6 Advantages of the Medical Billing Service



In these uncertain times, with all the 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 know 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 associated with them. There are many benefits to a Medical Billing Service. Below are six benefits which can be 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. In order to bring in the most sum of money on the claims being submitted there needs to be follow-up on the claims medical billing. This sometimes 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 become the priorities. For example when you have one biller in a two physician practice that sees a decent amount of patients each day, the biller’s time is mainly likely 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 is also true with payment posting; it’s time consuming to publish the amount of money received to each CPT code, yet extremely important. With only those two responsibilities, there’s very little time left for the claims that need more action. Usually the claims which can be 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 needed to have the claim paid. Follow-up alone is a full time position. With a Medical Billing Service there are multiple personnel employed by your practice. Quite often there’s one full time dedicated person following up on all claims that need further action. As opposed to 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

You can find multiple ways that a Medical Billing Service can raise the profitability of a Medical Practice, including, although not limited to staff availability, eligibility services, and CPT trending. Whenever you hire a Medical Billing Service you are getting multiple billers working on your account. There’s constant activity with claims submissions, payment posting, follow-up, patient billing and account inquiries. If one particular billers is out, there are multiple billers there to fill out, ensuring that no work is left until that biller is back the office. This means there’s 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 individual even walks through the doorway, the individual has received their eligibility verified. This in turn ensures the practice that the individual is currently covered underneath the insurance carrier on the file, and any referral that is needed has been obtained. Additionally, it allows for any Insurance Carrier discrepancies (such as a change of insurance, mistyped ID number, etc) to be fixed prior to the visit, resulting in an increase in “clean” claims, which often contributes 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 development to what codes are being paid and how much will be received per code. This can often result in two different scenarios. One being that certain codes are not being paid on, which often allows the practice to determine whether or not to carry on to provide that service with their patients, or find an alternative solution 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 just three out of numerous ways a Medical Billing Service can help Increase Profitability for a Practice.

Increase Physician Productivity with a Medical Billing Service

Whenever a physician is confident that the financial aspect of their business is in good hands, and isn’t focused on whether or not claims are being submitted and money will be collected, they could focus on what is the most important facets of a physician’s job – patient care. With a Medical Billing Service if there is a CPT code involved or even a diagnosis code that cannot be found, the Medical Billing Service will be able to help in discovering that code. This in turn allows the physician to help keep on seeing patients and charting without skipping a defeat, in place of sitting and trying to find out what the code is. Similar to CPT trending, which helps increase profitability, an identical 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 should 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 continue to work with the physician and their office staff and provide suggestions on how best to maximize the usage of tools on hand (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 also offer training on how best to properly register a patient, collect co-payments, and create an optimum office flow which will increase productivity throughout the office. Many office personnel do not realize the significance of their job; not realizing they are projecting the first impression on patients that walk through the door. Properly trained office staff can give more of their attention to the patients, which often is likely to be appreciated by those patients who’re also prone to recommend the physician with 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 features a question regarding a statement, or even a bill that they have received either from any office or an insurance carrier, the call is handled by the Medical Billing Service. They are able to assist your patient in an expert manner, with no pressure of getting to check on in patients, answer the device, etc. The eye and professional manner in which the Medical Billing Service personnel conduct their business will assure the patients that their questions and concerns are being managed properly.

Decrease Claim Denials with a Medical Billing Service

With a Medical Billing Service, the staff that is dedicated to your practice undergoes each claim before it’s submitted to be sure that it is a “clean” claim. A “clean” claim is what it seems like; a claim that has the right CPT codes associated with 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 being submitted to the insurance carrier. This increases the revenue returning to the practice in addition to decreases the amount of labor needed seriously 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 really 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 understand what money will be billed out to the insurance carriers, in addition to what is being received from insurance carriers and patient payments. This is turn allows the Medical Billing Service to run the right reports that show the physicians what they would like to know, in place of 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 offer physician requested financial reports very easily. For example, if your physician needs to understand 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 would be to trend the way the insurance carriers are paying. If an Insurance carrier increases or decreases the quantity received, it is likely to be seen right away by the Medical Billing Service, thereby allowing the correction or renegotiation of any discrepancy in payments.

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