(732) 520-8877
Speciality Specific Coding
(732) 520-8877
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(732) 520-8877
(732) 520-8877
Observation care billing is notorious for its complexities. Determining patient eligibility, deciphering the mix of inpatient and outpatient services and juggling the specific requirements of both 13x and 85x bills can feel like a never-ending headache. Add in the ever-changing CMS guidelines and payer-specific rules, and it’s no wonder many providers feel overwhelmed.
But what if you could transform this headache into a consistent source of revenue? What if those complex codes and confusing regulations weren’t a burden, but a path to increased profitability?
At Quest MBS, we’ve cracked the code to observation billing success. Our experts live and breathe the complexities of observation billing, staying ahead of the curve with the latest observation billing guidelines and best practices. We meticulously review every claim, scrutinizing Condition Codes 44 (for observation patients) and Type of Bill 13X (for hospital outpatients).Partner with Quest MBS, and let us transform your billing headaches into bottom-line results.
Quest MBS takes a comprehensive approach to observation billing, going beyond accurate coding to proactively maximize your revenue.
Meticulous review of medical necessity and documentation to ensure observation status is appropriate.
Accurate assignment of CPT and ICD-10-CM codes specific to observation services, minimizing claim denials.
Expert navigation of the Two-Midnight Rule, a critical determinant for observation or inpatient status.
Strategic use of Condition Code 44 to capture appropriate reimbursement when observation transitions to inpatient.
Proactive resolution of observation claim denials through appeals and communication with payers.
Continuous monitoring of regulatory changes and payer updates to adapt billing practices for optimal outcomes.
Analysis of billing patterns to identify trends, optimize reimbursement, and pinpoint areas for improvement.
Open communication and partnership with your team to ensure seamless integration and maximum results.
Observation billing demands precise understanding of CPT codes like 99217-99220 (initial observation care) and 99224-99226 (subsequent observation care). Incorrect coding can lead to costly denials and missed revenue. Quest MBS’s certified coders have deep expertise in observation-specific CPT guidelines, ensuring accurate and optimized claims.
Our approach is comprehensive and data-driven. We meticulously review medical records, applying the Two-Midnight Rule and Condition Code 44 as appropriate. We optimize revenue by identifying opportunities for observation upgrades and ensuring proper billing for procedures and tests performed during observation stays.
Our observation billing expertise isn’t just about knowledge; it’s about results. We combine a rigorous QA process with cutting-edge technology to streamline your revenue cycle, accelerating claims processing, minimizing denials, and enhancing your financial performance. See the Quest MBS difference – where accuracy, efficiency, and revenue growth converge.
Experience personalized guidance and expertise tailored to your specific needs. Whether you’re looking to optimize coding processes, enhance compliance, or maximize reimbursements, our consultants are here to chart a course for your financial success.
Our streamlined workflows and advanced technology expedite your billing process, getting you paid faster.
Through optimized coding, accurate documentation review, and proactive denial management, we consistently help clients unlock revenue potential.
We've helped numerous healthcare providers optimize their observation billing and achieve significant revenue growth.
Our clients trust us to deliver results and build long-term partnerships that drive their success.
