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Medicare, Medicaid Fraud Examples and Steps to Ensure You Don't Commit It

  • A medical doctor invoiced his patient’s Medicare insurance for both the services he actually delivered and for services that were not delivered. He fabricated his patient’s medical records to indicate office visits and treatments that never took place.
  • A gerontologist obtained the outcomes of medical testing executed by a diagnostic firm for her interpretation of the results. She billed the patient’s Medicare insurance as if she performed both the testing and interpretation of the tests.
  • A family physician worked at a medical center where low-income and needy patients were enlisted to submit to needless exams. While he consulted with few patients, medical records were forged by a physician’s assistant to support the billing of Medicaid for medical procedures never performed.
  • Patients with Alzheimer's disease were sitting unsupervised inside a small room of a medical psychological care facility watching the movie "Forrest Gump" for the umpteenth time. Granted, it's a great movie, but each time the patients sat in front of the tube watching it, the facility submitted insurance claims to Medicare for providing "group therapy."

*These are examples of fraud as it relates to Medicare and Medicaid.

Medical fraud is the intentional deception or misrepresentation of healthcare transactions by the provider for the sake of receiving unauthorized benefits or financial gain. Healthcare fraud is committed when a dishonest provider intentionally submits, or causes someone else to submit, false or misleading information for use in determining the amount of healthcare benefits payable by an insurer. Many leading, medical groups calculate fraud to amount up to 10% of all healthcare costs.

Most healthcare fraud today is being committed against Medicare and Medicaid, both funded with U.S tax payer dollars. Medicare pays out over $800 billion a year for claims. Medicaid also has enormous budget, providing $615 billion a year. Their sheer size makes these goliaths a target for those groups committing fraud. Plus with such volume, the U.S. Government is unable to police fraudulent claims. They rely on whistleblower. However, a ton, if not most goes undetected.

These programs process millions of claims per day, but it’s estimated that an extremely small percentage of them are audited. They are vulnerable to fraud due to underfunding and lack of oversight. Put simply, there just aren’t enough people on staff to check things out regularly.

Some of the More Common Examples of  Medicare or Medicaid Fraud include the following:

  1. Paying “kickbacks” in exchange for referring business
    “Kickbacks” are customary in healthcare fraud cases. State and federal laws by and large ban payments to individuals who refer patients to a particular hospital or medical provider. Medicaid fraud prosecutions have been brought, for example, against unethical physicians for splitting fees in return for rent, demanding cash payments for Medicaid patients or taking money in exchange for patient referrals.
  2. Phantom services
    Itemized medical bills are long and contain dozens of items the patient may not recognize. It’s tempting to throw an extra procedure onto the bill, while charging Medicare or Medicaid for services not rendered. The longer the bill, the simpler it is to slip in a fraudulent charge. Phantom charges also spread to durable medical equipment covered by Medicare Part B. Medicare is often charged for new DME even when the patient accepts used equipment. Some doctors even charge for equipment that was never supplied to the patient. Fraudulent providers also “upcode” various medical procedures. For example, when a patient sees a doctor, they may be unmindful of the scope of services that were delivered. If payment is made by units of time, the time can be extended. A minor service could also be "upcoded" to a more labor intensive or expensive service through fraudulent means. Another example, a bill sent for a healthcare service could be priced higher than it normally would be, based on the service that was performed.
  3. Purposely misdiagnosing a patient
    Here practitioners purposely misdiagnose patients, generally claiming their illness or injuries are more severe than they actually are, so they can bill for more costly treatments and procedures. Regrettably, the elderly and mentally disabled make easy targets for these schemes as they are less likely to have reservations about a physician’s diagnosis.
  4. Unbundling
    Physicians and hospitals often bundle services as a way to offer patient savings. Fraud occurs when the healthcare provider bills each item separately. Under Medicare and Medicaid guidelines, certain mandatory procedures are meant to be bundled together, but by separating them, physicians earn hundreds of extra dollars per patient. Here’s a prime example. A patient has an appendectomy that costs $2400 total. Instead of billing Medicaid for the entire bundle, the hospital bills for each individual step of the procedure resulting in a medical bill of $4300.
  5. Billing for a non-covered service as a covered service
    An allergy physician was providing a treatment that was considered experimental and therefore not approved by Medicare. With a few taps on a keyboard, the allergy doctor presented claim forms and still got paid for utilizing the experimental treatment. This was accomplished by calling (and coding) something else that was covered by Medicare.
  6. Overutilization of services
    This usually includes billing for services that aren’t necessary. Unprincipled providers might use this scheme on hypochondriac patients. Tests and exams can go on indefinitely or at least as long as a patient still has coverage. Alcohol and drug rehabilitation facilities are ripe for such overutilization.

There are other examples, but you get the point.

Charges of Medicare and Medicaid fraud can create serious legal headaches including massive fines, loss of healthcare licenses and even prison time. Even mere allegations of fraud can do considerable damage to the professional reputation of a healthcare practice.

Such fraud (or perceived fraud) is not always premeditated. However, it can arise as a result of negligence, sloppiness, mistake or oversight.

What steps can you take to ensure that you and your staff do not unintentionally cross the lines of Medicare and / or Medicaid fraud?

  1. Understand healthcare laws and regulations
    As a prime example, the False Claims Act bars medical practitioners from submitting insurance claims for substandard and overpriced goods and services, identifying individuals who do not report their knowledge of such claims as perpetrating fraud. The federal government may fine offenders up to three times the disbursements, plus $11,000+ for each false claim.
  2. Ensure accurate billing
    To avoid inadvertent fraud, healthcare providers must maintain accurate billing practices to steer clear of inaccuracies such as overcharges or claims for undocumented or undelivered services.
  3. Maintain updated and proper documentation
    Medical providers need to maintain accurate records to help assure that future treatments deliver the best possible patient outcomes. Detailed records can also assist providers in defending themselves against malpractice suits.
  4. Keep track of your licenses
    Check regularly to ensure your licenses and your staff licenses are up to date. If your license was expired at the time you performed medical treatment, then you may actually be charged with fraud, regardless of the fact you actually performed the procedure billed.
  5. Create and follow a compliance plan
    Medical providers can avoid fraudulent activity by creating and observing a compliance plan, a practice that the Affordable Care Act mandates to remain Medicare and Medicaid eligible. The Office of the Inspector General publishes the Compliance Program Guidance for Individual and Small Group Physician Practices to assist medical providers in establishing such plans.

