Tackling Injection and Hydration Billing with Infusion Billing Services

Infusion, injection, and hydration services all fall under the same radar. Infusion is the process of dispensing medications or fluids directly inside the patient’s bloodstream. Moreover, hydration is delivering intravenous fluids with or without electrolytes into the patient’s bloodstream and injection is injecting a fluid into the patients’ veins. So, you need to use proper CPT and HCPCS codes, apply the correct modifiers, create a proper documentation to make sure no claim denial occurs. As your healthcare staff stay busy with patient care, that’s why it can be a feasible option to outsource infusion billing services. Now, let’s dive into the documentation issues and then the billing tips used by these services.

Common Documentation Issues

Ever wondered what is one of the major reasons for claim denials? It is an incomplete documentation procedure. Hence, claims may be denied as these documents cannot justify the patient’s medical necessity. Below are the common documentation issues clinics face:

Intravenous Infusion Hydration Therapy: Many clinics fail to distinguish between hydration administration, facility protocol and drug protocol to administer hydrating fluids. Hence, it causes an inefficient billing process which leads to claim denials.

Infusion Services: In the documentation process, start and stop times for each infused substance is always missing. So, you need to know all the start and stop times to streamline claim submission.

How Can You Improve Your Billing Process?

There are several billing tips you need to keep in mind, starting from billing order for infusion and injections to documenting stop time for IV hydration infusion. Let’s start with the first tip:

Billing order for infusion and Injection: Amongst these three processes, infusion should come first and then injection and finally hydration service. This hierarchy is used to give priority to the complex billing process first, which leads to accurate claim submission.

Distinguishing between IV Infusion and IV Push: The IV push infusion process takes 15 minutes or less. But it requires the presence of healthcare professionals to give constant attention to their patients. However, in case of IV infusion, you need to give an infusion of 15 minutes or higher. So, most healthcare professionals cannot differentiate between IV push and infusion while creating bills for patients.

Billing Concurrent and Sequential Infusion: The hydrations happening at the same time through the IV access are termed as a concurrent infusion. On the contrary, sequential infusion needs to be billed to administer different drug from the same IV access. Billing these two infusions is an extremely difficult process.

Allowed Services/Day: The clinics can allow you only one initial code unless two separate IV sites are medically necessary.

Billing for Hydration Procedure: Documentation needs to show that hydration service is medically important. This procedure involves using complex modifiers and codes to streamline claim submission.

Documenting Stop Time for IV Infusion: You need to document infusion times as a 30-minute hydration is not separately billable. It is important to calculate the stop time with the start time, volume and infusion rate accordingly to create an accurate billing process.

Taking the Help of Infusion Billing Services in a Time of Need

As your healthcare staff have to take care of their patients, that’s one of the major reasons they can’t focus on streamlining administrative tasks. As a result, you can take the help of outsourced services. These experts know all the latest ICD, CPT, and HCPCS codes to make sure no claim denial occurs. Moreover, they also know how to streamline the prior authorization process by verifying patient’s insurance eligibility, collecting important documents and submitting PA requests.

Now, a question might pop up into your mind, “the in-house staff can do all of the administrative tasks, why is the need for outsourced experts?”. It is because you have to spend a lot of money on hiring and training in-house experts. On the other hand, the outsourced experts are previously trained, and they don’t need any separate office space, which can save a lot of cost for your clinic. In addition to that, they also know how to work with the clinic’s EHR system and the process of Electronic Prior Authorization Procedure (EPA) to submit claims electronically.

These infusion billing services provide timely charge sheet delivery within client-specified turnaround time. Apart from that, their codes hold ICD-10 certifications and maintain a 99.99% coding accuracy rate. Additionally, these services provide 10% buffer resources and can reduce your operational costs by 80%. Not only that, but they also provide dedicated account manager at no extra cost and have no binding contract or restrictive clause. These companies provide customized reports and the best infrastructure setup at no extra cost. Hence, if you are planning to streamline your billing process, it can be a good option to outsource external RCM experts in that matter.