Are you a dermatologist struggling with administrative burdens? It would help if you had dermatology medical billing software. The fact is that as a healthcare provider, your primary focus should be providing quality care to the patients. However, it doesn’t mean you should ignore using dermatology medical billing for your revenue cycle.
Billing is indeed an integral part of your dermatology practice, and it can be quite a complicated task to navigate through the intricate insurance landscape. In this blog post, we will explore the common challenges that dermatologists face in medical billing and provide some tips to overcome them. So, let’s dive in!
As a dermatologist, your EMR needs are very specific. It is not a simple process to select a Dermatology billing software that meets all your medical billing requirements.
What is Dermatology Medical Billing Services?
Dermatology medical billing is the process of submitting claims and receiving payment for medical services provided by you as a dermatologist. Dermatologists are specialists in treating various skin conditions.
They specialize in the diagnosis and treatment of various skin disorders. Dermatology medical billing is an essential part of a practice’s revenue cycle, as successful billing is directly responsible for a healthcare business’s financial health.
When you record on paper, there are high chances of data getting lost or
disorganized during the entire medical billing process. The billing software makes it easier to digitize the records, so they are easy to organize and keep secure.
With proper dermatology billing software like Unify Medicraft, the early detection and treatment of various skin conditions have become easier. Dermatology medical billing is an important component of every healthcare practice which ensures the seamless operation of medical practices while safeguarding patients’ well-being.
When your billing process is accurate, it not only keeps the practice financially fit but also ensures that patients receive the necessary care without strain.
Dermatology Medical Billing Guidelines
Medical coding in dermatology involves translating the diagnosis, procedures, and treatments provided by dermatologists into specific codes. Therefore, dermatology billers and coders must know codes for each diagnosis and treatment.
They must also know the difference between simple, intermediate, and complex sizing terms. Furthermore, they must understand the difference between cosmetic and medical dermatology.
Medical dermatology services treat a specific condition or disease and are usually covered by insurance. Cosmetic procedures, however, improve skin appearance and are billed directly to the patient.
Having a dermatology billing cheat sheet is also helpful when billing. It summarizes the important aspects of dermatological coding. These include accurate codes for each procedure and how modifiers should be used.
Common Dermatology-Related Medical Codes
Dermatology-related medical CPT code is the process of translating the diagnosis, procedures, and treatments provided by dermatologists into universally recognized codes.
The most common dermatology Current Procedural Terminology codes used by dermatology are listed below:
The ICD-10 Code for Urticaria :
- L50.0 Allergic urticaria
- L50.1 Idiopathic urticaria
- L50.2 Urticaria due to cold and heat
- L50.3 Dermatographic urticaria
- L50.4 Vibratory urticaria
- L50.5 Cholinergic urticaria
- L50.6 Contact urticaria
- L50.8 Other urticaria
- L50.9 Urticaria, unspecified
The ICD-10 Codes for Acne :
- L70.0 Acne vulgaris
- L70.1 Acne conglobata
- L70.2 Acne varioliformis
- L70.3 Acne tropica
- L70.4 Infantile acne
- L70.5 Acne excoriée
- L70.8 Other acne
- L70.9 Acne, unspecified
- L73.0 Acne keloid
Revenue Cycle Management Steps
- Verify Patient's Insurance Eligibility
It is important for healthcare providers to first verify patient insurance eligibility before providing treatments. The insurance coverage also depends on dermatology procedures and the patient’s insurance plan.
Accurate verification avoids claim denial and ensures timely reimbursement from insurance payers.
- Rendering Services and Capturing Charges
Healthcare providers must keep detailed records of patient appointments to include these services when processing their claims.
Capturing charges is often complicated for dermatology billers. This is because the same procedure can be carried out on different anatomic locations in a single visit. Also, billing and coding changes are based on treatment locations in the body.
- Claims Submission
After a medical appointment, a dermatologist medical coders translates the treatment into codes and medical billers submit these codes to the patient’s insurance provider. Claim submission before the deadline to avoid experiencing nullified coverage by some insurance companies.