Medwave is committed in assisting medical providers with their Medicare and / or Medicaid billing. Medwave helps avoid inadvertent fraudulent claims in medical billing. Contact us for complete details and pricing.

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Medical Billing Experts

Medical Billing Service Costs

How Does Pricing Work in Medical Billing?

The most familiar question medical billing companies hear, “What are your prices?” It’s an entirely reasonable question. After all, price is a sizable component in any business decision.

In this article, we’ll try to clarify some of the misunderstandings surrounding medical billing service rates. We’ll also attempt to present some of the factors that go into determining pricing.

In plain terms, the most treasured client for a medical billing company is a large healthcare practice, all operating in one medical specialty, in a single state, and performing a small volume of high-cost procedures. While no client is totally straightforward, a client with these characteristics would produce the most clear-cut, easy-to-manage amount of work for the billing company.

The more standardized the work, the easier it is to administer. On the other hand, a multi-state, multi-specialty medical practice will most likely interact with various insurance payers and considerably more rules and regulations. As a consequence, managing the work is going to take a bigger team with added know-how, and thus, burden the billing company with more costs. It’s that simple and a common reality for practices that are more challenging to manage.

Truth is, the majority of practices fall somewhere in-between. The closer you are to the ideal client, the lower the rate you can expect. The farther you plunge to suboptimal, the higher the rate you can expect.

Certain healthcare providers, such as solo practitioners, often struggle to find medical billing company that will take them on as a client. Many billing companies just can’t afford to take on specific clients, especially new practices. For example, if you’re a solo psychologist in need of fairly wide-ranging behavioral health billing, a billing company may have to charge more. And, regrettably, many solo therapists can’t afford to pay that added cost.

How do Medical Billing Companies Charge Providers?

  • Percentage basis
    Under this model, the medical billing company will charge a specific percentage on the amount collected each month. Typically, the average percentage is between 5 and 10 percent, contingent on patient volume, types of cases managed and the number of receivables.
  • Hourly rate basis
    Some billing services offer medical billing services on an hourly rate basis. This technique is reasonable for large-scale practices and hospitals with consistent claims, and where generally an equal number of claims is managed each hour. Typically, billing companies will employ staff devoted to one client under this model. The hourly rate would differ from client to client and be determined in the course of negotiations.
  • Fixed rate per claim basis
    Some medical billing companies might provide a fixed rate for each claim. Thus, the rates are based on the number of claims handled rather than the amount collected. The rates charged would be contingent on the intricacy and the average amount per claim.
  • Hybrid fee basis
    Finally, there’s the hybrid fee model. Essentially, a hybrid could be a combination of any of the aforementioned models. This basis fluctuates based upon a healthcare provider’s needs. You might benefit from a hybrid fee model, if you see patients during one part of the year and not during another part. For example, if you’re an allergist in need of allergy testing billing, your client volume might be much higher during spring and summer, rather than fall or winter.

Generally speaking, a percentage-based option is the basis upon which most medical billing companies charges their clients. We believe it’s the optimum choice for healthcare practices of all types.

In the end, hiring a billing company really comes down to what matters most to the client:

  • What level of service do you anticipate?
  • How much patient volume do you have?
  • How significant is accuracy to your cash flow? Or, to put another way, how costly are denials?
  • Do you look for the billing service to manage coding, claims appeals, credentialing, patient collections, etc.?
  • Beyond just billing, do you need assistance with HIPAA compliance, pre-authorizations, etc.?
  • Are you concerned whether your billing team is in the U.S. or overseas?

These are just a few of the questions you’ll want to ask. There are plenty of billing services out there. It’s the medical provider’s task to work out both the quantity and quality of service(s). The soundest advice that we can provide is to take a medical billing company’s words to heart. In other words, listen to how they present themselves and keep an eye on their on-board process.

Our Medical Billing Service Benefits Your Practice

Most healthcare providers want paid within a few weeks for rendering their services, rather than months. The fact of the matter, when there are errors in your billing procedures, it can take months to obtain payment. Hence, when clean claims are processed, they will most likely get paid within weeks. Our motto is simple, “Get the claim out the door clean the first time.” Remember, when you consider outsourcing, you agree to specialists assuming the tasks where errors can be costly.

Medwave professionals are trained and re-trained due to the dynamic changes in the industry. Regarding new codes, dated codes, modifiers and more. For payment, all of those items must be taken into consideration for each claim submission. For a healthcare provider, billing is one of the most crucial components. A sizable portion of your practice’s income is the result of a having a top-notch medical biller in your corner.

We understand that outsourced medical billing can be a big change for any healthcare provider, even new practices (who we take on as clients). Making the wrong decision on a 3rd party service can be risky. We simplify and make the transition as transparent as possible. Contact us now, we’ll be delighted to answer any and all medical billing service questions.

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Medical Billing and Credentialing

What’s a 3rd Party Medical Billing Service? Where’s the Value for a Healthcare Provider?

The Basics of Medical Billing

As a healthcare provider, you wear quite a few hats. Chances are medical billing might be one of them. But is there a better way? Let’s discuss the advantages for your healthcare practice to consider outsourcing to a professional medical billing company.

It’s Important that We Agree upon a Shared Understanding of Medical Billing

Medical billing is critical process in the ongoing, inner workings of any hospital or healthcare provider. It consists of preparing claims and submitting them to insurance providers. This makes sure that the provider is reimbursed the correct amount for the service(s) rendered to patients.

Medical offices and facilities are paid from private insurances providers and a number of healthcare programs such as Medicare and Medicaid, which are financed by the U.S. Government. Being paid the appropriate funds allows the medical provider to remain open and function. With lower than projected reimbursements, it’s virtually impossible for them to offer top-notch healthcare to patients.

Up to this point, it’s become transparent that medical billing is essential to the upkeep of any healthcare provider as medical facilities rely enormously on insurance groups and other healthcare programs for income. That’s why it’s extremely critical for medical billing to be done and done correctly. Every patient who visits a hospital, immediate care center or other medical facility has information that must be documented and billed. Not only that, precise medical billing is vital in making sure patients aren’t left paying more for a procedure than they should and that they and their insurance company are charged for the appropriate service.

Now that we’ve established a shared understanding of what medical billing is and its value and importance, let’s discuss how an outsourced medical billing service benefits a healthcare provider.

