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Prostheses medical billing services

Prostheses Billing Services

Prostheses Care is Complex For Several Reasons

Medical billing complexities extend beyond services to include prostheses, orthotics, and durable medical equipment (DME), all of which require coding and claim submission for insurers or government payers to cover the costs. However, each payer has distinct guidelines and rules regarding prostheses billing, specifying what is covered and under what circumstances. Keeping up with these varied details can be challenging for medical office staff.

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Outsourcing Medical Billing And Coding

Outsourcing medical billing and coding to a professional revenue cycle management (RCM) company, such as WeCare, has proven to be a hassle-free solution that enhances our clients’ revenue. Our certified billers have extensive experience with prostheses, and our entire staff is trained in HIPAA compliance, ensuring the security of patient data. You can trust that your billing and coding needs are in capable hands while focusing on your core healthcare services.

Fitting And Adjustment Appointments

When coding for fitting and adjusting prostheses, it’s important for billers to understand that the office visit code is already included, and, therefore, it should not be used in the same claim. This ensures accurate billing and prevents double billing for the same service.

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Overlapping Codes

There can be some overlap between the codes for providing and adjusting prostheses and the time spent by a skilled clinician training the user. Billing for prosthetics requires a thorough understanding of how to accurately identify and code for each instance, along with the use of modifiers to indicate reduced services and prevent duplicate payments. Failure to do so can lead to over-coding, potentially resulting in fraud charges against the physician. Proper coding and billing practices are essential to avoid these issues and maintain billing integrity.

Uncoded Products

You’re correct that not all prosthetic devices have established codes, which means medical coders and billers must have the expertise to find and apply the correct codes in such cases. This process of researching and identifying appropriate codes can be time-consuming, potentially causing labor costs to surpass the value of the claim. It underscores the importance of skilled and efficient coding and billing professionals who can navigate these challenges and ensure proper reimbursement while minimizing administrative costs.


Top Dedicated Experienced Billers

WeCare is a comprehensive prostheses billing revenue cycle management (RCM) provider with a dedicated and experienced team of billers. Our innovative approach to medical billing includes our proprietary software, which ensures that the latest codes are integrated into the system. Our billers are well-versed in the intricacies of prosthetic billing, enabling them to proactively prevent rejected and denied claims, ultimately streamlining the billing process for improved efficiency and revenue optimization.


Correct Coding Resubmission

When claims are rejected or denied, our billers are adept at swiftly identifying the issues, acquiring the necessary information, and correcting coding for resubmission. This efficient process can save hours of office staff time, which would otherwise be spent by less experienced coders and billers, reducing labor costs. Outsourcing to a professional prostheses medical billing company ensures maximum reimbursement and minimizes the number of unpaid claims, ultimately optimizing revenue for your practice.

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