services, from basic and routine examinations and extractions to more complicated surgeries and procedures.
Because managing the business aspect of a medical practice is often challenging, it is not unusual for the financial aspects of medical billing to go undermanned. Consequences of billing errors can include lost revenue, increased bad debt and denials.
Fortunately, there are organizations that specialize in medical billing and collections, including Doctors Office Solutions, and offer services to ease the administrative burden of dermatology practices. With specialized billing and collections professionals handling the financial aspects of a practice, physician owners are better able to focus on the medical aspects of the business, patient care, and organizational growth.
Common Dermatology Medical Billing Challenges
There are numerous challenges associated with the field of dermatology, and medical billing is one of them. Medical and cosmetic dermatology services need to be clearly differentiated when processing a bill. Code and document each service provided so that reimbursement is ensured.
- A dermatologist may provide the following services:
- Perform skin cancer screening
- Conduct other types of skin exams and biopsies
- Evaluate moles
- Treat skin infections
- Treat and manage eczema, psoriasis and acne
Other services may include cosmetic procedures to remove skin moles, blemishes and other lesions, spider veins and facial wrinkles; as well as cosmetic injections and other dermatologic surgeries.
There are several codes and modifiers used to indicate the type and extent of procedures performed, and providers have to ensure the correct codes and modifiers are used to avoid claim rejections and other financial losses.
Dermatology practices have to consistently ensure they follow the coding requirements to minimize claim rejections, delays in reimbursement and other financial risks.
Although dermatologic procedures are less complex compared to other types of surgeries, coders must pay attention to various relevant details including size, location, and medical necessity to ensure that the correct codes are assigned.
The billing specialists at Doctors Office Solutions assist in claim preparation by reviewing the documentation and ensuring the code assignments adhere to coding requirements. The specialists verify the accuracy of the procedures performed and assist in claim submission.
Importance of Efficient Insurance Verification
Insurance verification is part of the billing process for dermatology services. Practices need to verify that their patients’ insurance is active and benefits areadequately communicated.
When insurance verification is neglected, patients may receive an unexpected balance, and practices may not be reimbursed by the insurance company.
The Insurance Verification team at Doctors Office Solutions, defines the following insurance terms:
- Benefits
- Prior Authorization
- HMO/PPO plan limits
- Coverage
- Cost sharing (copays, coinsurance, and deductibles)
By verifying insurance and defining plan terms prior to the provision of service, practices eliminate billing issues and provide a better experience for patients.
Verification allows the staff of the billing and practice management office to reduce the time spent on clerical tasks and focus on other important activities.
Reducing Dermatology Claim Denials
One of the biggest issues faced by medical practices is the denial of reimbursement claims. A claim denial means that a practice is not able to collect payment for a service until the claim is corrected and resubmitted.
Possible reasons for the denial of dermatology claims includes, but is not limited to:
- Omission of patient’s name
- Submission of an incomplete or incorrect clinical document
- Misunderstanding of patient’s insurance benefits
- Failure to obtain prior authorization
- Resolving claim denial issues requires extensive work on the part of the medical practice.
Doctors Office Solutions provides dermatology practices with a means to reduce claim denials by reviewing all outgoing claims. The staff addresses claim rejection issues.
Their staff also communates with insurance companies to explain claim denial reasons and assists in the collection of unpaid claims. Ultimately, their goal is to recover practice revenue.
Revenue Cycle Management for Dermatology Practices
The revenue cycle encompasses all the activities related to the collection of funds from the services rendered by a medical practice. These include, but are not limited to, patient registration, service schedule and synchronization, insurance verification, coding and billing, collection activities and follow up.
An optimized revenue cycle is essential for dermatology practices to realize optimal reimbursement for the services rendered.
Doctors Office Solutions offers dermatology practices an end-to-end billing solution and optimizes critical billing processes such as charge entry and medical claim generation and follow up activities.
When the revenue cycle is optimized, practices benefit by having better control over their practice finances and reducing the number of issuers in their receivables.
The revenue cycle is incomplete without follow up and collection activities. Often, practices focus on the upstream and midstream activities of the revenue cycle and neglect the downstream activities. This leads to billing problems, dissatisfied patients and collection issues. An adequately managed revenue cycle helps billing personnel and practice staff spend more time on core activities.
Medical and Cosmetic Dermatology Billing
As the name suggests, medical dermatology is related to the diagnosis and treatment of conditions of the skin, hair and nails that are medically necessary. Cosmetic dermatology is related to the improvement of an individual’s appearance. Many dermatology practices offer integration of the two.
Doctors Office Solutions has experience with the billing integration and helps practices with financial record keeping. The solutions provided by Doctors Office Solutions help dermatology practices by eliminating billing complexities for the services offered by the practice.
Reducing Administrative Burden Through Outsourced Billing
Most dermatology practices find it challenging to navigate the medical billing process and often choose to handle it in-house. Managing an effective and efficient medical billing process requires:
- Knowledgeable Staff
- Current Coding Knowledge
- Accurate and Timely Claims Management
- Continual Training
The ability to stay current with ever changing regulations and requirements of the healthcare industry is a continuing challenge for small to medium practices.
Outsourcing medical billing allows a practice to reduce their administrative responsibility and improve office workflow.
Professional Medical Billing Services for Dermatology Practices
We understand the ever changing and complex realm of healthcare and continually strive to support our clients in pursuing and achieving their practice goals. The wide range of billing services we offer enable our clients to improve and solidify their practice.
Benefits of Professional Dermatology Billing Services
Our professional and caring billing service helps eliminate stressful billing issues for our clients. The numerous benefits of our service include improved financial collections, reduced office workload and improved office workflow.
Enhanced Practice Efficiency
Improved billing processes help healthcare teams work even better together.
Tailored Billing Services
We understand that every dermatology practice is unique. That is why we have created flexible solutions to better help you.
Conclusion:
There are many reasons that require a dermatology practice to outsource their medical billing. These reasons vary from the details and processes involved with billing, such as coding, claim submission, collecting and tracking payments, claim denial and appeals, etc., to the level of control and supervision that is required to effectively manage the financial health of the practice.
Doctors Office Solutions, understands the challenges and issues that dermatology practices face and has developed a variety of services focused on providing billing and practice management solutions to help alleviate the challenges and issues dermatologists face.
Because of the nature of the medical profession, dermatologists chose this career to practice healing and helping others, and not to manage business and medical billing practices. With the help of a medical billing service, dermatologists can practice their true passion and help improve the overall financial health of the practice.