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Break down payment process barriers

Medical and healthcare payment processes are more complex than ringing up a total and requesting payment from the person who received services. Accurately determining the cost of medical services involves a specialist properly coding for all the different diagnoses, equipment needed, and services provided into a universal code. This code is recognized by certified healthcare practices and insurance companies, allowing speedy reimbursement for insurance claims and continuity of care for the patient.

The universal code used in medical billing and coding is currently found in the tenth version of the International Statistical Classification of Diseases (also known as the ICD-10), which the World Health Organization issued. This system is regularly updated to account for new morbidities that may arise as emergent diseases, and new treatments are constantly evolving. For example, the disease known as Covid-19 was not recognized until 2019, nearly three decades after the approval of the ICD-10 by a congress of the World Health Organization in 1990. The World Health Organization released an updated version, the ICD-11, in January 2022. It has yet to be adopted fully, but the new and revised codes, especially those that emerged due to the pandemic, will require medical coders to adapt.

Stay ahead of constantly switching billing codes

Medical spas must stay up-to-date with the complex and ever-changing medical billing and coding industry. While many patients pay out-of-pocket for what may be considered luxury or vanity procedures, there are always patients who receive reimbursement from insurance. Their physician may have prescribed a procedure at a medical spa to help recuperate a life-threatening illness or event, such as covid, cancer, or a car accident. Further, in some cases, procedures such as Botox, rhinoplasty, and vein ablation may even be covered by Medicare if the patient needs the procedure for a medical reason.

Medical and healthcare billing and payment processes must constantly evolve as medicine evolves to accommodate and treat new diseases. Because medical spas do not treat emergency conditions, such as active cases of covid-19, they may be some of the last providers to adopt new medical codes. However, these codes are used by insurance companies to process claims, so up-to-date coding processes are necessary to ensure high first-pass rates (FPRs). This means that insurance claims are accepted the first time they are submitted, without the hassle of negotiating with the company or taking the time to go back and re-code for the patient’s diagnosis and services received. Up to 20% of submitted claims are rejected, and the work involved in re-submitting them is so significant that more than half are not re-submitted. Denied claims directly result in decreased revenue for any medical practice.

Keep your patient information secure with a HIPAA-compliant solution

Because medical spas perform medical-grade procedures, patient privacy (HIPAA) must always be observed. This patient protection extends to payment processes, as cybercriminals can steal credit card information directly linked to protected patient data. HIPAA-compliant credit card processing is indispensable to a medical spa to ensure that both payment information and patient data are protected from would-be data breaches.

Get an intuitive and modern software for your medical spa billing

Medical spas have to contend with all of these challenges while remaining profitable in a time of increasing rents, insurance premiums, and salaries. The solution to this ever-present challenge is a technology that evolves with the practice and the industry as a whole. Combining coding, editing for a higher FPR and successful appeals, HIPAA compliance, and patient desires through interoperable and connective technology will make a medical spa more profitable. Integrated solutions that involve healthcare payment technology, HIPAA-compliant payment processing, and evolving medical codes can prevent the loss of revenue to a medical spa.

AdvancedMD has vast experience providing medical spas with the billing solutions that they need to continue providing the highest quality of care to their patients. When billing and coding are no longer a primary concern for managing a medical spa, the staff can focus more on the direct care they provide to patients. Seamless and integrated technology will give owners and stakeholders in a medical spa the freedom to do what they set out to do in the first place – provide first-class medical care in a spa-like setting – while resting easy on the financial health of their practice.

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