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 common questions asked are… Am I collecting the most amount possible? Just how do I know I am collecting as much as possible? Just how can I increase my revenue? Perhaps a Medical Billing Service could answer many of these questions and calm the angst that is connected with them. There are many benefits to a Medical Billing Service. Guidelines six benefits that are explored in more detail.
Increase Collection Rates with a Medical Billing Service
Many folks are underneath the impression that Medical Billing is only data entry; however, it’s a lot more than that. To be able to generate the most amount of cash on the claims being submitted there needs to be follow-up on the claims medical billing company. This quite often is where in-house billing falls short, with regards to the level of staff that is part of the department, claim submission and payment posting end up being the priorities. For example if you have one biller in a two physician practice that sees a decent level of patients per day, the biller’s time is mainly planning to be spent on creating, submitting and posting payments for claims. Entering in the claims, and reviewing each claim before it gets delivered to the insurance carrier is time consuming. This really is also true with payment posting; it’s frustrating to create the amount of money received to each CPT code, yet extremely important. With just those two responsibilities, there is very little time left for the claims that need more action. Frequently the claims that are denied require little action in order to become paid claims. However, it does make time to follow-up with the insurance company to see what is needed to have the claim paid. Follow-up alone is really a regular position. With a Medical Billing Service you will find multiple personnel working for your practice. Sometimes there is one regular dedicated person following on all claims that need further action. Instead of investing in two regular employees most Medical Billing Services have follow-up on claims as a typical service of Claim Processing.
Increase Profitability with a Medical Billing Service
You will find multiple ways that a Medical Billing Service can raise the profitability of a Medical Practice, including, but not limited to staff availability, eligibility services, and CPT trending. Whenever you hire a Medical Billing Service you are getting multiple billers taking care of your account. There is constant activity with claims submissions, payment posting, follow-up, patient billing and account inquiries. If some of those billers happens to be out, you will find multiple billers there to fill in, ensuring that no work is left until that biller is 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 the easiest ways to make sure proper payment of claims. Before the patient even walks through the doorway, the patient has already established their eligibility verified. As a result ensures the practice that the patient is currently covered underneath the insurance carrier on the file, and any referral that is needed has been obtained. In addition it provides for any Insurance Carrier discrepancies (such as an alteration of insurance, mistyped ID number, etc) to be fixed before the visit, ultimately causing an increase in “clean” claims, which in turn contributes to an increase in profit for the practice. Another way to improve profitability with a Medical Billing Service is through CPT trending. When payments are getting posted to CPT codes, the billers often see a development as to the codes are now being paid and how much has been received per code. This may often lead to two different scenarios. One being that certain codes are not being paid on, which in turn allows the practice to decide whether or not to continue to supply that service to their patients, or find an alternative or comparable service that they can provide and which is paid. The second scenario is that the practice is performing a procedure often, therefore allowing a renegotiation with the Insurance Carrier of how much to be compensated. The aforementioned are just three out of many ways a Medical Billing Service will help Increase Profitability for a Practice.
Increase Physician Productivity with a Medical Billing Service
Whenever a physician is confident that the financial aspect of the business is in good hands, and is not focused on whether or not claims are now being submitted and money has been collected, they can give attention to what’s the main aspects of a physician’s job – patient care. With a Medical Billing Service if you have a CPT code in question or perhaps a diagnosis code that can’t be found, the Medical Billing Service will be able to help in discovering that code. As a result allows the physician to help keep on seeing patients and charting without skipping a beat, instead of sitting and trying to figure out what the code is. Similar to CPT trending, which supports increase profitability, an identical trend happens when the billers are reviewing claims prior in their mind being submitted to the insurance carrier. The billers will assist the physicians if you have a conflict in the codes being billed or if they see something that is being repeated that will help the physician and save them time when doing their chart notes. Many Medical Billing Services offer the services of a Business Analyst who will work with the physician and their office staff and provide suggestions on the best way to maximize the utilization of tools available (i.e. EMR, MAs, office flow, etc). This can increase efficiency and productivity.
Increase Staff Productivity with a Medical Billing Service
As well as offering the services of a Business Analyst, some Medical Billing Services will also offer training on the best way to properly register someone, collect co-payments, and create an ideal office flow which will increase productivity through the entire office. Many office staff members don’t realize the significance of their job; not realizing that they are projecting the very first impression on patients that walk through the door. Properly trained office staff will give more of the awareness of the patients, which in turn will undoubtedly be appreciated by those patients that are also prone to recommend the physician to their friends and relatives. Along side increasing the efficiency of any office a Medical Billing Service also eliminates many patient calls regarding their accounts. Whenever a patient includes a question regarding a record, or perhaps 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 experiencing to check in patients, answer the device, etc. The interest and professional way the Medical Billing Service personnel conduct their business will assure the patients that their questions and concerns are now being handled properly.
Decrease Claim Denials with a Medical Billing Service
With a Medical Billing Service, the staff that is focused on your practice undergoes each claim before it’s submitted to make sure that it is really a “clean” claim. A “clean” claim is what it appears like; a claim that’s the right CPT codes connected with the diagnosis codes, complete patient information, and complete insurance information. This decreases the chance of denial by the insurance company. Medical Billing Services ensure that the greatest percentage of “clean” claims possible are now being submitted to the insurance carrier. This escalates the revenue returning to the practice in addition to decreases the quantity of labor had a need to follow-up on claims. Medical Billing Services know that the time spent reviewing claims to make sure they meet the insurance carrier standards is well worth the time.
Gain insight into your practice financials with a Medical Billing Service
A Medical Billing Service knows which reports to operate to offer physicians complete insight to the financial side of the practice. Medical Billing Services know very well what money has been billed out to the insurance carriers, in addition to what’s being received from insurance carriers and patient payments. This really is turn allows the Medical Billing Service to operate the appropriate reports that show the physicians what they wish to know, instead of giving reports that show miscellaneous data that does not 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 your physician needs to understand just how many specific procedures were done in a date span for Credentialing, the Medical Billing Service can certainly obtain this information. Another way to get insight into the financial side of the practice is to trend how the insurance carriers are paying. If an Insurance carrier increases or decreases the total amount received, it will undoubtedly be seen right away by the Medical Billing Service, thereby allowing the correction or renegotiation of any discrepancy in payments.