Neurology Medical Billing Simplified – A Step-by-Step Guide

The systematic implementation of neurology medical billing includes a range of steps to generate reimbursement claims for neurology services. It is a vital process for healthcare organizations due to the onset of worldwide neurological disorders.

This blog will explore those steps in detail to determine their importance in the medical sector. It comes with its fair share of challenges and you can execute some countermeasures to minimize them. Continue reading further to learn about how you can diminish those challenges.

What Is Neurology Medical Billing?

Neurology medical billing is a process implemented in healthcare organizations to specifically bill neurological services availed by patients. You can file reimbursement claims so that insurance companies can pay for those services on behalf of your patients.

This process drives the revenue cycle of the neurology department in hospitals and clinics. You can effectively implement it to maintain your financial stability. Neurology medical billing guidelines can become complicated due to complex services based on varied diagnoses.

Steps Involved in Neurology Medical Billing

Neurology medical billing is a complex process and its implementation primarily involves several steps. You can initiate it by conducting pre-authorization and insurance checks, followed by billing your neurology services and submitting their reimbursement claims.

Healthcare organizations also provide details about their medical practitioners along with those claims to foster swift payments. In addition, you can record the billing data in your system. You may also utilize the payment details to implement denial management and many more steps.

    1. Insurance Verification

Insurance Verification Services | Health Quest Billing

Verification is an important step for neurology billing services and you must verify the insurance details of your patients. You can initiate it by conducting pre-authorization checks on their insurance eligibility and coverage.

Insurance providers have different plans to cover neurological treatments and procedures with specific terms and conditions. Therefore, you must ensure that your patients are eligible to avail of your medical services and that their insurance can cover them.

In this way, healthcare organizations can determine whether their patients will pay from their own pockets or through insurers. You can also minimize claim denials and increase timely reimbursements through those verified details.

    2. Billing Neurological Services

Billing Neurological Services

After verification, hospitals and clinics generally move on to billing the neurological services availed by their patients. This step is a key factor for revenue cycle management as you have to monitor your charges and regulate the revenue generated.

You can enable this by documenting details about your patient visits, like their neurological treatments and diagnostic tests. The amount of time spent in patient sessions also matters a lot as it can impact medical practitioners’ fees.

Whereas medical decision-making, evaluation and management levels are the main elements that determine the amount of medical bills generated. You must focus on them to accurately determine the criteria of your reimbursement claims.

    3. Provider Credentialing

Provider Credentialing Services | Health Quest Billing

Provider credentialing serves as an opportunity for your medical practitioners to connect with insurance companies. The connection enables patients to pay for neurological procedures through their insurers. In this way, you can also simultaneously receive swift reimbursements.

You can work with insurance providers to establish an Electronic Remittance Advice setup to accelerate your medical bill processing. This way, you can get more payment referrals to reduce your claim denials and prevent revenue leakage.

    4. Claims Submission

Medical Billing Claims Submission

Healthcare organizations typically start assigning specific medical codes to their services after capturing the charges for their medical bills. These are industry-recognized codes termed CPT and ICD-10 and later placed in reimbursement claims.

In this way, you can implement claims submission after neurological medical billing in which you have to submit those claims to insurance providers. This step has a common instance that involves individual patients with multiple visits and warrants separate claims.

    5. Processed Reimbursement Claims

Processed Reimbursement Claims

Claim submission completes the first stage of neurology medical billing after completing all the steps before the approval of reimbursement claims. The next step has to be executed by insurance companies by reviewing and processing those claims.

They can either release the necessary payments and approve the claims or hold them and deny your claims. In case of the latter outcome, you must appeal and resubmit your reimbursement claims.

You can send additional invoices in case of remaining balances even after the insurers have processed your reimbursements. This irregularity usually happens with overdue payments, and you can use the insurance plans of your patients to discuss potential options with them.

    6. Payment Posting

Medical Billing Payment Posting Services

Payment posting is the first process implemented after insurance providers process the reimbursement claims. It involves the management of payer issues in which you can work on the denials for your neurological medical billing.

You can handle the reasons given for those denials, like insufficient prior authorization and non-covered services. Insurance companies can also deny your reimbursement claims if they conclude that your neurology services are not medically necessary.

Healthcare organizations tend to comprehensively analyze their Explanation of Benefits to ensure accurate and complete entries in their billing system. You can do the same to update your patient accounts with the appropriate payment data.

    7. Claim Denial Management

Claim Denial Management

You also have to manage claim denials to prepare them for appeals and prevent the associated financial losses. Hospitals and clinics regularly track the status of their reimbursement claims so that they can initiate the mitigation process as soon as possible.

Insurance companies may or may not provide the reasons for claim denials, so you may have to act on your own in that regard. In that case, you have to identify the reason and devise solutions so that you can resubmit the relevant reimbursement claims in a timely manner. 

In addition, you must fill the information gaps in your claims if they are denied due to a lack of sufficient information. Those details are one of the most important aspects of the claims, so you must constantly analyze them to enhance their quality and minimize denials.

    8. Reporting and Analytics

Medical Billing Reporting and Analytics Services

You can report the data gathered through claim denials to analyze the financial aspects of your healthcare organization. It is a secondary step but equally important for hospitals and clinics to improve their future neurology medical billing.

