Expert Endocrinology Billing Services for Your Practice

Endocrinology Billing Services

Endocrinology medical billing is a specialized area that focuses on the accurate and timely submission of claims for services related to the endocrine system, which includes glands such as the thyroid, pancreas, and adrenal glands. Proper billing in endocrinology is essential for healthcare providers to ensure they are reimbursed for services rendered while also ensuring compliance with insurance companies and federal regulations.

Common Endocrinology CPT Codes

Below are some commonly used CPT codes for endocrinology services:

  • 99406 - Smoking and tobacco use cessation counseling visit

  • 93000 - Electrocardiogram (ECG or EKG)

  • 93010 - Electrocardiogram interpretation

  • 84436 - Thyroid stimulating hormone (TSH) test

  • 82947 - Glucose test for diabetes management

  • 90791 - Psychiatric diagnostic evaluation (relevant for patients with endocrine-related mental health issues, such as depression or anxiety from hormonal imbalances)

ICD-10 codes related to common diagnoses like diabetes (E08-E13 series) or thyroid disorders (E00-E07 series).

Endocrinology Medical Billing Best Practices

To ensure accurate and efficient billing, keep the following in mind:

  • Accurate Diagnosis Codes (ICD-10): Make sure to match the diagnosis code with the correct treatment. For example, use the specific code for Type 1 or Type 2 diabetes when appropriate.

  • Thorough Documentation: Ensure all patient interactions and treatments are thoroughly documented to support the codes submitted.

  • Payer Requirements: Different insurers may have specific rules for submitting claims. Always confirm payer-specific requirements to reduce the chance of denials.

  • Timely Filing: Submit claims as soon as possible to avoid any issues with claim acceptance and reimbursement.

Insurance Coverage and Reimbursement

Endocrinology services are typically covered by most major insurance plans, including Medicaid, Medicare, and private insurers. However, reimbursement rates and coverage may vary based on:

  • The specific condition being treated

  • The patient's insurance plan

  • Whether the service is provided in-network or out-of-network It’s important to verify insurance coverage before providing treatment to ensure that services will be covered and that the correct billing codes are used.

Our Denials and Appeals Process

Medical claim denials are a common challenge in endocrinology billing. Our process:

  • Understanding the Denial Reason: Denials could be due to incorrect coding, insufficient documentation, or missing information. We thoroughly review the insurance company’s reason for denial and address it appropriately through various modes of response.

  • Appeal Process: If the claim is denied based on coverage or medical necessity, an appeal may be necessary. We review the insurance company’s appeal process and act quickly to submit it and reduce potential delays or timely submissions.

How we can help:

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    Comprehensive coding and claim submission

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    Insurance verification and prior authorization

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    Denial management and appeals

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    Contracting and Credentialing

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    Patient statements and collections

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    We specialize in ensuring your practice receives timely reimbursements while remaining fully compliant with industry standards and payer requirements

✺ Frequently asked questions ✺

  • We offer full-service medical billing, including coding, claim submission, insurance verification, patient billing, accounts receivable management, and denial management. We also assist with prior authorizations and appeals to ensure timely reimbursement

  • We have over 20 years of billing in all the specialties we have listed on our site!

  • Yes! All our billers are experts in the field. With many years of experience and we ensure to only assign the best biller for your specialty. We undergo quarterly trainings and are all certified!

  • We only use your medical billing software for complete transparency in our performance and to safeguard your practice with ethical and accurate standards.

  • We provide regular updates through email or phone calls to keep you informed on your billing status. Additionally, we use an online chat system such as Google or Teams for daily needs. We also schedule monthly calls, if needed!

  • Our onboarding process is simple and efficient. After an initial consultation, we gather necessary documents, set up your accounts in your system and portals. We aim to have everything up and running within 1-2 weeks.

  • We specialize in personalized service for each client, ensuring that your practice’s unique needs are met. Our team consists of highly trained professionals with expertise in a variety of specialties, and we offer a high level of transparency and communication. We work to maximize your revenue while ensuring accuracy and compliance.

  • Our team regularly attends continuing education courses, webinars, and conferences. We also have access to coding and regulatory updates from organizations like the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC).

  • We offer a transparent pricing model, with fees based on a percentage of collections. The exact percentage depends on the volume of claims and the complexity of your practice’s billing. We can provide a customized quote based on your needs.

  • We have a dedicated team that handles claim denials and rejections. When a claim is denied, we review the reason, correct any errors, and resubmit the claim. If necessary, we also handle the appeals process to ensure that your practice receives the reimbursement it's entitled to.

  • We are fully HIPAA-compliant and follow all federal and state regulations regarding patient data privacy. Our staff undergoes regular training on HIPAA standards, and we use secure systems to manage and transmit patient information.

  • Yes, we offer coding and billing audits to ensure that all your claims are submitted accurately and in compliance with industry regulations. Our audits help identify any discrepancies or potential risks, so you can address them proactively.

  • Based on the Tier plan you select, we offer patient support services for billing inquiries, ensuring that patients have a clear understanding of their charges. Our customer service team is available to answer any questions patients may have regarding their statements, insurance coverage, or payment plans.

  • Yes, we provide regular reports on your practice’s financial performance, including revenue cycles, collections, and any outstanding claims. You will have access to real-time data and in-depth analysis to help you make informed decisions about your practice.

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