It is difficult to select the best medical billing company. However, if you know what questions to ask, making a decision will be much easier. You must be certain that a service is appropriate for you. Consider the following tips when selecting the best medical billing company for your needs.
When deciding on a service, consider more than just the price
A full-service medical billing company can charge more because they collect more than their competitors. However, you may be extremely concerned about the cost of the services you receive. However, keep in mind that just because a medical billing company has a lower price does not mean they are the best vendor for the job. Cheaper services tend to be of lower quality, and you may end up with less revenue.
Remember that technology is essential
There is a significant difference between traditional billers who use manual data entry or faxes and those who use cloud-based revenue cycle management software. Consider medical billing to be similar to your bank account. Some people collect paper bills, write checks, have them mailed, and manually tally their accounts. Others, on the other hand, pay their bills electronically. It only takes a mouse click and no time-consuming paperwork.
With the right software, your office can be linked to the remote billing office, healthcare rcm services can workflow streamlining, as well as have fewer total errors. Furthermore, when you use a cloud-based system, your data will be in compliance with nearly every HIPAA data storage regulation without your intervention.
Accept Nothing Less Than Complete Transparency
Back in the day, outsourcing to another medical billing company had a significant disadvantage in that you did not have access to financial data that was necessary for managing your practice. After you outsourced for medical billing solutions, you were reliant on the reports their biller could provide you to determine your practice’s financial health. Practice management was handled differently back then because reports were outdated by the time you received them, making them useless for real-time adjustments.
However, any medical billing company that uses cloud-based systems produces vastly different results nowadays. You have unlimited access to any claim and any data point at any time.
Tips for Getting the Most Out of Your Medical Billing Collections
Because the healthcare industry is constantly changing, the billers and coders who work in it must also be constantly changing. All of these employees must be up to date on the most recent billing and coding practices. This way, your medical facility can keep as much money as possible. Many people believe that medical billing and coding will never be the same again as new billing technology and tools are added to EHRs. This type of technology assists facilities in avoiding billing and coding errors while also ensuring that everything is submitted on time.
However, some practices are still not collecting as much revenue as they could, which is why we want to look at ways to increase revenue. Here are some medical billing tips to help your facility maximize its collections.
Get Your Coding Done Correctly
One of the most important steps in increasing collections is proper medical coding. You must code correctly to meet industry standards, and you must also reduce the number of rejections you receive. This way, you can get as much money as possible for the services you’ve provided. Every claim has a fee that must be paid before it can be resubmitted, so each claim that isn’t filled out correctly costs your facility money. If you want to collect as many claims as possible, it is best to get them right the first time.
Clean Claims Should Be Submitted
Naturally, the more claims that are denied, the more money you will have to spend on claim resubmissions. As a result, make certain that all claims submitted are completely clean. Clean claims result in faster reimbursement, which can help you optimize your collections. Many facilities have first pass acceptance rates of around 80%, but this is not where you want to be. If claims are submitted correctly, medical facilities should have a 97 percent acceptance rate. If you are not meeting this percentage, investigate the reasons for claim rejections and determine whether you have the appropriate technology to meet the needs of your practice.
Contract Enforcement by Payer
Underpayment caused by payers can be a problem for medical practices that want to maximize their collections. If you do not manage and enforce your payer contracts properly, you will lose a lot of money. Because keeping track of all your contracts can be difficult, having the right technology can be extremely beneficial. The right technology will be able to identify underpayments and assist you in disputing them with your payers so that you can receive the reimbursement you were hoping for.
Errors in Medical Billing That Lead to Claim Denials
Medical billing and coding can become quite complex, and due to the difficulty of the process, denials can occasionally occur; however, what causes those denials? The billing and coding processes will differ depending on your insurer, patient, and procedure. Fortunately, you can significantly reduce claim denials by simply understanding the most common causes of them. Here are some of the most common reasons for claim denials in medical billing and coding.
Coding isn’t as specific as it should be
All of your diagnoses must be coded to the highest level for that specific code. Coding should be done as precisely as possible so that all important details are captured for later use, which can affect how patients are treated.
Information is missing from claims
You cannot submit claims in the field of medical billing unless you have all of the necessary information. The date of the medical emergency and the date of the accident are two common pieces of information that are omitted from medical bills.
Before submitting a medical claim, double-check it to ensure that no information is missing and that all necessary documentation is included.
Claim is not filed on time
Even if your medical claims are submitted correctly, you may encounter issues if they are not submitted on time. Keep in mind that claims are denied if they are received after the deadline, even if they are sent out before the deadline.
You should also be aware that certain supporting documents will be required if you want to be reimbursed for any denied services.
Incorrect Patient Identifier Information
There are numerous ways in which a patient’s information can be incorrectly documented. Documents could contain the incorrect patient name. The birth date could be incorrect. Perhaps the patient’s sex is incorrect. There could even be incorrect payer information, or the policy number could be invalid.
If your biller or coder does not enter the correct codes, or if your codebook is out of date, your claims will most likely be denied. You must also have sufficient documentation to justify payment for the services you provided. If you do not provide enough information, you will not be paid for the services you provided to your clients.