Hospitalist Pediatric and Adult Professional Billing -- The Medx Specialties


A medical specialty known as a hospitalist has been on the rise in hospitals providing care for very ill patients after admission, throughout their stay and upon discharge. Hospitalists are well qualified, and have the technical training and experience in treating the severe acute patient.

We specialize in Hospitalist billing and have many years of experience in several facilities in Southern California. Many specialty hospitalists work in the 12-hour shift model, and work in groups with various coverage schedules. Our office monitors the physician schedule to insure we receive the physician charges for the coverage days and contacts the physician if any charges are not received.

We know how to assist the physician in selecting the appropriate CPT codes(s) for his/her time due to the many hours they may spend with a patient at bedside or elsewhere on the floor/unit. For groups with multiple physicians rendering service over a 24 hour period, we know the proper use of modifiers allowing the second physician to bill for a visit to the same patient previously seen on the same day by another physician.

For fast, efficient billing, Hospital Based Practices need to have electronic connectivity with hospitals to retrieve medical records and face sheet information. We make all the arrangements with the hospital for electronic retrieval of patient information by preparing HIPAA Business Associate Agreement and having our IT staff meet with the hospital’s IT department.

We review the CPT charge code assigned by the doctor and eliminate any bundled codes which will cause a denial or reduced payment.

We determine new patient’s insurance by using the hospital’s information and then re-verify for insurance accuracy and eligibility prior to billing claims electronically.

A vigorous insurance follow-up system is utilized to collect on outstanding claims and we also leverage the reporting of unfair payment practices to the Department of Managed Health Care and Department of Insurance for slow payers.

We can also assist the physician group with insurance contract negotiations and credentialing.