In recent years, infusion billing practices have experienced swift and effective market expansion and is projected to exceed approximately $113 billion by 2032. With a poised growth rate of 8.99% compound annual growth rate (CAGR), infusion domain is quite demanding. While the industry is growing rapidly, many infusion practices are encountering reduced revenue. Now, you might be wondering to know the reason behind it. Well, the reason is that most practices are unable to navigate the complex infusion billing process.
Understanding the infusion billing confusion:
Although your facility is flourishing, the truth is an ineffective billing process can steer your practice towards financial setbacks. A vital step in boosting revenue is to streamline infusion billing and coding procedures. As errors in documentation, insufficient patient information, and inaccurate coding can all result in revenue loss. Furthermore, adapting to evolving guidelines and insurer requirements in billing is heightening with constant changes. In such circumstances, a dedicated team is essential to unravel the challenges in the billing and coding process.
Now, we are going to share some critical infusion billing tips to make your process easy and more efficient-
Billing Recommendations for Infusion, Injection, and Hydration Services-
- Prioritize billing for infusion over injections/IV pushes, then hydration therapy.
- For initial services, bill one initial code per patient encounter, unless two separate IV sites are medically justified. Use modifier 59 for Medicare claims if billing another initial code during the same encounter.
- Differentiate between IV pushes (lasting ≤15 minutes) and infusions (lasting >15 minutes), ensuring continuous monitoring for IV pushes.
- Sequential infusions can be billed after the initial infusion, administering different drugs or services through the same IV access, justified clinically. Concurrent infusions occur simultaneously, using the same IV access; hydration is not separately billed in concurrent infusions.
- Hydration billing requires clear documentation of medical necessity and reasonableness, distinct from other services. Incidental hydration is not separately billed. Hydration lasting ≤30 minutes is not separately billed; additional hours require separate initial services.
To maintain an efficient billing department at your infusion center, partnering with a dependable revenue cycle management organization is crucial for streamlining billing and coding processes.
Outsourcing has emerged as a strategic solution for many healthcare providers aiming to optimize operations and enhance the revenue cycle. Strategic offshore outsourcing presents an effective avenue to circumvent the high labor costs in the market.
Sunknowledge: The Premier Infusion Billing Partner
Are you in search of a dependable vendor to meet your needs? We stand ready as your trusted ally, providing actionable support as your dedicated partner. Our comprehensive infusion billing services distinguish us in the healthcare sector.
Expect substantial cost reductions of up to 80% with our assistance during these challenging times. Count on our adept infusion coders and billers for meticulous management of your billing practices.
Collaborate with us to unlock greater success. We specialize in optimizing your collections and aligning your front and back-end infusion billing priorities where others may falter.
Sunknowledge Services Inc. – an ISO 27001:2022 certified, American-owned & operated company, headquartered in New York City – is a leading global provider of Business and Knowledge Process Outsourcing services in the US healthcare domain.
