Process of Electing Hospice

Before the outsource palliative care billing process begins, one has to verify whether a person has actually elected hospice or not. This directs your services and you can easily navigate the claim submission process. This will help you avoid any misunderstandings leading to the provision of unrelated services, causing harm to the Palliative Care Billing.

The Clinical Credentialing Process

Like any other healthcare segment, Palliative care also has a credentialing process providers need to observe and complete. Without prior credentialing, a provider is not allowed to provide palliative care to patients. Therefore, it is highly imperative to verify before billing that the practice has a specialty code and taxonomy code issued by Medicare.

Place of Service Codes Must Be Correct

Other than the credentialing requirements, it is also important to correctly report the place of service codes where the palliative care is being provided to patients. There are multiple places where these palliative care services can be provided including outpatient offices, hospitals, nursing homes, and nursing facilities as well. All locations have their own CPT codes which have to be mentioned correctly.

Submitting the Diagnosis

While submitting your diagnosis, it is important to mark it as the primary diagnosis in order to avoid any duplication in the clinical efforts. There is always a threat of conflict in the overall treatment plans, and therefore every specialty must be very conspicuous regarding the conditions they are responsible for managing. 

Avoid Claim Denials as a result of Group Practice

It is important to note that according to Medicare, the physicians working in the same group as colleagues are considered as one physician. Confusing as it sounds, but this aspect can cost physicians with higher claim denials because if a palliative care billing for a physician is done on the same day as for the other colleague to a single patient, only one claim will be billed and the other denied. This is where advance palliative care billing comes in handy as one could base the overall level of service according to the combined documentation that bills for both visits.

Documentation Process

One cannot stress enough on the fact that documentation is highly essential for claim reimbursement. Most palliative care services are subject to the pre or post-payment reviews of the payers, and one needs to ensure that the overall documentation is representing the need or medical necessity for the palliative care services.To sum it all up, one can claim that palliative care services need a robust mechanism for effective billing as the cost is highly expensive and involves substantial human resource as well. This is why the reimbursements in the revenue cycle management have to be smooth and carefully dealt with. MPD LLC, as a palliative care billing company is able to provide all the palliative care services with optimum efficacy as we have over 1000+ palliative care consultants working round the clock in 50 states across the United States.