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.

Medical Billing Solution for Dermatology CureMD 08:12

Selecting the Right Medical Billing Solution

The choice when looking for a medical billing solution is  not always be obvious, this will require you to ask as many questions as you can to yourself:

• What is the current collection rate of my practice?
• Will my current process have any effect on the result?
• Am I using the right billing software and is it giving me any benefits?
• Do I need to outsource or does my staff has the necessary experience and knowledge to bill effectively?

The factors that decide whether it’s the right time to switch things or not are technology, people, profit and process.

Knowledge of Dermatology

When you sign up your practice for medical billing services you should expect that your account will be handled by professionals that know what is best in dermatology. They would have the right professionals who have the required expertise needed to take your collections to the next level.

State of Art Web Technology

While using the services of Medical Billing Company you are not expected to maintain any hardware or software systems in your office. The billing company will provide you with the Web Based billing software that is available in the market, you and your staff can access the software from anywhere at any time. Furthermore you can also migrate your current patient’s demographic data over to your new system and provide your staff training either on site or via remote support.

Transparent Billing Process

In what way you determine the effectiveness of the current billing process that you are following? Do you look at performance reports like total collections rate or you manage? Whether you manage your billing in house or you outsource it to a third party it is important that you must be able to view the critical financial information that is required to process your billing. Using the medical billing software you can use features such as your systems standard reporting capabilities to supervise your receiving’s and to track your progress over time. 

 

Outsourcing your Medical Billing CureMD 07:56

The reasons whether to outsource the medical billing or keep the process in house is what differentiate one practice from another. The correct answer will vary from practice to practice depending on certain number of reasons such as age of practice, practice size, number of staff etc.

1. Saves time and resources: Outsourcing medical billing saves you time that you can use to spend with your patients. The practice staff can focus on the patient care while the medical billers will focus on your patient billing. Doing so saves time, money and resources that can instead be used to further hire, train and supervise your billing staff, outsourcing allows to make better use of your staff around the office allowing them to spend more time on patient care. 

2. Experts in the field: Medical Billing companies focus on the practice billing. They can point out errors that lead to practices have a high number of rejected claims. Experts at medical billing companies can detect these errors and rectify them that in turn save you money on rejected or returned claims. Office staff is more prone to making errors in billing as they are expected to do other tasks as well at the same time. When you outsource your medical billing to someone or group of people they will make sure that with their dedicated time they make your billing right.

 3. Increased flexibility: when you outsource your medical billing it gives you increased flexibility in tasks and workflows. As having the billing company handles all billing related tasks is one of the best options to get optimum results. Medical billing companies offer services that are customized to your practice. These services usually include posting of co-payments and mail payments, patient statements, concise monthly reporting, quality control audit etc. medical billing companies would allow remote access to view the financial and patient via the internet from your home work. 

 4. Advanced Business Management: Medical Billing Company can become an important business partner. They will provide you with tools such as reports containing the detailed financial health of your practice. Following a close relationship with your medical billing company helps in other areas across the healthcare technology field.

 

 

Outsourcing Medical Billing CureMD 08:35

For medical professionals most of the times the complex part of their job is not about patient care but medical billing. That is why most of the time medical practices have decided to outsource their medical billing. Some of the physicians and practices will be uncertain about making the switch but it has many benefits that can make the practice run effectively and efficiently.

For healthcare professional and physicians the decision to switch from in house billing to outsource medical billing requires a lot of research and better understanding of how medical billing affects a practice. Once this is understood, the practice can save a lot of money and stress by outsourcing the medical billing.

Reasons to go for an Outsource Medical Billing Company

• Reduction in billing errors- There will be huge reduction in billing errors once the practice outsource their medical billing to an outside billing company. The percent of claims that are rejected or denied will decrease, giving a maximum reimbursement on claims. The billing company will make sure that all the claims are submitted in a timely manner.

• Skilled professionals- Medical billing professionals are proficient in insurance rules and regulations as well as HIPAA guidelines. Outsourcing medical companies are expert in dealing with the insurance companies. They will be able handle the negotiations and stay in constant touch with them which ensures the accuracy of a claim.

• Ease up the providers- Many providers would prefer to focus on their patients rather than spending lots of time on the paperwork required for a claim. This becomes possible when outsourcing is done. Healthcare professionals often spend large part of their day filling out the details for medical claims and bills that they get very little time to spend with their patients.

• Improves scheduling- Excessive paperwork can affect the number of appointments that are scheduled by the healthcare provider. This will reduce the practices ability to become profitable and also contribute to the decrease in patient satisfaction.

• Saves time- Making the billing outsourced allow healthcare professionals to focus on the patient care rather than focusing on other technical details.

• Cost effective- The reason why outsourced medical billing is so famous among practices is that it is cheaper than a company doing its own billing. Those practices that outsource the billing are able to cut down on the unnecessary office hours that are required for the billing and the extra employees.

Outsourcing companies are better and affordable choice than in-house medical billing employees because they do not need benefits nor are they paid hourly salary. Instead these companies charge a flat rate per claim or collect some percent of the reimbursements on a claim. Outsourcing would lower the costs for medical billing allowing the practice to save money which can be further used as an investment for improved patient care.

EHRs revolutionizing the medical billing and coding CureMD 08:45

Introduction of the electronic health records (EHRs) and the Affordable Care Act has brought an immense change in these last few years. Medical billing and coding plays a major role in making sure that the American healthcare systems works perfectly and smoothly.

Medical billers and coders use International Classification of Diseases (ICD) when processing the claims and billing insurances. The number of codes will change from 13,600 to approximately 70,000 codes as the system switches from ICD-9 to ICD-10.

It seems like a huge number but anyone who has been trained on medical billing and coding need not to be afraid. This is all happening due to the change that all healthcare providers have to eventually adopt the electronic health records.

EHRs, what are they?

Electronic health records have replaced the paper based patient health records. EHRs help reduce errors in patient care and cut the costs of the healthcare industry. Coders and medical billers use EHR systems to receive financial reimbursements from the insurance companies. EHRs can be used to generate bills for the patients as they contain all the details regarding the patients from procedures to tests.

Do I have to learn ICD-10?

The last date for ICD-10 compliance is October 1, 2014 and all those healthcare providers who are covered by HIPAA are required to successfully complete the transactions using the ICD-10 codes latest by the date mentioned above. This also includes those healthcare providers who have chosen not to switch to an EHR system.

How ICD-9 differs from ICD-10?

There are various differences between the ICD-9 and ICD-10 codes. The structures of ICD-9 and ICD-10 are completely different. The ICD-9 code uses three to five digits whereas ICD-10 codes uses combination of three to seven consisting of letters and numbers. The new codes are separated into categories and provide more accurate information for treatment of patients.