Specifications include, but are not limited to: Pathology Medical Coding and Billing Services are to be provided for the TTUHSC EP campus. Contractor must be capable of providing registration/enrollment and insurance verification, accurate procedural and diagnostic codes to be used to report and bill for TTUHSC services, to provide coding compliance review services, coding helpline services, onsite documentation and coding training, telephonic education Services, electronic billing and payment entry – to include negotiation for payment rates from insurance companies with guidance from the Pathology Medical Director, accounts receivable management and reconciliation. 1. Coding Services: a) Ability to review documentation and request clarification, addendums, or further information from physician or department for maximization of procedure code assigned for the service rendered and accurately assigns CPT and ICD codes based on current CMS or insurance carrier specific guidelines. i. Contractor will provide timely feedback within 2 working days, to requests for claim edits, questions, and denials for proper payment by payors and claim follow through assistance as part of the initial coding request.