- Payment By Insurance Company
The insurance company will review and process the claims after submission. Payment will be issued for approved claims, and any denied claims will be appealed or resubmitted.
- Data Reporting
Dermatology uses data reporting tools to accurately track and report data on the services provided, payments received, and outstanding claims denials. This is important for monitoring the financial performance of their practice and identifying areas for improvement.
The Challenges of Dermatology Medical Billing:
- Challenges Regarding Documentation
There are various reasons to ensure that the documentation you provide is accurate. It acts as a legal document that will prove what services were rendered, why those services were rendered, and why the patient came to the provider.
If the situation arises, this documentation can also act as evidence in a court of law. Apart from that, it is essential to ensure accurate reimbursement for the various procedures performed.
- Different Systems for Coding
Coding systems are followed for the procedures performed by physicians after the patient arrives. Reimbursement is provided by the Insurance companies based on these coding systems. In a general sense, providers must use The International Classification of Diseases (ICD) and the Current Procedural Terminology (CPT) codes.
Under the Health Insurance Portability and Accountability Act (HIPAA), ICD-10-CM is the standard transaction code set for diagnostic purposes. In ICD-10, the codes for diagnosis are much more detailed, typically 3 to 7 characters in length and start with an alpha character.
Every kind of inpatient and outpatient procedure is indicated with the Current Procedural Terminology (CPT codes). To bill for in-office procedures like skin biopsies, destructions, excisions, and Mohs surgery, Dermatology practices use many of these codes.
- Dermatology Billing Compliance
If you don’t have prior knowledge regarding dermatology billing, it can lead to overuse of modifier 25 and modifier 59. If we talk about modifier 25 it is defined as “significant, separately identifiable (E/M) service by the same physician on the same day of the procedure.”
However, modifier 59 is defined as a Distinct Procedural Service. There are certain circumstances where it may be important to indicate that a procedure or service was independent of other non-E/M services that were performed on the same day.
- Outdated patient information
Various dermatologists find it challenging to collect the latest insurance information from their patients. However, it is important to ensure the updated patient information gets paid and avoid any claims denials. When you double-check insurance information, it can save your practice months of unpaid claims time.
The challenges in the entire billing process are inevitable. However, with proper tips and strategies, these challenges can be eliminated.
Best Practices for Dermatology Medical Billing and Coding
Understanding the best practices for dermatology medical billing and coding increases your revenue, efficiency and saves staff time. Here are some of the practices you can incorporate in your billing process:
- Complete Documentation
Pay attention to detail and document every step from initial diagnosis, patient history, and pre-existing conditions to procedures and approved treatment plans. These ensure your code and filings are accurate.
- Accurate Coding
Ensuring your staff is up to date with the current coding guidelines is essential for successful dermatology billing. Set up continuous training to stay abreast of any changing regulations.
Under-coding is also a significant problem, and it occurs when a dermatologist treats several related skin conditions but only bills for one procedure using a single CPT code.
Dermatologists can achieve maximum reimbursement. by ensuring their medical billing service team understands the right code to use for every treatment.
- Timely Claim Submission
Medical billing requires timely submission of claims ensuring prompt claim approval. It also avoids waiting too long to resubmit any denied claims as this can lead to reimbursements being stalled.
- Effective Follow-up
Following up on your claim submission is vital for successfully increasing your revenue. Your database must have current patient information and a system for automated and manual follow-up.
Tips for Improving Dermatology Medical Billing and Coding Services
- Submission of Claims on Time
If you want to increase your chances of full reimbursement from the payer, timely claim submission is a must. Make sure you make it your priority for your back office to file claims daily. This helps to improve your clean claims ratio.
- Determine Co-Pays at Time of Service
You must have a proper mechanism to determine in advance the co-pay each patient owes you. There should be an official policy to collect payments in advance. Your front-desk staff must sort out if there are any issues with the patients who refuse to make the payment.
