Where to begin when choosing or switching to a new TPA…
Common Procedural Technology (CPT) codes are a five-digit numeric or alpha numeric codes set and maintained by the American Medical Association. It describes the diagnostic, medical and surgical services and procedures provided by medical practitioners to their patients. It is designed to allow medical practitioners, payers, accreditation companies, and coders to share the same information as far as a description of medical services and procedures is concerned.
Insurers and medical management companies also use CPT codes as basis to check the correctness of medical services a patient receives, and determine the amount an insurer has to pay a practitioner for those services. CPT codes are intended to create consistency and uniformity in the medical tracking and billing process. It is similar in purpose to the Healthcare Common Procedure Coding System used by Medicare members.
How Medical Management Companies Use CPT to Reduce Medical Costs
Many business organizations will certainly find it hard to communicate with physicians, insurance companies and government agencies regarding the status of employees they have committed in hospitals or medical service facilities. It can even eat up a lot of time from your HR employees who may be compelled to spend hours per day doing this thing – with limited output.
You can make this process easier and more efficient for your company by allowing a medical billing professional or medical insurance adjuster to take care of this process. By giving the job to experts, you will be able to save time and get faster, more accurate results at a lesser cost. This is possible because medical billing companies:
- Specialize on expediting, tracking and reviewing the medical services provided to patients who are covered by health care companies. They can do the job more efficiently than your HR staff who may have other, more important matters to attend to. This increases the productivity of your HR personnel which ultimately leads to cost-effectiveness.
- Know exactly what each CPT code stands for; this enables medical management professionals to detect errors such as erroneous claim information, upcoding, undercoding or sloppy documentation. This can result in the rejection of the medical billing claim.
- Track a patient’s claim expeditiously.
- Review medical billings including PPO discounts from hospitals, laboratories, medical practitioners or other health care providers, as well as statements provided by Medicare or your insurance company.
- Track and review claims to ensure that patients and their insurers pay only for services they actually received.
- Know the exact description of each CPT code because they have complete access of its list. Getting a free access to this list is not possible because it is protected by copyrights owned by the American Medical Association. You may be able to obtain a copy of the list but you have to pay fees for it.
When you outsource the medical review and tracking from your HR department to a competent medical insurance adjuster or medical management company, you can be assured of benefits that go beyond cost-saving. It allows your own personnel to focus on other pressing issues and ensure that your employee-medical claimant is given an equitable and correct share of the medical bill amount.
Contact Action Claims Service at (888) 691-1095 for expeditious and efficient medical management services.
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