In
these uncertain times, with all 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 maximum amount possible? How do I know I am collecting as much
as possible? How can I increase my revenue? Perhaps a Medical Billing Service
could answer all of these questions and calm the angst that is associated with them.
There are many benefits to a Medical Billing Service. Below are six benefits
that are explored in more detail.
Benefits of a Medical Billing Service
Many
people are under the impression that Medical Billing Services is merely data entry; however, it is much more than that.
In order to bring in the maximum amount of money on the claims being submitted
there needs to be follow-up on the claims. This often times is where in-house
billing falls short, depending on the amount of staff that is part of the
department, claim submission and payment posting become the priorities. For
instance if you have one biller in a two physician practice that sees a decent
amount of patients per day, the biller's time is mainly 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 is also true with payment posting; it is time consuming to post
the money received to each CPT code, yet extremely important. With just those
two responsibilities, there is little time left for the claims that require
more action. Most often the claims that are denied require little action in
order to become paid claims. However, it does take time to follow-up with the
insurance company to see what is required to get the claim paid. Follow-up
alone is a full time position. With a Medical
Billing Service there are multiple personnel working for your practice.
Often times there is one full time dedicated person following up on all claims
that require further action. Instead of paying for 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 a Medical Billing
Service can increase the profitability of a Medical Practice, including,
but not limited to staff availability, eligibility services, and CPT trending.
When you hire a Medical Billing Service you are getting multiple billers
working on your account. There is constant activity with claims submissions,
payment posting, follow-up, patient billing and account inquiries. If one of
those billers happens to be out, there are multiple billers there to fill in,
ensuring that no work is left until that biller is back in the office. This
means there is no disruption in the Billing Process and no hiccup in the
revenue received. Patient Eligibility is one of the easiest ways to ensure
proper payment of claims. Before the patient even walks through the door, the
patient has had their eligibility verified. This in turn ensures the practice
that the patient is currently covered under the insurance carrier on their
file, and any referral that is needed has been obtained. It also allows for any
Insurance Carrier discrepancies (such as a change of insurance, mistyped ID
number, etc) to be fixed prior to the visit, leading to an increase in "clean"
claims, which in turn leads to an increase 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 to what codes are being paid and how much is being received per code.
This can 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 offer that service to their patients, or find an alternative
or comparable service that they can provide and which will be 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 above are only three out of many ways a Medical Billing Services can help Increase Profitability for a
Practice.
Increase Physician Productivity with a
Medical Billing Service
When
a physician is confident that the financial aspect of their business is in good
hands, and is not worried about whether or not claims are being submitted and
money is being collected, they can focus on what is the most important aspects
of a physician's job - patient care. With a Medical Billing Service if there is
a CPT code in question or a diagnosis code that cannot be found, the Medical Billing Service will be able to
assist in finding that code. This in turn allows the physician to 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 helps
increase profitability, a similar trend happens when the billers are reviewing
claims prior to them being submitted to the insurance carrier. The billers will
assist the physicians when there is 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 how to maximize the usage of tools on
hand (i.e. EMR, MAs, office flow, etc). This will 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 how to properly register a patient,
collect co-payments, and create an optimal office flow that will increase
productivity throughout the office. Many office staff members do not realize
the importance of their job; not realizing that they are projecting the first
impression on patients that walk through the door. Properly trained office
staff will give more of their attention to the patients, which in turn will be
appreciated by those patients who are also more likely to recommend the
physician to their friends and relatives. Along with increasing the efficiency
of the office a Medical Billing Service also eliminates many patient calls
regarding their accounts. When a patient has a question regarding a statement,
or a bill that they have received either from the office or an insurance
carrier, the call is handled by the Medical Billing Service. They are able to
assist your patient in a professional manner, without the pressure of having to
check in patients, answer the phone, etc. The attention and professional manner
in which the Medical Billing Outsourcing Service
personnel conduct their business will assure the patients that their questions
and concerns are being dealt with properly.
Decrease Claim Denials with a Medical
Billing Service
With
a Medical Billing Service, the staff that is dedicated to your practice goes
through each claim before it is submitted to make sure that it is a "clean"
claim. A "clean" claim is what it sounds like; a claim that has the
correct CPT codes associated 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
highest percentage of "clean" claims possible are being submitted to
the insurance carrier. This increases the revenue coming back to the practice
as well as decreases the amount of labor needed 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 run to give physicians complete
insight to the financial side of their practice. Medical Billing Services know what money is being billed out to the
insurance carriers, as well as what is being received from insurance carriers
and patient payments. This is turn allows the Medical Billing Service to run
the appropriate reports that show the physicians what they want to know,
instead of giving reports that show miscellaneous data that does not pertain to
the main financial insight of the practice. Many Billing Services are also able
to provide physician requested financial reports very easily. For instance, if
a physician needs to know how many specific procedures were done in a date span
for Credentialing, the Medical Billing Service can easily obtain this
information. Another way to gain 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 amount received, it will be seen right away
by the Medical Billing Service, thereby allowing the correction or
renegotiation of any discrepancy in payments.
Elite Medical
Business Solutions is a reliable and leading medical billing company with
vast experience and expertise in the field of Insurance Credentialing Services and Coding and Chart Documentation Audit Service. For more information
on the services offered by them you can log on to their website www.elitemedbiz.com.