With a Quality, 3rd Party Medical Billing Service, Here are Some of These Paybacks:

  1. Furnishes Medical Billing Experience and Removes Stress Factors

    True, your in-house billing team may have an ample amount of qualified experience, but outsourced medical billing eliminates many of the stress factors your practice encounters. In addition to being strictly committed to your billing, the staff at a medical billing company are attentive to any changes in the regulatory environment and in what way(s) they may affect your practice. Ensuring regulatory compliance means your medical practice will experience the most precise processing available.

  2. Eliminates Pain Points Linked to Medical Billing

    The seamless delivery of medical services is not quite as straightforward as one might believe, since healthcare providers have to not only dispense the proper care to patients, but carry out any number of administrative duties as well. Medical billing eats up valuable time, which could be spent resolving more urgent issues. The process of acquiring, training, insuring and retaining the appropriate candidates to administer billing task can be ineffective, expensive and beyond demanding. Plus, if claims are processed incorrectly, it can paint a negative portrait on the medical practice. A qualified, 3rd party billing group removes these pain points by enabling easier medical billing.

  3. Enables More Predictable Cash Flow; Speeds Up Collections

    Reliable medical billing companies employ skilled professionals that scrub claims (through a quality insurance process) before sending them off to the insurance payors. This leads to speedier claim processing, fewer rejections and consequently, a decrease in your outstanding AR days. The target should be to maintain your outstanding days in AR, at less than 30 days and an effective medical billing company should meet or exceed that goal. Lowering your outstanding AR days will deliver a more consistent and predictable cash flow.

  4. No Excuses, Single Point of Contact

    Most medical practices are forgiving of deficiencies in internal medical billing, since they are aware that their billing team gets pulled in any number of directions. Usually, this is linked to patient care or administrative duties which leads to accepting excuses and putting up with run-of-the-mill billing outcomes. With an experienced medical billing service, there are no disruptions and therefore, no excuses, since their single goal is collecting as much receivables as possible; in the quickest amount of time.

  5. Provides Consistency in Processing Medical Claims

    Another reason for using a medical billing company, the consistency provided in the form of denied claims appeals, staffing necessities, and a variety of other processing practices for medical claims and billing procedures. The professionals hired by a qualified, outsourced medical billing company are specialists in their fields. They understand precisely what needs to be done in order to process claims quickly and cost-effectively. Not only are they capable of upholding industry guidelines, but the medical billing company will be able to abide by ever-changing standards and legislation in the field(s).

  6. Exhibits Total Transparency Throughout the Medical Billing Process

    It’s evident that transparency is a significant component within the business relationship of a healthcare provider and a billing company. A reliable billing company is honest and up-front. This includes its data and services. Such transparency equates to an accurate and well-timed billing report. This is crucial, since medical practices do come under scrutiny for how they bill, the legalities behind it. Healthcare providers deserve to understand every aspect of their billing. Whether the information is technical or beyond the practice’s area of expertise, there is the requirement to know.

  7. Medwave Offers Best-In-Class Medical Billing Services

    Medwave extends its medical billing services to a plethora of medical provider types and specialty practices. Currently, we work for medical practitioners who focus effectively on delivering healthcare services and worry little about the medical billing side of things. Our clients are paid expeditiously and invariably with celerity.

Our staff of billing professionals are well versed with the codes of each billable claim. They remain resolute in the face of all new and old codes and stay updated to all the dynamic changes in compliance rules and regulations. By relying on our professional staff, you’ll appreciate the lasting benefits that come with how our experts provide accurate, efficient billing services for your healthcare practice.

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New Jersey Medical Billing, Credentialing

Medwave is pleased to offer our medical billing and credentialing services to healthcare professionals across the entire State of New Jersey.

Home to a strong network of world-class hospitals, New Jersey healthcare systems outpace the nation on several quality measures. New Jersey is home to 113 hospitals and 71 acute care hospitals. According to U.S. News & World Report’s 2019-2020 Best Hospitals rankings, five are nationally ranked and 15 meet national high performing standards.

Hackensack Meridian Health is a leading health care organization that is the largest, most comprehensive and truly integrated health care network in the state, offering a complete range of medical services, innovative research and life-enhancing care. The network comprises 17 hospitals with more than 500 patient care locations and 7,000 physicians. The Hackensack Meridian School of Medicine, the first private medical school in New Jersey in more than 50 years, welcomed its first class in 2018.

The merger of Barnabas Health and Robert Wood Johnson Health System in 2016 created RWJBarnabas Health and is one of the state’s largest integrated healthcare delivery systems. It provides treatment and services for more than five million patients each year and employs a workforce of more than 32,000.

Cooper University Health Care, the clinical campus of Cooper Medical School of Rowan University, is a leading provider of health services to southern New Jersey and has been a vital institution in Camden for over 125 years.

In the past decade, it has expanded throughout southern New Jersey with the construction of a state-of-the-art medical tower, the creation of a new medical school and the opening of MD Anderson Cancer Center at Cooper, bringing a broader range of options for cancer patients in southern New Jersey, Delaware and the greater Philadelphia region. 

New Jersey is also respected globally for its strength in the biopharmaceutical and medical device industries, thus the name “The Medicine Chest of the World.”

The state is home to 14 of the world’s largest pharmaceutical companies, including Novartis, Merck & Co., Johnson & Johnson, Bristol-Myers Squibb, Novo Nordisk and Bayer Healthcare. New Jersey also boasts a well-educated workforce with a high concentration of scientific professionals.

Managing the overall administration and reimbursement for all these medical facilities and practitioners is definitely not an easy task. That’s why we offer our medical billing and credentialing to a wide range of healthcare professionals in New Jersey.

How does Medwave Improve your New Jersey Medical Billing?

  • Cut rejections and denials – We will evaluate claims carefully to ensure they are finished before submitting to insurance, cutting rejections and denials.
  • Liberate your staff – Since we will process your billing, your staff can concentrate on their primary concern — caring for patients.
  • Improved cash flow – We sustain an increasing flow of claims going out and cash coming in. The result: As a rule, you get paid faster.
  • Make claims and collection processing more efficient – Our team will professionally manage your claims and ensure you have timely and appropriate reimbursements for the work you’ve completed.
  • Transparency — You can go through assembled data or oversee the process on your own schedule. This gives you on the spot assessments of how your practice’s billing is being processed.
  • Data security – Safeguarding patient data is essential. We will be responsible for protecting all patient information (HIPAA compliant).

Our expert medical billers, with their pool of knowledge, will provide your medical practice the edge in measuring up to other New Jersey medical practices.

