In these uncertain times, with the changing regulations of how claims are submitted, received and processed by Insurance Carriers, it can be quite overwhelming financially. The most frequent questions asked are… Am I collecting the most amount possible? Just how do I understand I’m collecting around possible? How can I increase my revenue? Perhaps a Medical Billing Service could answer all of these questions and calm the angst that’s related to them. There are numerous benefits to a Medical Billing Service. Guidelines six benefits which can be explored in more detail.
Increase Collection Rates with a Medical Billing Service
Many folks are under the impression that Medical Billing is merely data entry; however, it is a great deal more than that. To be able to bring in the most amount of cash on the claims being submitted there needs to be follow-up on the claims medical billing company. This often times is where in-house billing falls short, depending on the amount of staff that’s area of the department, claim submission and payment posting become the priorities. For example when you yourself have one biller in a two physician practice that sees a good amount of patients each day, the biller’s time is principally going to be spent on creating, submitting and posting payments for claims. Entering in the claims, and reviewing each claim before it gets sent to the insurance carrier is time consuming. This really is also true with payment posting; it is time intensive to post the amount of money received to each CPT code, yet extremely important. With only those two responsibilities, there is short amount of time left for the claims that want more action. Usually the claims which can be denied require little action to be able to become paid claims. However, it will take care to follow-up with the insurance company to see what must have the claim paid. Follow-up alone is just a full-time position. With a Medical Billing Service there are multiple personnel doing work for your practice. Quite often there is one full-time dedicated person following up on all claims that want further action. Rather than spending money on two full-time employees most Medical Billing Services have follow-up on claims as a standard service of Claim Processing.
Increase Profitability with a Medical Billing Service
There are multiple ways that the Medical Billing Service can boost the profitability of a Medical Practice, including, however not restricted to staff availability, eligibility services, and CPT trending. Whenever you hire a Medical Billing Service you’re getting multiple billers focusing on your account. There’s constant activity with claims submissions, payment posting, follow-up, patient billing and account inquiries. If some of those billers is actually out, there are multiple billers there to fill in, ensuring that no work is left until that biller is back in the office. What this means is there is no disruption in the Billing Process and no hiccup in the revenue received. Patient Eligibility is one of many easiest ways to make sure proper payment of claims. Before the individual even walks through the doorway, the individual has received their eligibility verified. This in turn ensures the practice that the individual happens to be covered under the insurance carrier on the file, and any referral that’s needed has been obtained. In addition, it provides for any Insurance Carrier discrepancies (such as a change of insurance, mistyped ID number, etc) to be fixed ahead of the visit, leading to a rise in “clean” claims, which often leads to a rise in profit for the practice. Another way to increase profitability with a Medical Billing Service is through CPT trending. When payments are getting posted to CPT codes, the billers often see a trend from what codes are now being paid and just how much will be received per code. This could often cause two different scenarios. One being that certain codes aren’t being paid on, which often allows the practice to decide whether to keep to provide that service to their patients, or find an alternative or comparable service that they may provide and which will be paid. The 2nd scenario is that the practice is performing a procedure often, therefore allowing a renegotiation with the Insurance Carrier of just how much to be compensated. The above are merely three out of several ways a Medical Billing Service can help Increase Profitability for a Practice.
Increase Physician Productivity with a Medical Billing Service
Each time a physician is certain that the financial aspect of these business is in good hands, and is not focused on whether claims are now being submitted and money will be collected, they are able to concentrate on what’s the most crucial aspects of a physician’s job – patient care. With a Medical Billing Service if you have a CPT code under consideration or even a diagnosis code that cannot be found, the Medical Billing Service will be able to help in finding that code. This in turn allows the physician to keep on seeing patients and charting without skipping a defeat, as opposed to sitting and trying to find out what the code is. Just like CPT trending, which supports increase profitability, the same trend happens when the billers are reviewing claims prior to them being submitted to the insurance carrier. The billers will assist the physicians if you have a conflict in the codes being billed or when they see something that’s being repeated that can help the physician and save them time when doing their chart notes. Many Medical Billing Services offer the services of a Business Analyst who works with the physician and their office staff and provide suggestions on the best way to maximize the usage of tools available (i.e. EMR, MAs, office flow, etc). This can increase efficiency and productivity.
Increase Staff Productivity with a Medical Billing Service
Along with offering the services of a Business Analyst, some Medical Billing Services will even offer training on the best way to properly register someone, collect co-payments, and create a maximum office flow that may increase productivity throughout the office. Many office workers don’t realize the importance of their job; not realizing they are projecting the initial impression on patients that walk through the door. Properly trained office staff gives more of these focus on the patients, which often will soon be appreciated by those patients who’re also more prone to recommend the physician to their friends and relatives. Along with increasing the efficiency of any office a Medical Billing Service also eliminates many patient calls regarding their accounts. Each time a patient has a question regarding a record, or even a bill that they have received either from any office or an insurance carrier, the decision is handled by the Medical Billing Service. They are able to assist your patient in a professional manner, minus the pressure of having to test in patients, answer the phone, etc. The attention and professional way the Medical Billing Service personnel conduct their business will assure the patients that their questions and concerns are now being managed properly.
Decrease Claim Denials with a Medical Billing Service
With a Medical Billing Service, the staff that’s focused on your practice goes through each claim before it is submitted to ensure that it is just a “clean” claim. A “clean” claim is what it seems like; a claim that has the correct CPT codes related to the diagnosis codes, complete patient information, and complete insurance information. This decreases the chance of denial by the insurance company. Medical Billing Services make sure that the best percentage of “clean” claims possible are now being submitted to the insurance carrier. This escalates the revenue coming back to the practice as well as decreases the amount of labor had a need to follow-up on claims. Medical Billing Services realize that enough time spent reviewing claims to be sure they meet with the insurance carrier standards is worth the time.
Gain insight into your practice financials with a Medical Billing Service
A Medical Billing Service knows which reports to perform to provide physicians complete insight to the financial side of these practice. Medical Billing Services know very well what money will be billed out to the insurance carriers, as well as what’s being received from insurance carriers and patient payments. This really is turn allows the Medical Billing Service to perform the right reports that show the physicians what they wish to know, as opposed to giving reports that show miscellaneous data that doesn’t pertain to the key financial insight of the practice. Many Billing Services may also be able to supply physician requested financial reports very easily. For example, if a physician needs to understand how many specific procedures were done in a romantic date span for Credentialing, the Medical Billing Service can quickly obtain this information. Another way to achieve insight to the financial side of the practice is always to trend the way the insurance carriers are paying. If an Insurance carrier increases or decreases the quantity received, it will soon be seen right away by the Medical Billing Service, thereby allowing the correction or renegotiation of any discrepancy in payments.
