Healthcare Backoffice Services

Medical Billing Services and Medical Coding Services

 

Our team dedicated to work in medical billing services and medical coding services with several years of expertise on CPC and CPC-H outpatient facility certified coders from American Academy of Professional Coders (AAPC) ensure highly accurate and compliant medical-billing-coding services. Our two certified extremely experienced PMCC trainers oversee daily operation of our medical-billing-coding department and see to it that all industry standards and compliances needs are met.

The medical-billing-coding process includes the following steps:

• Patient documents / files / reports that are electronically scanned at our client's office are seamlessly and securely accessed by our offshore center using our value platform VPNs connections
• Our teams verify and validate the documents, split them into batches and review them for completeness, quality and readability
• Diagnosis, Procedure Codes and modifiers are assigned as per client descriptions and guidelines. Modification of certain codes may be made as per carrier requirement (e.g. certain insurance carriers require ASA code)
• Our diligent auditors and Six Sigma oriented quality control team audit the coded charge sheets and process it further for charge entry and cash posting

We use the following industry coding standards:

• Diagnosis Codes (ICD-9: International Classification of Disease)
• Procedure Codes (CPT-4: Current Procedural Terminology)
• Coding for Inpatient Services (ICD-9)
• Drug Codes (NDC: National Drug Codes)
• Dental Procedure Codes (CDT: Current Dental Terminology)
• Other Procedure Codes (HCPCS: Healthcare Common Procedure Coding System)

Key Highlights

• Simple Solutions' AAPC certified coding team is proficient with CPT, ICD-9, HCPCS level II and DRG codes across various specialties.
• Coding in accordance with NCCI (National Correct Coding Initiatives) and LCD (Local coverage decision and medical policies) as per set rules for different states across US
• Trained and Monitored by PMCC certified Trainers
• The coders complete a comprehensive training program and are involved in continuing education programs.
• Quality and Compliance are continually monitored via a Corporate Quality Assurance Program and a Corporate Compliance Program.
• Minimum accuracy deliverables of over 95% and above on both CPT and ICD components.
• Simple Solutions provides 24 to 48 hour turn-around of all completed source documents.
• Assurance in maintaining coding policies and procedures, appropriate and accurate managed contract advice and reports

Simples' coding team, led by MD physicians, ensures that continuous updates are sent to our clients to keep up with minimum documentation and to allow our team to bill for maximum accurate reimbursements for services rendered by them.

We provide regular feedback to our clients on changes in code selections affecting reimbursements and front-office documentation practices to be followed as per CMS guidelines for appropriate reimbursements to physicians as well as insights into coding related denial analysis. Our expertise in E/M Evaluation & Management Services have driven clients across US to use our services for physician education and audits on coding done by other medical billing companies and/ or physicians themselves.