New Jersey Credentialing Services

We are mindful of how the credentialing procedure can play havoc with your bottom line. Let’s say you have a medical professional just starting up in your practice or you simply want some help with the routine functions having to do with credentialing — either way, we’re here to help.

These are just some of the benefits we can provide for your credentialing process:

  1. A decrease in errors which would most likely delay the application procedure.
  2. Saves your practice time and paperwork and does away with aggravation.
  3. Frees up scheduled time for staff to work on patient care.
  4. You’ll witness an overall decline in routine operating costs.

Medwave is a respected credentialing company. We strongly believe we’ll have more success getting you credentialed (efficiently) than most other credentialing services. What does this mean for you? You can begin seeing patients with insurance(s) sooner rather than later. knowing the importance of medical credentialing can benefit any medical provider.

Medwave provides superior medical billing and credentialing services to the entire state of New Jersey which includes the cities of Atlantic City, Camden, Clifton, Elizabeth, Hackensack, Hoboken, Jersey City, Morristown, Newark, New Brunswick, Paterson, Passaic, Piscataway, Princeton, Secaucus, Teaneck, Tom’s River, and Trenton, among others. Contact us to find out more.

Original Story: New Jersey Medical Billing, Credentialing

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Medical Billing and Credentialing Made Easy

“There just has to be an easier way to perform our billing and credentialing.”

Does any of this sound familiar?

  • I’m tired of dealing with insurance companies!
  • I got into healthcare because I wanted to focus on patients, not paperwork and red tape!
  • I’d rather do without having to hire and train billing staff.
  • I’m ready to say goodbye to frustrating phone calls with insurance companies.

If you’ve had to perform your own billing and credentialing, you know exactly what we’re talking about. 

For any number of healthcare practices, in-house billing and credentialing is an unpleasant, yet necessary, chore. This is about to change.

From Miami to Phoenix, Washington, DC to Cleveland and Detroit and cities in between, Medwave is prepared to provide your healthcare practice or facility with the most efficient billing and credentialing services available.

Based in the Pittsburgh region, Medwave is recognized as a premier supplier of billing and credentialing services in the region, but we’re ready to offer our experience and know-how to healthcare providers based elsewhere.

In addition to those mentioned above, we’re also prepared to provide billing and credentialing services to healthcare practices, hospitals, testing labs, and other such facilities in Charlotte, Louisville, Tampa Bay and Philadelphia, as well as our neighboring state of New Jersey.

What can Medwave offer healthcare providers such as yourself?

First and foremost, we’ll take the confusion out of billing

For many physicians, the most anxiety-producing part of their job is handling their insurance payments. Moreover, as the billing process gets more and more complex, physicians and other healthcare providers see less and less revenue coming in.

We are a partner in getting your practice the money you’ve already earned. We’ve learned how to quickly generate clean and correct claims so that insurance reimbursements show up faster. This means, as a prime example, that Philadelphia medical billing is made easier and more efficient. 

We Reduce Medical Billing Errors

There’s no denying that healthcare is an ever-changing industry. For example, Miami medical billing rules and regulations are constantly changing and keeping up with all the variations can be rather time-consuming. This is even truer if you only have a few persons doing all the billing tasks. We’ve heard accounts from small practice Tampa Bay medical billing professionals concerned with the increasing number of changes. 

By employing Medwave, you won’t have to stress about all the rules and regulations changes. We’ll make sure our billing staff is always up-to-date on the latest changes, making it more likely to experience less billing errors that hold up reimbursements.

We Shrink Claim Denial and Rejection Rates

Denial management is an essential factor for healthy and successful cash flow. In the revenue cycle, timely follow-up, recognizing and effectively handling denials plays a crucial role. Cleveland medical billing experts tell us that high rejection rates are a constant drag on cash flow.

At Medwave, our experienced and proactive denial management team maintains close tabs on rejections and denials, acting quickly to revise any errors and making sure your claim gets paid in an appropriate manner. In addition to Cleveland, we invite the fellow Great Lakes City and their healthcare providers to consider a Detroit medical billing service.

That’s because they recognize that we have the know-how to evaluate and deal with reasons for rejections and, where doable, resubmit claims for reimbursement.

Likewise in North Carolina, we offer a Charlotte medical billing service.

Accounts Receivable is Indispensable to your Cash Flow

If it’s interrupted because of claims denials, payer guidelines or other matters, we’ll investigate and sort out the problem, ensuring your practice optimum cash flow. Keep in mind our goal is to take the financial pressure off you. 

We’ve talked to some Phoenix medical billing consultants about how important cash flow is in today’s economy and how we can help. There’s little doubt in our minds that Tampa Bay medical billing, credentialing consultants agree with this notion.

You’ll see a Reduction in Overall Costs

A number of New Jersey medical billing practitioners have discussed how the decision to outsource medical billing and credentialing to a third-party billing service has led to a dramatic cut back on overall costs for many practices. It’s because of the right mix of skill, experience and flexibility that allows a billing service such as Medwave to accelerate your revenue cycle. Let us help you put a lid on expenses.

You can Rest Easy with Transparency you can Trust

Youi don’t lose control of your practice by outsourcing to us. Allowing Medwave to manage your billing doesn’t mean you’re out of the loop. We offer the best of both worlds: Our highly proficient in-house team of experts handles your medical billing while you maintain full transparency into your practice’s financial performance. It’s this transparency that has convinced Louisville medical billing authorities to give us consideration as their medical billing service.  

We also help to pinpoint financial opportunities so you can drive practice revenue while we fast-track your billing processes and collections.

We’ll make sure you’re HIPAA Compliant

By law, medical billing services must conform with the Health Insurance Portability and Accountability Act (HIPPA). Any confidential patient information needed for coding claims and billing must be protected at all times, both at rest and in transit. 

Washington, DC medical billing professionals are especially on top of HIPPA rules.

At Medwave, we constantly educate ourselves on the complexities of HIPPA and the consequent regulations. A constant quality assurance program makes sure our team is constantly on top of the ever-changing billing rules.

We Drive Patient Satisfaction

The primary objective of every healthcare provider is to furnish quality medical care to all its patients and, in turn, acquire patient satisfaction and trustworthiness. Patient satisfaction is vital to attracting new patients and maintaining established patients. 

By using Medwave, the streamlined procedures promote patient’s satisfaction and trustworthiness for the healthcare provider.

Philadelphia medical billing, credentialing authorities, among others, have examined the importance of patient satisfaction.