Reporting generates key insights into the prevalent trends and patterns in claim denials. You can utilize those insights to consistently review your neurology medical billing practices and identify potential areas for improvement.

These measures enable you to implement informed decisions and improve your future billing. It is important that the relevant data is submitted into your system to uphold the standards of data compliance and quality.

Common Challenges Faced in Neurology Medical Billing

There have been various challenges faced by healthcare organizations in their neurology medical billing process. The two common challenges, namely misunderstood codes and time-consuming tasks, continue to negatively impact billing practices.

    1. Misunderstood Neurology Codes

Misunderstood Neurology Codes

Medical billing professionals tend to misunderstand a vast majority of neurology codes as their appropriate treatments and procedures are highly nuanced. It has become a common occurrence for even experienced billing professionals to make mistakes.

The problem arises when those incorrect neurology codes result in insurance companies denying your reimbursement claims. An example involves specific neurological symptoms that can have multiple codes based on their diagnoses.

As a result, healthcare organizations are not able to maintain specificity in their coding reports. In addition, patient records can be misinterpreted and result in significant distinctions. These distinctions can cause insurance companies to deny claims due to the relevant discrepancies.

    2. Time-Consuming Billing Tasks

Time-Consuming Billing Tasks

Neurological treatments and procedures are one of the most common services provided in healthcare organizations. As a result, you may have to process more reimbursement claims than possible. Your billing tasks may become more time-consuming and cause payment delays.

These limitations are more likely to increase your paperwork and cause further mishaps in the form of coding errors. In addition, it is common for medical practitioners to file multiple claims for individual patient visits. This can affect your billing practices and result in overdue payments.

How to Optimize Neurology Medical Billing?

You can set up automated software to optimize your neurology medical billing system. It should be equipped with various medical servicing tools that can perform better than electronic health record systems.

In addition, healthcare organizations can also focus on implementing digital capture solutions to automatically assign medical codes. These codes can enable medical practitioners to utilize patient information to identify any missed or lost charges.

You must also monitor the constantly updating policies and regulations of the professional medical billing sector. This measure can ensure that your neurology medical billing solutions are compliant with those industry policies.

The Bottom Line

This blog simplifies neurology medical billing for you by providing a step-by-step guide about how it is implemented. We also looked at its two prominent challenges along with some effective measures to optimize the process.

Our medical billing department has a whole team of experts just for neurology services who can assist you in your tasks. Get in touch today and discover the best ways to generate medical bills for your neurology treatments and procedures.

Frequently Asked Questions (FAQs)

    1. How do you code neurology?

You can code neurology with the CPT codes 95700-96020, which are assigned to the services of a neurologist. Healthcare organizations assign these codes to different types of consultations for neurological services.

    2. How to learn medical billing?

You can learn medical billing by understanding the requirements of several open job positions. Prospective candidates should also gain an extensive knowledge of payment policies, medical codes, and industry regulations.

    3. What is the ICD-10 for neurological exams?

ICD-10 is a medical code assigned to the screening procedures for neurological exams. It is medically classified by WHO as an important aspect of the healthcare sector.

    4. How do you code an MRI?

There are various medical codes for an MRI, like 70549, 70553 and 70559. These codes refer to specific MRI sequences that are performed with contrast media.

    5. What is the ICD 9 code for neurology?

The ICD 9 code is assigned to a range of different neurological conditions based on their subdivisions. For example, multiple sclerosis, hemiplegia and infantile cerebral palsy fall under the services of ICD 9.

    6. How can medical coding improve neurology practices?

You can enhance your neurology practices by ensuring accurate medical coding, which helps in streamlining billing processes and reducing claim denials. Proper coding ensures that you’re reimbursed correctly for the services you provide.

    7. Why is it essential for medical billing companies to understand neurology-specific codes?

For medical billing companies, understanding neurology-specific codes is vital because it ensures that claims are processed without errors. Accurate coding can also reduce claim denials and enhance the relationship with healthcare providers.

    8. How can healthcare providers benefit from expert medical billers in neurology?

By employing expert medical billers who specialize in neurology, healthcare providers can ensure accurate billing, leading to timely reimbursements and a smoother revenue cycle. Expertise in neurology billing also means fewer claim denials and a better understanding of complex neurology procedures.

    9. What is the significance of Accounts Receivable in medical billing services?

Accounts Receivable is crucial in medical billing services as it tracks pending payments and ensures that healthcare providers receive due compensation for their services. By effectively managing Accounts Receivable, you can maintain a healthy cash flow in your medical practice.

    10. How do coding services improve the accuracy of medical records in neurology practices?

Coding services play a pivotal role in translating patient treatments into universally recognized codes, ensuring that medical records accurately reflect the care provided. Accurate coding also ensures that your medical records align with billed services, preventing discrepancies and claim denials.

    11. What should one look for in a neurology billing company to guarantee accurate billing?

When selecting a neurology billing company, you should prioritize their expertise in neurology billing, familiarity with diagnosis and ICD-10 codes, and their ability to tackle billing challenges. A company with a strong track record can ensure that your billing processes run efficiently and accurately.

    12. Why is proper documentation crucial in coding processes for nervous system treatment plans?

Proper documentation in coding processes ensures that the specific treatments and procedures for the nervous system are accurately represented. When you maintain thorough and accurate documentation, it ensures that healthcare services are billed correctly, minimizing underpaid claims and denials.