Significance of medical Billing

The physicians and healthcare providers not only have to be at top of their game in their respective specialties in order to lead and innovate, but they also have to be extra careful and time cautious in the preparation and submission of claims. No matter how much a healthcare provider familiarizes and teaches himself about the nuances and gradations of his field, the financial success relies heavily on efficient medical billing processes. Dilly-dallying with it for any reason costs depletion in the financial reserves.
So what exactly is medical billing? To put it simply, it is a process in which physicians and doctors or nurses fill forms having the complete information of medical services and processes given to patients in order to send them to the insurance companies for maximum reimbursements. In a nutshell, medical billing is a process that decodes healthcare services into streamlined billing claims for maximum reimbursements for practices and healthcare facilities.
In a glance, it seems that a medical checkup only involves patient and a healthcare provider, but it is more than that. The complete medical diagnosis and treatment is a three-way system. That is patient, healthcare provider and insurance companies. So all that extensive and exhaustive medical billing process comes into play for the third entity the insurance companies.

Getting Paid by Payers Super-Fast

As we have established that payers are crucial in overall revenue generation, so, it would be wise to employ efficient and smart processes to increase the chances of landing successful timely claims. Following are some methods which can help fast and efficient payers reimbursements.

Clear Collection process

Open and transparent communication with patients is of an absolute importance. There should be a clear collection policy in order to avoid confusion in the collection of the revenue. Without a concrete road map to follow there are less chances of streamlining the processes which hinders the capacity of generating healthy financial output for the practice. One way to make the overall collection process more efficient and easier is to collect payments at the time of providing service. However, it is important to let patients know of this policy beforehand in order to avoid any misunderstanding later, either by telling them before giving them service or with the help of signs hanging in waiting rooms or lobbies explaining the collection policy. Moreover, healthcare provider’s front desk should inform the patients of different payment methods available, whether they are credit cards, checks or hard cash.
In case of an insurance card, verify the eligibility of the patient at every visit in order to avoid denied claims later. An automated system for this purpose does not only save time but also labor cost and help the practice to keep churning the cycle of cash inflow.

Maintain and Update patient Files

In continuation to above stated points maintaining and timely updating patient files is crucial for reimbursements from the payers. Failing to update patient information results in billing discrepancies and leads to financial losses for the practices. The staff employed by the healthcare provider or hospitals should be well-versed with the process of verifying patient demographics and insurance information at every visit and in case of any change either in physical address or insurance must be updated and maintained correctly.

Claims Management

Most of the medical billing claims are rejected by insurance companies because of incomplete or inaccurate information. Payers have strict policies regarding claim submissions and they don’t shy away or hesitate at all to reject or deny claims on basic errors. So healthcare providers need to tread carefully while preparing claims. The rejection and resubmission of claims can take weeks affecting the financial output of the practice. Because of such punishing nature of aging, it is crucial to submit claims with complete and accurate information.

a. Incorrect patient information is one of the main reasons in the rejection of claims. Make sure to include correct name, date of birth (DOB), contact information and address in the submission of the claims.

b. Be mindful about the healthcare provider information. Like patient’s information, healthcare provider’s name, address and contact information should be accurate.

c. Insurance information of the patient should be accurate and updated and healthcare specialist staff should make it a habit to verify insurance information and demographics of the patients upon every visit.

d. Another reason is failing to verify if a service given has already been reported or reimbursed by the healthcare provider. This often plays its role in the rejection of claims taking a toll on the practice.

e. Documentation is perhaps the most crucial aspect in the submission of claims. Incorrect, inaccurate and incomplete documentation of services or procedures make it difficult for medical coders to attach right codes, thus giving an opportunity to the payers to question the cogency of the claims.

f. No Explanation of Benefits (EOB) on a denied claim makes it more difficult to spot and correct the error.

Outsourcing Medical Billing Services

There are numerous advantages and benefits to outsource billing services to medical billing companies. Chief among them are

Save Labor Costs
By outsourcing the medical billing services to the professional and trained billers, healthcare professionals and facilities don’t have to hire and train staff for claim submissions. Practices can save money and resources in terms of staff salaries, office infrastructure and also in purchasing, maintaining and up gradation cost of billing software.

Focus on Patient Care
Another advantage of outsourcing the services of medical billing companies is that healthcare providers don’t have to overly burden themselves with the overwhelming and tiresome administrative and billing tasks without having the fear of hurting cash inflows, which is the crucial aspect of medical billing and without healthy revenue generation no practice can sustain let alone thrive. Having medical billing professionals on the back of providers fighting for every single penny on their behalf gives an opportunity to healthcare providers to direct their focus on the patient care and wellbeing. Reduce Billing Errors

Clean and timely claim submission is the bread and butter of any medical billing process. Though, sound simple it involves an overwhelming amount to detail. Professional billers ensures patient eligibility, confirm insurance information, correct documentation of service(s), verify DOB, match ICD-10 and CPTs and attach units (in case of Anesthesia billing), all the right procedures and set of protocols to guarantee clean submission. If any of the above mentioned factors are taken lightly or haven’t done properly will sabotage the revenue cycle. Therefore, hiring the services of professional medical billers ensure reduced billing errors results in increased cash flow.

Improve Patient Satisfaction

By freeing office staff with the billing duties, staff can better focus and manage patients which increases the productivity and efficiency of the office yielding better results and revenue for the practices. Happy and satisfied customers are good omen for any business and in healthcare these factors even play more crucial role.

Secure Data

Outsourcing billing services to third party means increased security of the data. Well established medical billing companies offers transparent and secure billing processes and services. So in order to maintain the transparency and patient information security it is wise to outsource the services of medical billing services.

Changing Rules and Regulations

The rules and regulations of medical billing world are continuously changing and updating. Keeping up with all the changes and the updates is cumbersome for the practices and demands a lot of time and resources. By outsourcing the services to professional billers, healthcare providers can free themselves and their staff to constantly monitor the changes and can focus on other more important areas.

Payment Follow-Ups

Professional and trained billers are more efficient and well-rehearsed in identification and rectification of the errors. Often time’s payers delay or reject claims based on minor objections. In such cases billers aggressively follow-up with the payers and after identifying and correcting the errors resubmit the claims and make sure that the practices get the maximum reimbursements without the delay. Outsourcing medical billing services not only ensures peace of mind from the cumbersome billing tasks but also increase revenue for the practices and let them balance work and family time.