Medical credentialing: Equip Your Healthcare Practice

The medical credentialing process is a systematic approach to collect, record, review and verify a healthcare provider’s professional qualifications. These professional qualifications are reviewed and verified carefully and include such items as the healthcare provider’s training, license to practice, certifications or registration to practice in the healthcare field and background checks.

Poor, or no credentialing, is one of the biggest mistakes made by any medical entity. Becoming credentialed with insurance companies can be a formidable process, but that lack of credentialing will result in denied claims, which means no revenue until the claims can be rebilled.

Just ask Cleveland medical billing, credentialing professionals about the consequences of poor processes. Phoenix medical billing, credentialing experts share these concerns.

As you can see, healthcare credentialing management is a critical function for hospitals as well as individual and group practices. It not only helps protect a provider from potential lawsuits, it’s also a way to ensure that medical practitioners are qualified to do the job they’re being hired for. It’s actually a safeguard to protect patients by providing qualified, high-quality healthcare providers.

For the healthcare provider, however, the process of medical credentialing can be a nerve-racking task. With the millions of medical practitioners currently working in the U.S., along with the average practice length of about 40 years, insurance panels are becoming crammed and are slow to accept new medical providers into their network.

Miami medical credentialing experts are among those that have experienced this slow-down in the credentialing process.

Bid Goodbye to Downtimes and Lengthy, Arduous Credentialing

Our credentialing team helps group practices, healthcare organizations and independent medical practices to credential effortlessly with federal, private and workers compensation payers. 

We do so by providing the same benefits as described for billing to include a reduction in application mistakes, a savings in time and a reduction in paperwork, and an overall decrease in operating costs. 

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Allergy Immunotherapy Billing Options

The complexities of allergy immunotherapy billing

Allergy immunotherapy (aka allergy shots) is the recurrent administration of specific allergens to individuals with immunoglobulin E(IgE)-mediated condition. The goal is to reduce or stop the allergy by diminishing the strength of the IgE response. These treatments, being patient specific, can have serum mixed for up to one year of usage.

Put simply, Immunotherapy involves injection of the exact things to which you are allergic, named allergens. For example, if your skin test indicated that you are allergic to trees, small amounts of tree pollen extract will be utilized in your allergy vaccine.

Allergy testing and immunotherapy have had a significance in reestablishing and preserving balance in the patient’s biochemical system while dealing with a variety of medical emergencies. That’s why the field of immunotherapy has been demonstrating such an impressive growth. While this growth has no doubt improved medical practice volumes, it has not curtailed billing complexities that may have adversely affected reimbursements. This is where knowledgeable billing services can help a medical provider take command of their reimbursements and allow them to concentrate on their core medical practice.

As an example, the process may involve the desensitizing procedure in order to create a maintenance dosage of antigen for each patient. Once again, billing know-how is essential in determining if the insurance company will reimburse for the pre-mixed allergens or batch billing at the time of mixing. Billing for administering the antigens, either single or multiple shots, and desensitization also demand an understanding of this specialty.

At Medwave, we recognize the challenges and concerns in immunotherapy billing, including the disparities in the build-up and maintenance dosages.

One other concern: If a medical practice accepts Medicare, there is a totally distinct set of rules regulating serum billing and mistakes in the billing process can result not only in claims denials but end up with fines.

Why use Medwave as an allergy immunotherapy billing partner?

  1. Better claim processing
    Every insurance claim should be paid quickly and accurately in order to boost a medical office’s cash flow. Time is precious. By and large healthcare staff don’t have the luxury of assessing and following-up on each and every claim. Let’s face it, healthcare professionals and their support staff are often yanked in a variety of directions and wear many hats. Claims need to be presented as-soon-as-possible and accurately the first time. Otherwise, unpaid claims can instantly rob an office of resources that could be employed elsewhere. Loads of phone calls to insurance providers only squanders more time and increases internal resource frustration. By outsourcing your allergy testing billing, (typically) you save a bunch of money as you won’t have to invest in office infrastructure, medical billing software and the salaries of added staff.  Always keep in mind, qualified billing companies have a cost-effective way of getting claims accepted by insurance providers. Overall, the well-timed submission of claims boosts your revenue.
  2. Higher reimbursements
    By handing your complex billing processes over to qualified and experienced billing experts, healthcare providers achieve record numbers in reimbursement. Expert billing professionals remain up-to-date on today’s medical billing codes and are able to code claims more precisely. They review claims to make sure they are accurately coded and track them so they can be halted, before they ever have the chance to be denied. By attacking your denial rates and improving your clean claims, outsourcing your medical billing earns your practice quicker and higher reimbursements on average.
  3. Reduces staff errors
    Even the smallest blunder can make an insurance company refuse a medical claim. Obliging someone on your staff to fix the mistake, resubmit the request and wait for the corrected application to be accepted and administered can be very time-consuming. Working with a specialty firm such as Medwave vastly cuts down on staff blunders, given that they have more experience working in medical billing and have gone through lengthy training. Generally speaking, this support is superior to most in-house team(s) performance.
  4. Allow medical providers to focus on patient care
    Medical billing can be hectic from time to time and trigger a considerable amount of stress. Imagine if you or your medical staff are not the ones performing all the billing responsibilities—wouldn’t you be overjoyed? And on top of that, you and your staff can truly focus on taking care of your patients. Truth is, this is more helpful and advantageous to practices that are new or can’t afford to hire a medical staff to perform hectic billing tasks. Aside from that, hiring a firm like Medwave gives physicians much needed relief from performing time-consuming billing. Additionally, it makes good business sense to invest time and effort on your core competencies, such as patient care. It’s really quite easy — engage Medwave and let us be your billing staff. You won’t have to be concerned about taxes, vacation/sick leave, payroll or personnel management if you work with us. Even if you decide to keep some (or all) of your existing billing staff, but redistribute their responsibilities, you can be assured in seeing your billing is being managed professionally and being dealt with each day.
  5. Transparency
    Others in the medical industry think that outsourcing your billing represents you giving up control and the power of your practice, but this is completely untrue. When you outsource your billing to Medwave, you really gain greater control as well as transparency. You will be able to review your performance data or examine the process at any time of your choosing. This gives you up-to-the-minute assessments of how your practice’s billing is being handled, at any point.

Conclusion

Whether or not your practice should outsource billing services is a question that quite a few medical practices before you have asked. Some say, under your own nose is where medical billing should reside, but that’s not automatically the case. Many medical providers manage their billing processes in-house only to have denials slip through their fingers, payments going unpaid, and an ever more annoying administrative responsibility facing them.

