Geriatrics Billing

Billing for geriatrics is complex, requiring exceptional attention to detail in coding, compliance, and accounts receivable (A/R) management. Each patient encounter involves a myriad of variables—chronic diseases, multi-disciplinary care, and evolving Medicare regulations—that challenge even the most experienced practices. At Sionis RCM, we bring expertise, advanced technology, and proven strategies to address these unique challenges and streamline your revenue cycle management (RCM) process.

Geriatrics Billing Challenges: Why It's Harder Than Ever

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  Navigating Complex Diagnoses with Specific CPT Codes: Geriatrics billing involves chronic care management, comprehensive evaluations, and care coordination, requiring accurate use of codes like 99213, 99387, 99490, G0181, and G0511. Incorrect or incomplete coding can result in claim denials or underpayments.

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  Stringent Medicare and Medicaid Regulations: Extensive documentation is required to justify chronic care visits and home health care supervision, using appropriate HCPCS modifiers to ensure compliance and avoid audits.

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  Denials and Claims Management: Common denial reasons include coding errors, eligibility issues, and insufficient documentation, which lead to recurring revenue losses if trends aren’t identified.

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  Patient Financial Responsibility: Confusion about out-of-pocket costs and co-pays often delays payments and increases bad debt rates, costing practices up to 20% of patient revenue.

How Sionis RCM Tackles Geriatrics Billing Challenges

1. Accurate Coding with Expert Knowledge

At Sionis RCM, we employ certified medical coders trained to use appropriate CPT, ICD-10-CM, and HCPCS codes for geriatric-specific services. This reduces revenue leakage and ensures compliance.

2. Comprehensive A/R Management Techniques

Our proactive approach to A/R management includes advanced claim tracking, targeted follow-ups, and denial analysis to reduce A/R days by an average of 40%.

3. Medicare Compliance Assurance

We provide audit-ready documentation and keep your team informed of Medicare billing guideline updates, decreasing claim denials by 35%.

4. Patient-Centric Financial Solutions

Clear statements, flexible payment options, and dedicated patient support improve collections and reduce confusion, leading to a 25% increase in patient payment collections.

Proven Results: The Sionis RCM Difference

Why Choose Sionis RCM for Geriatric Billing?

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  1. Expertise in Geriatrics RCM: With a deep understanding of the complexities in geriatrics billing, our team specializes in handling chronic care management, Medicare compliance, and advanced coding requirements.

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  2. Data-Driven Insights: Our reporting tools provide actionable analytics, helping you understand revenue trends, denial patterns, and opportunities for improvement.

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  3. Scalable Solutions: Whether you’re a single-provider clinic or a multi-location geriatric practice, we tailor our services to meet your unique needs.

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  4. Human-Centered Approach: From our certified coders to our patient support specialists, we combine technical expertise with a human touch to deliver results that matter.