How to make a right Medical Billing Team for your Practice? CureMD 07:17

Staff is the backbone of any business, particularly service-based business like a medical practice. It is necessary that there is an adequate number of staff with proper skills required by the medical practice.

Like the clinical staff, the medical billing staff should also be trained in their duties to bring efficiency in their performance that effect directly on the medical billing services.

Your practice should have right number of medical billing staff

There are several ways to determine the right number of staff for the billing department. This may depend on the number of patient visits, volume of claims to be processed, and number of accounts that each biller has.

However, the best practice is to have an established standard to determine the accurate number of employees you will need to run your medical billing department. The standard may vary between specialties, depending on their workflow and patient visits.

According to the benchmark set by American Academy of Ophthalmic Executives (AAOE) for ophthalmology practices, cost of billing staff should be approximately 5% of your income.

Make sure your billing staff has the right skills

While advertising the position of medical biller, be very particular about SOP of the billing services and specific requirements of your specialty along with the general responsibilities.

Billing is a complex department. In order to deal effectively with insurance payers and patients, the medical biller need to be self-motivated, has an eye for details and creative enough to find problems to issues.

It is ideal to hire billers who have experience or knowledge of medical terminology and medical coding system. However, in-house training provided to the billers can be more beneficial. Well-trained billers will understand the specific workings of your practice, the patientflow and mechanism to deal with the issues faced with payers.

Make Patient-Practice Communication part of your Medical Billing Process CureMD 09:29

Communication is the key to a strong relationship. In a patient-practice relationship, effective communication of financial responsibilities of patients can result in increased payments.

Patient payment is crucial part of the medical billing procedure. Taking care of your patients means that you are taking care of your business, ensuring that the patients’ cooperation in paying bills.

Let’s find out how communication improves your medical billing practices.

Listen to your patient

Listen to understand is the first rule of effective communication. While taking down information from patients, listen to them carefully. Train your staff in standards of clear and comprehensive communication of financial details and responsibilities of patients. This includes practice’s payment policy.

This way, patients are left with no ambiguity regarding their payment plans and responsibilities towards the practice.

Make the message simple

Patients are not financial analysts. While drafting medical billing policy of your practice, keep in mind that it should be in a language which is comprehensible by the patients. Refrain from using too many billing and insurance jargons. Keep it simple and concise.

However, patients should be informed about necessary insurance plans and procedures, like deductibles, co-insurance in a simple language.

Be transparent in your dealings

A medical billing process of a practice should be fair and transparent. When a new patient makes an appointment, communicate to them about your insurance eligibility policies. Discuss with them what is included and what isn’t in their health insurance plan and whether your practice can assist them in this regard.

Do not make promises that you cannot deliver in future. It is better that the patients are communicated about their responsibilities, and procedures and services allowed in their insurance plan.

Medical billing process is a complicated segment of practice. To make things relatively simple, practitioners should try to develop a strong relationship with theirpatients for timely patient collections. 

How does outsourcing medical billing expedite claims? CureMD 06:04

The time between when a claim is sent out from your office to the time you receive a reimbursement for that claim varies from practice to practice. You might have noticed competitors managing the process swiftly and efficiently, and getting their money faster in the process. There are two ways by which you can do the same; a huge billing department with as big a payroll or via outsourcing your billing service to professional billing companies.

By outsourcing, you can still maximize reimbursements without the added cost of allotting lavish budgets to your billing department. The article will give you an overview of the claim submission process after which you will have a better understanding of the benefits of outsourcing.

   

With in-house billing, once you code and document a patient’s visit, the claims are sent to the insurance carrier or Medicare for reimbursement. The process can take approximately 3 to 6 weeks.  

However, with outsourcing, the process will be shortened to just a couple of weeks. Additionally, your patient information is just as well protected, if not more.

Here’s how the process will work

First is the transmission of claims (either electronic or paper) for coding to the outsourcing company. The billing company will enter and recheck your claims for errors before transmitting batch orders.

The batch orders are sent either to a clearinghouse or directly to the insurance carrier. The clearinghouses convert the data into a standard format before sending it to the carrier for processing. 

The clearinghouse helps identify any medical coding errors and results in the amount of claims delayed due to errors falling to almost nil.

When the carrier gets the claim, it issues a receipt of conformation for claim tracking. Receiving a reimbursement via electronic claim filling usually takes around two weeks after which you receive a reimbursement check and an Explanation of Benefits (EOB).

Furthermore, you can always find out the status of any claim from the outsourcing company. And without worrying about your practice’s billing, you can focus more on your patients as the billing process is in the hands of competent and experienced professionals. 

Why should a small practice outsource medical billing and coding? CureMD 09:42

With the amount of regulation in the healthcare industry, a few errors are all that separate your practice from a huge compensation price. This makes a lot more sense in the context of billing documentation and medical coding; a few errors in either could cost the disruption of quality care to your patients in addition to making your wallet significantly lighter.

By outsourcing, you will save the expense of employing personnel with diverse skill sets. In most cases, especially for smaller practices, it is not practical and feasible to employ separate IT specialists and separate billing specialists.

Consequently, with thousands of new ICD codes coming up, coupled with the HIPAA audits beginning this year, you will require competent, experienced and able personnel to do your medical billing for you. Here’s how they’ll help your practice prosper and flourish:

Facilitating compliance with strict coding regulations is one of the foremost and key benefits of outsourcing. Taking time on billing is important, as you don’t want insurance companies to deny payments because of small errors in your bill. With so many deadlines, guidelines and instructions, even the biggest of practices fall prey to such mistakes. Your practice is much smaller, and thus, such mistakes will have more impact on your revenue stream with the subsequent audits and potential fines. 

   

The specialized personnel to whom you've outsourced this service have a strong grasp of the service, and the expertise required to get the job done with the maximum success rate in the minimum time. Moreover, they possess the extra time, which a small practice like yours seldom has, to recheck the reports they've compiled and to identify any changes in regulation and compliance that you could easily overlook. 

The overall revenue for your practice will also rise as they have the resources and the experience to effectively claim reimbursements, ensure receivables are collected faster and to minimize denials. With the revenue cycle of your business flourishing, your practice will enjoy accelerated growth.

Your patients will also be more satisfied with lesser errors, and more importantly with the added time that you are now able to dedicate to them.

Consequently, you save a significant amount of money and markedly more time to focus on your practice.