Our certified team is on hand to deliver total management of immunotherapy medical billing, from claims submissions to payment posting to coding with steadfast support along your entire path.

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Allergy Testing Billing and Credentialing

Testing is Critical to Treating Allergies

Allergies are the fifth leading chronic disease in the United States and third-most common chronic disease among youth. Allergies impact in excess of 50 million people living in the USA, according to the Allergy Testing page at American College of Allergy, Asthma, and Immunology website. Inhaled allergens are by far the most widespread type.

Allergy symptoms are the outcome of an overreaction of a person’s immune system to an irritant or allergen, such as dust, mold or cat dander. The immune system releases immunoglobulin (IgE) antibodies in an attempt to fight off the irritant, or allergy. Allergy tests attempt to detect these IgE antibodies in different ways. Since allergies can cause symptoms ranging from mild to life-threatening, if a person has an allergic reaction, they’ll want to know what’s causing it.

Blood testing and skin prick testing are the usual tests to help determine the likelihood of having an allergy. This assists the doctor in identifying the allergies That way, the patient and doctor can work together to find ways to stop or lessen the symptoms.

Obviously, testing is critical to treating allergies. The specific allergy must be identified (by an allergist or immunologist) before it can be treated accordingly.

Allergy Testing Billing is not a simple, clear-cut process

If you’ve had to do allergy testing billing before, you know how muddled it can get. Not all insurance companies view allergy tests identically and the way they deal with them is often differently from the Medicare / Medicaid billing system, as well.

This places those in charge of allergy testing billing management in tough circumstances. If you take the time to assure that each and every claim is submitted accurately, it can leave you little if any time for to be more patient-oriented. If you don’t, you can see a cascade of fines, deferred payments or outright rejected claims.

Moreover, some allergy testing services have acknowledged that they have been on the radar of third-party payer investigation units because they have learned that many practices bill these services incorrectly.

How cumbersome is allergy testing billing?

Allergy testing billing can be challenging. 

For starters, as skin testing is used as the principal tool to establish treatment for the allergic condition, billing for this component demands wide-ranging experience.

Knowing when to use modifiers, in concert with the appropriate number of skin tests to be billed, and how the specific insurance company responds all need to be determined at the beginning of treatment. As the number of testing “pricks” increase in terms of quantity, the amounts billed must be plainly defined and documented. Many insurance firms have “ceilings” or quantity limits for a specific day of treatment thus leading to the necessity for return visits. Failure by the biller to identify the proper amount of testing can lead to a denial of claims.

Food sensitivity testing, poles apart from prick testing, requires the grasp of billing protocols for lengthy services and for reporting the monitoring of the patient’s vitals (blood pressure, pulse rate and respiration) throughout the documented test.

Another potential logjam — In standard medical practice, allergy testing is not to be performed on the same day as allergy immunotherapy and this means that the two different billing codes should not be reported together. Instead, allergy testing must be executed before immunotherapy, so as to identify the offending allergens.

For this reason, the number of tests administered must always show on any billing claim.

Benefits of partnering with Medwave

Our billing personnel are aware of the nuances of allergy testing billing and coding and we will work hand-in-hand with your practice to identify potential problem areas. You can be assured that our team of certified medical billers will manage all aspects of your allergy billing to help ensure you receive proper compensation with no unwarranted delays.

With years of experience managing allergy testing billing, we reduce costs and risks while bringing you best-in-class service that will deliver the following benefits:

  • Streamline claims and collection processing. Our professional medical billers make sure your claims are submitted in an accurate and timely manner to ensure you receive timely reimbursement for the work you have performed.  We have actually seen some of our clients increase their revenue without seeing any additional patients.
  • Decreased rejections and denials. We thoroughly review claims to ensure they are complete before submitting them to insurance companies or government programs such as Medicare. We address each and every claim as you would, not just high-value claims.
  • Leads to an increase in cash flow. Whenever your staff is away, on vacation or for other reasons, the claim submission gets delayed leading to a lot of backlogs and issues with cash flow. Irrespective of your current staffing situation, our billing service maintains a continuous flow of claims going out and cash coming in. With this, you will typically get paid faster by investing almost nothing in staff training.
  • Free up your staff to focus more on patient care. Because we manage the billing process, you and your staff members are relieved of billing duties and can give your complete attention to solving patient’s needs. it just makes good business sense to invest time and effort in your core competencies like patient care as it sets you apart from the competition.
  • Ensures billing compliance. There’s no denying that healthcare is an ever-changing industry. Among all these changes, keeping up with medical billing comes as a challenge the practice owner has to make sure that the office is following all the rules and protocols. With Medwave, there are no such concerns as we stay atop the latest changes to ensure proper submission of claims and complete compliance. 
    • Improved security of patients’ data. When it comes to medical records, data protection is critical. As information stored in health records is more valuable than ever before, it becomes expensive to maintain a system to guard that data. By assigning all your allergy testing billing to Medwave, we make a patient repository and protect all data records. We also ensure there is no or minimal possibility of a data breach.
  • Peace of mind. Outsourcing medical billing services gives you peace-of-mind that your claims are clean, your patients understand their billing responsibility and that your practice is in the hands of billing experts who will not let you down.

Bottom Line: What’s in it for you?

Outsourcing healthcare billing work can be a tough decision, but (ultimately) it will save your allergist practice time and money.

The result of engaging Medwave will lead you and your team to considerably less stress. You can concentrate on providing the best possible services while we make sure you get efficiently paid for it. Additionally, you’ll see significantly more return on claims (annually), meaning you’ll have more access to funds and your business will thrive, allowing you to offer effective patient care.

At Medwave, we’ve built our business model around a commitment to creating trustworthy partnerships. We believe in setting clear expectations for performance and striving to always meet these expectations. Contact us today to see how we can be the best asset to your allergy testing practice, by helping you get paid fast and efficiently.

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Prior Authorization Medical Billing

Health Insurers and Prior Authorization

Like sands through the hourglass, so are the days of prior authorization

“This procedure will require prior authorization.” Words that no patient or healthcare provider wants to hear when they are ready to proceed with a doctor-approved procedure for a medical matter. However, it’s one of the utilization management tools that insurance companies have fostered to decide if specific prescribed procedures, services and medications are medically required or whether there is an equivalent useful treatment existing for the patient. Healthcare.gov defines prior authorization as “approval from a health plan that may be required before you get a service or fill a prescription in order for the services or prescription to be covered by your plan.”

