The medical billing services of a professional and knowledgeable service provider can help you streamline your revenue cycle. Ensuring accurate and timely billing is a time consuming procedure, but one that ensures many benefits. Insurance company policies, compliance regulations, government policies, and healthcare reforms are always changing, and medical practitioners and their support staff often find it difficult to keep track of these changes and adhere to standard norms. This makes revenue cycle management a difficult task. Outsourcing is a very viable solution for these issues.
Balance Between Competent Healthcare and High Operational Costs
Outsourcing the medical billing job is useful for various medical specialties including anesthesiology, radiology, orthopedics, urology, podiatry, internal medicine, physical therapy, gastroenterology, obstetrics, neurology, pediatrics, pathology, pulmonary, vascular, psychiatry, cardiology, pain management, general surgery, osteopath, and physical medicine. It can help healthcare practices create an effective balance between competent healthcare and rising operational costs. The healthcare practices can thus maximize their productivity. Other benefits include fewer denials, decreased payer and patient collection costs, and shorter A/R days. All this is achieved without compromising on the quality of the deliverables.
Here is a look at the various solutions that come under the medical billing services package:
- Patient Registration and Authentication – This is the process of feeding the patient’s demographic data and validating its accuracy.
- Coding – The coding for diagnosis, suitable modifiers, and services offered is confirmed and set.
- Claims Management – Paper claims and e-claims are created and sent to payers through the service provider’s clearinghouse. The acknowledgements of claim receipts are checked and re-filing of unsent claims is undertaken. Payer responses are verified and processed.
- Electronic Claims Submission – Claims are submitted electronically to Medicaid, Medicare, and other commercial carriers.
- Denial Management – Claims rejected on Explanation of Benefits (EOB) are made right and re-filed or suitably appealed for.
- Charge Posting – Charge data is fed into the computer to generate a claim after a detailed reconciliation.
- Insurance Verification – Patient schedules are received through EDI, fax, or email and verified everyday using appointment scheduling software. The insurance coverage of the patient is confirmed with primary and secondary payers. Patients are also contacted whenever extra information is required. The system is updated with verification and eligibility data such as group ID, co-pay information, coverage period, member ID, and other benefit information.
- Reports – Reports provide valuable information about possibilities for improving the practice such as cost savings, guidelines for growth, and techniques for improving profitability. These reports are made available at least on a monthly basis.
Advantages of Quality Medical Billing Services
- Utilization of VPN system
- Faster turnaround
- Faster reimbursements aided by web-based software
- Continuous analysis for procedures, global issues with respect to suitable timely reports, and patterns on codes
- Effortless scalability
- Round-the-clock customer care
- Reports (weekly and monthly) including projections, international pending problems, procedure code analysis, and productivity
- HIPAA compliance
- Expertise in use of medical billing software such as Lytec, Medisoft, Inception, Nextgen, IDX, Misys, and Medic
- Clean claims
When you outsource to a reliable medical billing company, you are ensured of customized service in line with your requirements:
- Fee analysis
- Insurance payment profiles
- Help with utilizing and comprehending coding and compliance modifications
- Profitability assessment on the basis of procedure code
- Accounts Receivable Management
Finding the Right Service Provider
To identify the right service provider, search online directories and the yellow pages. Medical billing services can definitely help you streamline your revenue cycle if you choose the right service provider.