What Practitioners Need to Look For in a Medical Billing Company
The basic services that a medical billing company should be able to offer: Claim Generation: The process involves entering patient demographic details plus insurance and encounter information into the medical billing software.
Claim Submission: This process relates to the claim submissions sent through a clearinghouse if it is in a digital format.
If it is on paper, the documents are sent by mail.
Quality Assurance: The quality assurance applies to electronic claim submission and paper claim submissions.
The premium medical billing software programs have in-built quality assurance check features called 'Scrubbers' that enable the billers to track any mismatch of procedural codes and diagnosis.
The quality assurance for claim submissions documented on paper is manually checked.
Following-up of claims with carriers: The billing company's ability of follow-up on the claims submitted should come into sharp focus, because reimbursements and revenue collections of a practice have a bearing on the kind of follow-up provided by the service provider.
It is only through a follow-up, the medical billing companies get to know about partially paid or unpaid claims.
The billing service company in coordination with the provider and the carrier must ensure that edited or resubmitted claims are accurate and without errors.
Workers compensation claims: These secondary or tertiary claims require additional documentations and deft handling.
The service provider has to be experienced in documenting these unique claims, because it entails entering many details into the documents.
Reporting & Analyzing: billing software's have a report generating feature and as part of medical billing service, regular reports provide practices in-depth information that will help increase profitability, save costs and provide the practice the direction towards growth.
The medical billing company should provide monthly reports, with recommendations that will assist practices in enhancing profitability.
Patient Invoicing: This detail-oriented process if done professionally enhances the revenue of the practice.
The process requires balancing accounts, printing statements, stuffing envelopes and applying postage.
The billing company will also need to take care of queries that patients may raise after they receive the statement.
The billing company that has good infrastructure and customer support will eventually reflect the quality of your practice.
HIPAA compliance: The billing company's awareness of HIPAA regulations also needs a look-in, apart from health care providers these regulations apply to any agency that has access to patient information.
Claim Submission: This process relates to the claim submissions sent through a clearinghouse if it is in a digital format.
If it is on paper, the documents are sent by mail.
Quality Assurance: The quality assurance applies to electronic claim submission and paper claim submissions.
The premium medical billing software programs have in-built quality assurance check features called 'Scrubbers' that enable the billers to track any mismatch of procedural codes and diagnosis.
The quality assurance for claim submissions documented on paper is manually checked.
Following-up of claims with carriers: The billing company's ability of follow-up on the claims submitted should come into sharp focus, because reimbursements and revenue collections of a practice have a bearing on the kind of follow-up provided by the service provider.
It is only through a follow-up, the medical billing companies get to know about partially paid or unpaid claims.
The billing service company in coordination with the provider and the carrier must ensure that edited or resubmitted claims are accurate and without errors.
Workers compensation claims: These secondary or tertiary claims require additional documentations and deft handling.
The service provider has to be experienced in documenting these unique claims, because it entails entering many details into the documents.
Reporting & Analyzing: billing software's have a report generating feature and as part of medical billing service, regular reports provide practices in-depth information that will help increase profitability, save costs and provide the practice the direction towards growth.
The medical billing company should provide monthly reports, with recommendations that will assist practices in enhancing profitability.
Patient Invoicing: This detail-oriented process if done professionally enhances the revenue of the practice.
The process requires balancing accounts, printing statements, stuffing envelopes and applying postage.
The billing company will also need to take care of queries that patients may raise after they receive the statement.
The billing company that has good infrastructure and customer support will eventually reflect the quality of your practice.
HIPAA compliance: The billing company's awareness of HIPAA regulations also needs a look-in, apart from health care providers these regulations apply to any agency that has access to patient information.