Importantly, services (medications, imaging studies, etc.) that need prior authorizations require healthcare providers to acquire consent from the patient’s health insurance before the cost of the service is covered by the company. 

The process can be lengthy and can frequently put off patients getting the care they need. These roadblocks can often trigger frustration and apprehension for doctors, hospitals and patients while adding to the mountain of paperwork doctors and hospitals must complete.

What are the effects of prior authorizations on the medical industry?

It’s like being on an un-merry-go-round

Truth is, one of the more irritating tasks for physicians and other healthcare providers is securing prior authorizations for matters such as testing and prescriptions. In the eyes of some, prior authorizations are not anything more than insurance companies injecting themselves into the provider’s decision-making activity, generating glitches for both providers and patients.

Moreover, prior authorizations have produced a restraint on the revenue stream of many healthcare provider organizations. If a treatment procedure doesn’t get authorized, the provider can’t continue with the service. In some instances, such interruptions bring about a loss of revenue since the patient ultimately decides to proceed without the treatment or because such circumstances compel additional negotiations before the insurance company will sanction the procedure.

The prior authorization process is often further muddled by a mixture of factors:

  • Plenty of mandatory steps, each presenting the possibility for interruptions and mistakes.
  • Involvement by many people including patients, healthcare professionals, and the patient’s health insurance company.
  • Absence of standards, especially when it comes to payer policies.
  • Shifting payer rules that must be continuously reviewed and amended.
  • Thousands of payers and health plans all competing for a rapid response.
  • Manual assessment of prior authorization requests and medical charts by clinicians.

Depending on the complexity of the prior authorization application, the volume of manual work required, and the prerequisites specified by the insurance company, a prior authorization can take anywhere from a single day to a month to process. The AMA’s Prior Authorization Physician Survey disclosed that 26 percent of healthcare providers reported waiting three days or more for a decision.

The AMA found, on average, a medical practice will complete 29.1 prior authorization requests per physician per week that take 14.6 hours to process. About half of the requests are for medical services, while the other half are for prescriptions.

According to another AMA survey, 75 percent of physicians participating reported that issues related to the prior authorization process can cause patients to abandon their recommended course of treatment. In the same survey, 28 percent reported the prior authorization has led to a serious adverse event for a patient in their care. Says Matthew Hahn, MD, author of Distracted: How Regulations are Destroying the Practice of Medicine and Preventing True Health-Care Reform, “The more hoops a doctor or practice has to jump through to obtain care for their patients, the less likely that care will take place.” He adds, “The burden created by prior authorizations is extremely taxing to physicians and medical practices, creating minutes to hours of work just to obtain basic care for their patients. This translates into added administrative costs for practices, and incredible distraction from patient care, which is difficult even under optimal conditions.”

What can be done about prior authorizations to improve revenue?

Some physicians who have taken it upon themselves to streamline the prior authorization process have suggested that healthcare practices need to standardize their in-office procedures for processing such authorizations. 

Adds one such physician, “The real challenge is knowing which services will require prior authorization. We realize that it’s going to be an administrative burden, but if we can approach it as a team so that the providers are not completely overburdened, it makes it seem more manageable.” There are also technologies that can help. Says one healthcare professional, a strategy would be to take advantage of any electronic or automated processes a payer may have for receiving requests and returning determinations.

Physicians must also communicate effectively with patients concerning prior authorizations and it’s usually best to tackle the situation proactively rather than wait until a treatment is denied. Once it’s understood that a prior authorization is required it’s important for physicians to educate the patient on the process and the possibility that the authorization might be disallowed. Another physician tells us, “Patients need to understand, up front, that prior authorizations take time, and it could mean a delay in care.”

Additionally, make sure the administrative staff are knowledgeable in the coding requirements for the various payers. From time to time, denials take place when a physician or technician enters data without complying with the coding requirements of the insurer. 

Lastly, the staff should reexamine the prior authorization applications before submission to steer clear of errors.

How can a coding and billing firm such as Medwave help with the prior authorization process?

Studies show that over 80 percent of reimbursement claims are denied because the healthcare provider did not get the appropriate prior authorization, or the application included errors. Any errors contained in the prior authorization form, from egregious to trivial, may flag it for a denial. It could be that two different specialists both ordered a CT scan for dissimilar purposes, but the insurance company won’t approve both unless a medical necessity is indicated. Or it could be as innocent as a number on a patient’s health ID card may be transposed, a middle initial might be keyed inaccurately, or an address may be half finished.

Such a healthcare provider can slash these errors by employing a coding and billing company to help expedite the approval process.

Medwave provides a total medical billing solution that can be included with your electronic health records to aid you to better manage your income stream. This makes it possible for healthcare providers to submit claims more promptly, acquire prior authorization quicker so you can provide care straightaway and, of course, get paid sooner.

TAGS: health insurance, healthcare, healthcare providers, Medical Billing, medical credentialing, medical practice, prior authorization, utilization management

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Behavioral Health Billing

Behavioral Health Billing Case Study

Type of Practice: Behavioral Health Group

The Challenge:

A successful behavioral health practice approached Medwave to manage their billing process. Up until now, they were performing their own billing in-house using various staff members who had had some formal training. However, they were finding that these staff members were spending an inordinate amount of time with billing, insurance regulations and collections than they were with patients. The process was ugly and it wasn’t streamlined very well.

Additionally, they wanted us to address claim-related glitches that included a lack of follow-up on claims, delays due to coding errors, issues causing claim underpayments or no payments and claims denials due to lack of prior authorizations.

The Response:

At the onset, our billing experts followed up on several of the client’s unpaid, underpaid and denied medical claims. Next, we quickly fixed the client’s problems with insurance companies. We then established a proficient medical billing team that included both medical coding and billing professionals.

The client was satisfied with the way we managed their coding and billing needs and after a month they made the decision to partner with us for full-service behavioral health billing.

The End Results:

  • Our medical billing team significantly brought down the client’s average days from 35 to 21 within 6 months.
  • We boosted the client’s collection percentage from 48 percent to 65 percent within 6 months.
  • By improving their collection ratios, the client was able to benefit from a substantial upgrade in cash flow.
  • The client was able to apportion all their time and effort to patient care. Staff were able to concentrate on their healthcare practice rather than dealing with medical coding and billing.
  • We were able to maximize the client’s operating efficiency and radically reduce their administrative costs.

TAGS: Behavioral Health, Behavioral Health Billing, Medical Billing, Mental Health, Mental Health Billing, Pittsburgh Behavioral Health Billing

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Medical Billing

Billing and Coding Partner for Healthcare

Medwave is a premier provider of medical billing and coding services. But, exactly why are billing and coding so important and how can Medwave help your healthcare center perform these functions?

