Geriatrics
Medical billing for geriatric practices
Nearly all your patients are on Medicare or a Medicare Advantage plan, and a lot of the care happens after they've left the office. We check that the billing picks up what's documented.
It's free, and you can keep your current biller
What geriatric billing has to account for
- Medicare rules on nearly every claimWhen almost everyone's on one program, a single rule change or plan shift can touch a big part of your revenue at once.
- Work that happens between visitsA daughter calls about her mother's medications, the nurse coordinates with the home health agency, and that may be billable, but only if it's documented correctly.
- Multiple programs for the same patientSome services can't be billed together, and that's easy to miss when two programs are running for one patient, so we look for it before claims go out.
- Patients moving between plansAnnual enrollment moves people between Medicare and Medicare Advantage, and the rules change with them. You tend to find out in January.
Common geriatric billing checks
- Care plan oversightG0181G0182 For home health and hospice patients, with required time.
- Complex CCM9948799489 Complexity and time need to be documented.
- Advance care planning9949799498 Time and voluntary participation should be on record.
- Annual wellnessG0438G0439 Frequency limits apply.
These codes are examples. Rules change by year and payer, so we check current guidance.
Where to start
- Care management billingWe check prerequisites first, then support the billing for CCM, CPO, RPM and PCM.
- Medical billingWe prepare, check, submit and follow up on claims within your agreed scope.
- Denial managementDenied claims worked by cause and deadline, and tracked to an outcome.
- Insurance verificationWe check coverage before the visit and tell your front desk about the problems.
Further reading: the basics of billing CCM and CPO and how timely filing limits work in medical billing.
Questions
Questions about geriatrics billing
Can you check for incompatible billing across programs?
Yes. We check for duplicate or incompatible billing before claims go out, and we verify the rules against the current year's guidance.
Do you help with Medicare enrollment?
Yes, through our credentialing service, which includes PECOS and revalidation tracking.
How do you handle Medicare Advantage plans?
We treat each plan as a separate payer with its own rules, and we track authorizations and denials by plan.
Find out what your geriatrics claims are leaving behind
Send us your denial and A/R reports and you'll have a written report within 48 hours, for free. You can keep your current biller while you decide.
