Reduce billing errors and boost reimbursement with an expert Infusion Billing Company

In case of infusion therapy, patients often undergo multiple healthcare treatments that include various medications and intravenous procedures. Infusion service providers lose millions of dollars every year due to inefficient billing practices. Most of these inefficiencies occur due to complex documentation and coding requirements, and evolving healthcare regulations.

The infusion billing services focus on proper documentation and correct coding (CPT code 96413), which makes it possible for them to prevent common mistakes. As a healthcare provider, dealing with infusion services, it is necessary for you to be aware of the common billing mistakes that occur in your services. Hiring a professional infusion billing company ensures that your clinic is immune to these errors so that revenue can be optimized.

Understanding the common billing mistakes in infusion practices

The billing team often struggles with infusion coding errors and documentation challenges. Due to this reason, your clinic’s revenue and quality of patient care are affected. Thus, it is important to know the frequent errors and how professional billing companies can handle them.

1.    Start and stop times - Infusion services are time-based and depend on how long a patient receives therapy. In infusion billing, the documentation of the correct time is highly critical. It helps determine whether an infusion should be billed as a push or long charge. The long charge is applicable for those infusions that are longer than 15 minutes. Even a minor difference of a few seconds could record the long charge as a push. This leads to denial in claim due to incorrect documentation. The expert infusion billing companies accurately record each medication administration, which impacts the application of correct CPT codes. The billing professionals also use automated infusion pumps or EHR integrations to record accurate infusion timings.

2. Hierarchy of medications – Infusion services are highly dependent on specialized infusion medications. These medicines are categorized into therapeutic and chemo medications. When a patient undergoes infusion treatment, both therapeutic and chemo medications are used. The billing team often bills the initial medication as therapeutic, which impacts the revenue. This happens because the billing of initial medication as chemo offers the highest rate of reimbursement. The infusion billing services follow payer-specific medication hierarchy rules that vary from one insurance company to the other. They also maintain a medication hierarchy guide and regularly train their staff for its implementation. For an effective billing practice, it is necessary that infusion billing professionals follow the below mentioned hierarchy:

•    Chemotherapy infusion
•    Chemotherapy push
•    Chemotherapy injection
•    Therapeutic/diagnostic infusion
•    Therapeutic/diagnostic push
•    Hydration

3.    Calculation of units – In infusion services, units refer to the numeric measure of medication vials, injections and hours of infusion. Some of the common challenges in calculation include miscounting drug vials, confusing partial and full units, and misinterpreting time-based units. This miscalculation of units often leads to services being underbilled, claim denials and compliance risks. The outsourced infusion billing solutions use standardized calculators and specialized billing software to auto-calculate units for infusion time durations.

4.    Hydration coding discrepancies – Hydration codes like CPT 96360 and 96361 are specifically used for infusion services aimed at providing rehydration to patients. The claims for hydration services are often denied due to incorrect documentation. This leads to the absence of the medical necessity for the specific hydration service. These services have lower reimbursement rates when compared to other therapeutic infusions. However, incorrect documentation for hydration services often leads to missed opportunity for claim reimbursement. An infusion billing company tackles this challenge by guiding their staff on structured documentation templates. These templates record all the important hydration details and identify any incorrect use of CPT codes for infusion therapy.

Streamline your infusion services with professional billing companies

A professional infusion billing company has professionals who are skilled in dealing with documentation, prior authorization and coding requirements. Addressing the hindrances in IV therapy billing requires expertise, advanced technology, and time. The billing services also come with 100% HIPAA compliance that prioritizes patient safety and security. They have trained staff who maintain a coding accuracy rate of 99.99%. You also get the benefit of a personalized plan to resolve the issues in your infusion billing process.

These companies also offer timely delivery of charge sheets within the specific turnaround time (TAT). This further reduces the chances for any possible delays in the reimbursement process. The most important benefit that you will get from these outsourced billing companies is the reduced cost of service. They offer services at a reduced expense of $7 an hour along with 30 days of free trial. This not only gives you the opportunity to have experience of their services but also shows their confidence in accuracy and increased reimbursement rates. If you are still struggling with infusion billing challenges, it is best for you to partner with an expert billing company, to reduce billing errors and maximize revenue generation.