It’s certainly no surprise that the healthcare business is thriving, and its growth is projected to endure well into the future. With a population exceeding 46 million Americans (ages 65 and older), which is predicted to double by 2060, the demand for healthcare workers will not disappear anytime soon. At initial glance, doctors and nurses would seem to be directing the show at medical facilities across the country. That’s a reasonable judgment, seeing as they’re the ones treating patients. However, there are numerous other individuals performing at hospitals, medical offices and similar healthcare locations that make those visits to these healthcare providers possible.

Two such jobs are medical billing and coding

These functions are among the more indispensable elements in any of today’s medical practices. Accuracy in both is critical to meeting concerns such as patient safety, prompt payment and a generally successful business venture. That’s why medical billing and coding demand experienced professionals able to read, understand, document and track intricate medical information without delay, uphold patient privacy and pay strong attention to detail.

*THAT’S WHERE MEDWAVE COMES IN

To better understand their importance, however, we first need to be sure we’re on the same page when it comes to their day-to-day duties. Medical billing consists of preparing billing claims and submitting them to insurance providers. This makes certain that the hospital or medical office is reimbursed the accurate amount for the services they offer patients. Such reimbursements are provided by private insurance firms and assorted government healthcare programs, such as Medicare and Medicaid.

While it also concerns insurance reimbursement, medical coding is different in that it consists of a distinct code for each diagnosis and medical procedure. The conversion of diagnoses and procedures into these universal codes permits the healthcare provider to accurately process the bill. Insurance firms, clearinghouses and other healthcare payers rely on professionals to accurately describe what medical services, tests, procedures and medical devices were provided to patients. When a service, test or procedure appears out of place, claims may be denied or rejected.

Did you know that medical coding actually dates to public bills of mortality posted in 18th century London? It was through correlating these bills that doctors were able to establish the cause of a cholera epidemic.

Truth is, it’s just as critical today as the data collected via medical coding is drawn upon to enhance overall healthcare. Yes, the results are submitted to payers, but the data stemming from the codes are used to clarify utilization, manage risk, pinpoint resource use, build actuarial tables and bolster public health in general.

So, just how does medical billing and coding help to improve the medical industry?

Help to improve patient-centric care

Perhaps you’ve overheard a conversation in a doctor’s office or hospital on what persuaded a person to become a doctor. Most responses would center around:

  • I want to care for people.
  • I’ve wanted to be in the medical professional for as long as I can remember.
  • I want to discover a cure for diseases.
  • I want to help make the world a better place.
  • I want to make a lot of money (ha!)

We bet, however, you’ll never hear anyone replying he/she wants to become an expert in billing and coding requirements. After all, these functions are the last thing on one’s mind when contemplating a career in medicine. A medical provider’s principal job is to ensure the health of his/her patients, not devoting hours to labor-intensive paperwork.

What can Medwave do? Our medical billers and coders make sure they competently handle patients’ insurance claims so that medical providers can fulfill their responsibilities to their patients without fussing over billing and coding tasks.

Help comply with rules and regulations

Another responsibility of medical coders and billers is to observe the appropriate medical rules and regulations. For example, they must adhere to the rules pronounced by the Health Insurance Portability and Accountability Act (HIPPA) and other similar agencies.

The HIPPA Act was passed in 1996 and is sometimes called the Privacy Rule. One of the most important regulations in this act is patient confidentiality, which has made it necessary for every medical practice to create safeguards against the leaking of confidential patient information. This means every employee, including billers and coders, must have a thorough understanding of and commitment to patient confidentiality.

Another requirement of HIPAA is the use of ICD-10 codes which allow for more specificity in the reporting of patient diagnoses. These codes support medical billing by explaining why a patient sought medical services and the severity of their conditions or injury.

Medical coders also must assure that the information they are making use of is secure and is never furnished to any person that may possibly breach the confidentiality of the contract. That’s why healthcare providers need coding specialists who have a thorough understanding of the security measures and strive to follow the rules.

What can Medwave do? Our medical billers and coders are well versed in the rules and regulations, as well as the security measures, that safeguard a patient’s privacy.

Help smooth flow of payment

Medical coders and billers are, above all, accountable for the smooth flow of medical payments. Coders translate medical terminology into a standardized format, allowing information to be transmitted accurately between healthcare providers and insurance payers.

On the other hand, medical billers manage claims capably by having a thorough knowledge about how to handle claims denial, claim follow-ups, submission of appeals, billing of claims and other such matters.

What can Medwave do? The medical billing and coding process is vital to the existence and financial health of a medical practice or facility. Our team of coding and billing experts possess the necessary skills to make sure your claims are handled right the first time, every time.

Help insurance providers

Insurance firms generate their profits by charging those who hold policies monthly fees, or premiums. The buy-ins from the policy holders in the pool allows the insurance providers to cover the bulk of medical costs, depending on the specific policy. That’s a bunch of money coming in from reimbursements and not out of consumer’s pockets. That’s why it’s so critical that medical billing and coding be managed and managed correctly. Every patient who visits any type medical facility has information that must be recorded.

What can Medwave do? Precise medical billing and coding is essential to ensuring that patients aren’t left paying more for a procedure than they ought to and that they and their insurance provider are charged for the appropriate services. Our coding and billing professionals help ensure patients and insurance providers are charged accurately and insurance carriers pay their claims accurately and on time.

Summary

Just like any business venture, your medical practice must have a viable revenue stream and a steady cash flow to not only thrive, but to survive. Problem is, we’ve witnessed various medical practices struggle with exactly how best to bill for services rendered and collect payment for those services, sometimes putting the entire practice at risk.

At Medwave, we understand nothing is more critical to your business than the efficient managing of your revenue. In response, we’ve created a full-service medical billing and coding service to help you get paid both faster and in full. By not concerning yourself with these functions, you don’t have to worry about hiring your own team of billers and coders, saving you time and money.

Maybe all of this makes no sense to you and you’re asking yourself, “what is medical billing?” If that’s the case, just call us.

In brief, we have helped solve the puzzle that has troubled healthcare providers since the leather-bound volume of patient payments was kept by Philadelphia physician William Shippen, Jr. in the late 1700s – getting paid!

Medwave offers top-notch medical billing services. Contact us to find out what we can do for your healthcare group.

 Healthcare Billing, HIPPA, Medical Billing, medical coding