Navigating Pulmonology Billing Services

Healthcare providers depend on medical billing services for timely and reliable reimbursements for the care they offer. Those within the field of respiratory medicine undergo this process, known as pulmonology billing.

What are the latest industry regulations that those within the healthcare industry must follow? How can you make medical coding and billing more effective? Why is the accurate coding of various tests and specialized procedures so important?

This guide answers these questions and more.

Understanding Pulmonology Billing

Pulmonology medical billing services refer to the administrative process of claiming reimbursement for medical care. While this sounds simple and straightforward, healthcare organizations must abide by many complex steps for effective results.

Key Components of Pulmonology Medical Billing

The patient billing team has the following responsibilities:

• Registering patients
• Verifying their insurance
• Documenting healthcare services, also known as a charge capture
• Coding the services accurately
• Submitting a claim
• Posting the payment

Experts must ensure accuracy within each of these essential elements. Any errors prevent the providers from getting paid in a timely manner.

Common Challenges in Pulmonology Billing

Medical billing is not without its challenges, including in the field of pulmonary medicine. Some of the biggest obstacles include:

• Denied claims: Every time an insurance company denies a claim, it’s extremely difficult for hospitals and practices to increase revenue. According to the Journal of AHIMA, unresolved claims cost hospitals $5 million annually.
• Complex procedure coding: The team in charge of billing documentation must use Current Procedure Terminology codes when charging for accurate tests and treatments. Human error could lead to denied claims, making revenue cycle management difficult.
• Updated billing codes: CPT codes frequently change, so coding experts must stay in the loop.

Best Practices in Pulmonology Medical Coding

If you’re overseeing your practice’s billing and revenue system, execute these best practices for seamless patient billing. Pulmonology billing experts recommend the tips below to streamline workflows, increase revenue, and reduce errors.

Guaranteeing Accurate Documentation

The billing and claims process can face lengthy setbacks if you don’t provide detailed clinical documentation. Rather than put your revenue cycle at risk, take steps to reduce claim denials and audits. Establish methods to cut down on errors and run analytics on patient statements for insight into common data trends.

Staying Updated With Coding Changes

Say someone visits your clinic for basic pulmonary function tests, such as measuring their lungs’ diffusion capacity. Their bill could be drastically different than someone undergoing sleep studies to diagnose sleep apnea as well as those receiving treatment for chronic obstructive pulmonary disease or lung cancer.

Each of these services has an assigned CPT code, with which professionals must remain current. Regular training and support help your billing department stay on top of coding changes. Take advantage of resources from the American Thoracic Society for reliable information regarding the latest coding updates.

Using Certified Coders

Employ AAPC-certified pulmonology coders for improved operations and results. These specialists provide ample benefits to practices, including:

• A comprehensive understanding of pulmonary tests and their CPT codes
• Support throughout the process
• Compliance with healthcare regulations

Having HIPAA-compliant coders on your team protects sensitive patient data. You’ll also avoid the steep fines and other harsh penalties for non-compliance.

How To Optimize Pulmonology Billing Processes

Are you looking to optimize your clinic’s revenue cycle? Consider the following strategies to enhance your approach to medical billing.

Implement Advanced Billing Software

Invest in specialized software that can streamline the coding process and reduce errors. Add a modern system that leverages AI for automated charge captures. You can collect payments faster by introducing technology that offers a variety of payment options, making it easier than ever for patients to pay their bills.

Perform Regular Audits

Avoid errors in your revenue services by conducting regular internal audits. This allows you to identify common mistakes in your process and quickly correct them. In addition, you should monitor key performance indicators like:

• Daily charges
• Claim denial rates
• Reimbursement rates
• Time from the patient’s date of service to receiving the final bill
• Time from submitting claims to receiving payments

Tracking these metrics helps pulmonology practices become more efficient.

Outsourcing Pulmonology Billing Services

Instead of overwhelming your office manager with billing services, consider partnering with a third party. Outsourcing your needs offers several benefits, including:

• Improved accuracy
• Ensure compliance with regulations
• Greater likelihood of timely payments

Tips for Enhancing Patient Communication and Engagement

Patient care doesn’t stop when they leave the exam room. Keep them engaged and informed about their statement with the following tips.

Establish Transparent Billing Practices

Make sure patients are aware of their financial responsibilities and deliver detailed statements following services. Whether they seek treatment for asthma or interstitial lung disease, their bill should clearly outline the costs for tests and other procedures. Consider offering flexible payment options to accommodate patients.

Utilize Technology for Patient Engagement

Don’t underestimate the importance of communication when it comes to the patient experience. Deploy modern technology like:

• Two-way texting with medical professionals
• Online portals with test results
• Automated appointment reminders

Enhance Your Pulmonology Practice With Weave’s Advanced Technology

There’s no denying the importance of effective pulmonology billing processes. However, it’s just one key aspect that pulmonology practices have to focus on. In addition to performing and documenting various procedures for respiratory conditions, clinics must streamline their communication.

Weave offers customized solutions for pulmonology practices and other healthcare specialties, including phones and digital forms that promote fast yet reliable communication. Beyond that, our products assist with email marketing, online scheduling, appointment reminders, and billing and payments.

Take charge of your practice management tools with Weave. Call 833-572-2139 to schedule a free demo and explore the key benefits that await.

Want to see
more about
Weave?
1 System for Phones, Texting, Payments, & More
 Access a full suite of patient communication tools with Weave! Texting, payments, reviews, & scheduling in one place. Get started today!
Schedule Demo