In these uncertain times, with all the current changing regulations of how claims are submitted, received and processed by Insurance Carriers, it could be very overwhelming financially. The most typical questions asked are… Am I collecting the most amount possible? How do I understand I am collecting as much as possible? Just how can I increase my revenue? Perhaps a Medical Billing Service could answer all of these questions and calm the angst that is related to them. There are numerous benefits to a Medical Billing Service. Below are six benefits that are explored in more detail.
Increase Collection Rates with a Medical Billing Service
Many people are underneath the impression that Medical Billing is only data entry; however, it’s a great deal more than that. To be able to generate the most amount of money on the claims being submitted there must be follow-up on the claims medical billing. This often times is where in-house billing falls short, with regards to the amount of staff that is part of the department, claim submission and payment posting end up being the priorities. As an example when you have one biller in a two physician practice that sees a good amount of patients daily, the biller’s time is principally planning 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. That is also true with payment posting; it’s time intensive to post the amount of money received to each CPT code, yet extremely important. With just those two responsibilities, there’s 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 will remember to follow-up with the insurance company to see what must obtain the claim paid. Follow-up alone is a full time position. With a Medical Billing Service you can find multiple personnel working for your practice. Sometimes there’s one full time dedicated person following through to all claims that require further action. Instead of investing in two full time employees most Medical Billing Services have follow-up on claims as a typical 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, although not restricted to staff availability, eligibility services, and CPT trending. Once you hire a Medical Billing Service you are getting multiple billers taking care of your account. There’s constant activity with claims submissions, payment posting, follow-up, patient billing and account inquiries. If one particular billers is out, you can find multiple billers there to complete, ensuring that no work is left until that biller is back the office. What this means is there’s 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 in-patient even walks through the door, the in-patient has already established their eligibility verified. This in turn ensures the practice that the in-patient is covered underneath the insurance carrier on the file, and any referral that is needed has been obtained. Additionally, it makes for any Insurance Carrier discrepancies (such as a big change of insurance, mistyped ID number, etc) to be fixed before the visit, resulting in a rise in “clean” claims, which 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 receiving posted to CPT codes, the billers often see a trend from what codes are now being paid and just how much is being received per code. This may often cause two different scenarios. One being that certain codes are not being paid on, which allows the practice to choose whether or not to carry on to provide that service to their patients, or find an alternative or comparable service that they may 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 just how much to be compensated. The aforementioned are only three out of several 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 isn’t concerned about whether or not claims are now being submitted and money is being collected, they are able to give attention to what’s the most crucial aspects of a physician’s job – patient care. With a Medical Billing Service if you have a CPT code involved or even a diagnosis code that can’t be found, the Medical Billing Service will have the ability to assist in finding that code. This in turn allows the physician to keep on seeing patients and charting without skipping a beat, as opposed to sitting and trying to determine what the code is. Much like CPT trending, which helps increase profitability, an identical trend happens once the billers are reviewing claims prior to them being submitted to the insurance carrier. The billers will assist the physicians if you find a conflict in the codes being billed or should they see something that is being repeated that will assist the physician and save them time when doing their chart notes. Many Medical Billing Services provide the services of a Business Analyst who will continue to work with the physician and their office staff and provide suggestions on how to maximize the use of tools readily available (i.e. EMR, MAs, office flow, etc). This may 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 how to properly register someone, collect co-payments, and create an optimal office flow which will increase productivity through the office. Many office workers do not realize the significance of their job; not realizing that they’re projecting the initial impression on patients that walk through the door. Properly trained office staff gives more of the awareness of the patients, which is likely to be appreciated by those patients that are also prone to recommend the physician to their friends and relatives. Along with increasing the efficiency of work a Medical Billing Service also eliminates many patient calls regarding their accounts. Whenever a patient has a question regarding a record, or even a bill they’ve received either from work or an insurance carrier, the decision is handled by the Medical Billing Service. They can assist your patient in a professional manner, with no 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 is focused on your practice experiences each claim before it’s submitted to be sure that it is a “clean” claim. A “clean” claim is what it appears like; a claim that has the right CPT codes related to the diagnosis codes, complete patient information, and complete insurance information. This decreases the opportunity of denial by the insurance company. Medical Billing Services make sure that the greatest percentage of “clean” claims possible are now being submitted to the insurance carrier. This advances the revenue returning to the practice in addition to decreases the amount of labor needed seriously to follow-up on claims. Medical Billing Services know that enough time spent reviewing claims to make sure they meet up 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 operate to provide physicians complete insight to the financial side of the practice. Medical Billing Services understand what money is being billed out to the insurance carriers, in addition to what’s being received from insurance carriers and patient payments. That is turn allows the Medical Billing Service to operate the appropriate reports that show the physicians what they would like 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 are also able to supply physician requested financial reports very easily. As an example, in case a physician needs to learn exactly how many specific procedures were done in a date span for Credentialing, the Medical Billing Service can simply obtain this information. Another way to achieve 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 is likely to be seen straight away by the Medical Billing Service, thereby allowing the correction or renegotiation of any discrepancy in payments.