- Frequently Update & Verify Patient Insurance
The patients who are your most frequent visitors are reluctant to share information and give their insurance cards each time they come in for treatment. However, make sure that you check patient insurance every time they come. This helps handle things appropriately with the insurer.
- Track & Follow-on Unpaid Claims
You should keep track of submitted claims which helps you to know “what you’re not being paid for” and “what you’re being paid”. If a claim takes longer than sixty days to be paid, follow up before you resubmit. Sometimes all it takes to get your claim handled by a payer is a phone call.
- Hire Professional Dermatology Billing Services
Hiring a professional medical billing company like Unify Medicraft is essential to avoid claim denial and revenue loss. Medical coding in dermatology can be challenging for providers to keep up with billing regulations. So, partnering with a professional billing company helps streamline their billing processes, free up internal resources, and maximize revenue.
Features Of Unify Medicraft: Your Dermatology Billing Software
When you choose medical billing software to manage the coding and billing procedures in your dermatology practice, you handle your patient information and data more effectively. Unify Medicraft, the professional software for your dermatology practice, comes with the following features.
- Get Customized Templates
We know that as a dermatologist you are exposed to treating various skin conditions from rashes to insect bites, and more. It means that your patients’ needs vary. With various specialized templates available, the treatment of patients can be easier and quicker.
- Personalized Dashboard
The feature of the Dashboard is extremely helpful in managing the day-to-day tasks of your healthcare practice. Through the personalized dashboard, you can review tasks and assign tasks to other staff members.
- Proper Lab Integration
When you have proper integration and lab connections through your EMR, it helps receive quicker lab results, and hence patients can receive treatment faster.
- Practice Management Solutions
One of the fast and effective ways to finish and manage clinical tasks and document patient encounters is with Dermatology-specific Practice Management (PM) solutions by Unify Medicraft.
- Patient Engagement Tools
It is important to engage patients when they are connected to you. Patient care engagement tools like patient portals help patients to get control over their billing process. It assists them in scheduling appointments online and communicating with their doctor with the help of messaging, email, or video securely.
- Coding & Billing Services
You will have your coding and billing process sorted with us. Our smart billing solutions offer advanced functionalities for checking claims, e-claim submission, and denial management. This reduces the chances of any human errors.
Benefits of Outsourcing Billing Services to Unify Medicraft
Unify Medicraft has served multiple healthcare providers. Our billing teams possess diverse experience in serving dermatologists in various specializations nationwide. It includes:
- Cosmetic Dermatology
- Dermatological
- Procedural Dermatology
- Dermatopathology
- Dermato-epidemiology
- Immuno-dermatology
- Hair Transplantation
- Oncology
- Pediatric Dermatology
It is time for you to detect & prevent revenue leaks and secure higher reimbursements through meticulous coding and billing operations with Unify Medicraft.
Conclusion
Therefore, it is obvious that the spectrum of dermatology demands precise documentation and coding for accurate reimbursement. However, in the entire process of getting reimbursed, there are various chances for errors that can impact the financial health of your healthcare practice. That’s where Unify Medicraft, a smart dermatology billing software, is going to help you.
FAQs
What is the CPT Code for Dermatology?
Current Procedural Terminology (CPT) code is a universal code used by dermatologists for medical billing for every procedure and service performed. Some common codes include Skin biopsies: 11100-11101, Excisions: 11400, Cryosurgery: 17000, and Actinotherapy (UV light) 96910. The code helps streamline the billing process and increase accuracy.
What is the CPT Code Range for Dermatology?
Every procedure done by a dermatologist has a corresponding code for medical billing. The CPT Code range for dermatology is 96900 to 96999.
What is Physician Billing in Medical Billing?
Physician billing is the process of submitting and receiving payment for medical services provided by a physician or other medical professional to insured patients. Physician billing is also used to bill suppliers and non-institutional providers for their services.
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