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How We Help Credentialing for Your Urgent Care Center

An urgent care center is a good halfway point for those who need treatment for acute illnesses and non-life-threatening injuries yet don’t need to go to an emergency room. The wait time at urgent care centers is significantly shorter than what you would find in an emergency room, there’s always at least one licensed physician on staff, and it’s much less expensive. The only problem is that insurance companies can make it very difficult for urgent care centers to become credentialed.

What is Credentialing?

An urgent care center requires the proper licenses to operate in a particular jurisdiction, but it also needs to be affiliated with major insurance companies so it can accept third party reimbursement. This is known as credentialing, and it allows a center to receive steady payments and treat a greater number of patients. In other words, it is essential for the operation of any urgent care center.

Credentialing may seem like a simple matter, but it can be a major obstacle for an upstart urgent care clinic. First of all, the process can take as long as six months, so a center needs to get a head start on it if it is going to have a steady cash flow as soon as it opens. Second of all, the credentialing process varies from one payer to the next. The staff at New England Medical Billing stays up to date on the ever changing requirements for each payor.

How New England Medical Billing Can Help You

If you’re concerned that your urgent care center won’t be properly credentialed, you can always go to a medical billing service to assist in the process for you. That’s where New England Medical Billing can help you. We expedite every step of the credentialing process for urgent care centers. We can help you fill out all the proper paperwork, handle the communication between you and the insurance companies, make sure that all submitted claims are paid and generally ensure that you have a steady cash flow.

Running an urgent care center is a lot of work, and we want to help make things a little bit easier. Contact New England Medical Billing to find out how we can help you with all of your medical billing needs including credentialing.

How We Help Credentialing for Your Urgent Care Center2016-07-11T16:26:41+00:00

ICD-10 Training Course

As of October first, ICD-10 coding will be mandated by Centers for Medicare and Medicaid Services. With the release date quickly approaching, we know you’re doing everything you can in advance to get ready for the transition. To further help you prepare, New England Medical Billing is offering a training course in ICD-10 and Ambulance documentation requirements! This two hour course is complimentary to NEMB clients and is approved for two CEU credits.

We will be covering extensive information to prepare you for transition. Topics that will be covered are an ICD-10 background, the effect on documentation, common documentation examples, as well as ICD-9 to ICD-10 examples. The different areas that are being covered will continue to build your ICD-10 knowledge and familiarize you with the material.

HIPAA is requiring this for transition to ICD-10, so it is important to make this a priority. As previously mentioned, this course is complimentary for NEMB clients. All others who would to attend this training course should contact Patricia Packard at 508-297-2068 x 229. Remember, this is only one step of many your practice should be making in order to prepare for the transition to ICD-10!

Visit https://www.nembgroup.com/ to learn more!

ICD-10 Training Course2019-01-02T17:52:52+00:00

ICD-10 and its Effect

Many people in the healthcare profession are familiar with ICD-9, and also familiar with the fact that it will be replaced by ICD-10 on October 1st, 2015. ICD-10 stands for International Statistical Classification of Diseases and Related Health Problems – 10th Revision.

This change is well overdue, as ICD-9 has been in effect for over 30 years. While ICD-9 has been useful, it can no longer keep up with today’s fast paced technological changes. It supports only 14,315 codes, while ICD-10 is set to support 69,101 codes. This massive increase in the number of codes will allow the service provider to be far more detailed and specific when entering the codes.

The new medical classification list, by the World Health Organization, is programmed to provide higher-quality information in all areas of the medical field. It will make it easier to keep track of diagnoses, patient abnormalities, complaints, and medical information. The code sets will lead to more efficient, accurate and informative data.

The biggest change being implemented in ICD-10 is the ability to keep up with new advances in the medical field. The alphanumeric format is designed to allow for future updates and revisions. This malleable system is less restricting and will stop the overlap and confusion that ICD-9 would cause. As a result, there will be endless opportunities to improve the system.

Structurally, the codes will be set up similarly to the codes of ICD-9, but will be more efficient than before. ICD-10 codes will range from 3-7 digits, allowing for two digits more than ICD-9. The very first digit will be alpha, including all letters except U. The next two digits will be numeric, and the 4th, 5th, 6th and 7th digits can be either alpha or numeric. The decimal appears after the first three digits, as it does with ICD-9. After the decimal point, the next three digits represent etiology, anatomic site and severity. The last digit will be an extension, with any extra information.

While making the switch seems daunting to many healthcare professionals, the new system is designed to be easier and more practical to use. The improvements that are being made will prove to be extremely useful. It is understandable that many people are extremely apprehensive, but the effect that ICD-10 will have on medical documentation will be nothing but positive.

If you have any questions about converting to ICD-10, please contact Nancy Dolgin with New England Medical Billing.

ICD-10 and its Effect2016-07-11T16:27:14+00:00