Billing for neurology services is complex—procedures are detailed, coding is technical, and payer rules are constantly changing. A neurology clinic in Rochester was dealing with these challenges daily, with revenue performance falling short due to frequent denials, underpayments, and delayed reimbursements.
By partnering with MBW RCM, the clinic revamped its billing operations. In just six months, they recovered $389,000 in missed revenue, reduced denials from 24% to 11%, and shortened payment cycles by 22 days—a major improvement to their financial stability.
Key Challenges in Neurology Medical Billing
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Neuro diagnostic Test Bundling Errors
Tests like EEGs, EMGs, and nerve conduction studies often involve bundled codes. Incorrect bundling can lead to rejection for unbundled services or inappropriate duplicate billing.
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ICD-10 Specificity in Neurological Disorders
Conditions such as epilepsy, multiple sclerosis, or neuropathies require precise subcategory codes (e.g., G40.901). Generalized codes may result in claim denial or audit flags.
3. Billing for Tele-Neurology and Remote Services
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Virtual neurology visits require modifiers (e.g., 95, GT) and documented patient consent. Missteps in telehealth coding lead to claim denials or improper billing.
4. Cognitive Assessment and Neuropsychology Billing
Services like Montreal Cognitive Assessment (CPT 96132/96133) are frequently under-billed or misclassified due to confusion around complexity levels or time-based components.
Chronic Care Management (CCM) Oversights
Monthly billing for CCM (e.g., CPT 99490) requires detailed time logs and patient consent. Lack of proper documentation can result in lost recurring revenue.
Our Neurology Billing Approach
MBW conducted a full audit of the clinic’s neurology revenue cycle and implemented a series of targeted improvements:.
Results After 6 Months
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Claim denials dropped from 24% to 11%
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$389,000 in recovered revenue
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Payment turnaround improved from 65 days to 43 days
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98% of claims accepted on first submission
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Authorization-related denials reduced from 20% to 5%
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Neurology coding errors dropped by 70%
Conclusion
At MBW RCM, we focus on solving the real challenges neurology practices face every day. By improving code compliance, reducing denials, and speeding up reimbursements, we helped this Rochester clinic recover revenue and gain stronger control over its billing process.
Looking to improve your neurology billing?
We provide medical billing services that help healthcare practices minimize claim issues, increase revenue, and simplify their billing process.
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Our focus on resolving denials by identifying and systemically eliminate the root causes, helps our clients improve revenue by a minimum of 20%. To learn about how we can help you reduce denials and improve revenue cycle metrics, please fill the form below, and we will be in touch.