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Medical Billing Management Services to Ensure Timely Reimbursement

Topic: Business OpportunitiesPublished April 28, 2012

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Providing quality healthcare services and managing the financial aspects of your practice are two very different things. The more time you and your staff devote to patient care, the less time you have for medical billing and claims management. This can lead to denied claims and delayed payments, which could become the bane of your medical practice. Fortunately, there are professional outsourcing companies offering efficient medical billing management services. Outsourcing your medical billing tasks to an experienced service provider is the best way to ensure timely reimbursement.

End-to-end Medical Billing and Management Services

Medical billing companies offer a wide gamut of services that decrease the burden of your paperwork, reduce your overhead, and ensure more time for patient care.

Insurance verification: This is performed prior to patient enrolment. The process consists of insurance verification and authorizations. Invalid or incomplete eligibility claims would be delayed or rejected. Eligibility systems are used to determine if a patient is a member of a health plan Verifying patient insurance eligibility and benefits minimizes the risk of claim denials. Calls may be made to the insurance company if necessary.

Enrollment: In the enrollment process, information about the patient such as name, address, details of health insurance and so on, are loaded into the eligibility system. Providing accurate demographic information and insurance information will ensure speedy claim processing.

Coding: Accurate coding of all medical procedures is necessary to secure reimbursement. Many claim denials occur due to incorrect coding. Procedure and diagnosis codes must be assigned for every encounter. A medical billing company has coding specialists on its team who perform coding accurately and in accordance with the rules and regulations of insurance companies. Coding solutions are available for all medical specialties.

Billing and reconciling of accounts:Important processes such as charge entry, payment posting and reconciliation of accounts are taken care of by the service provider.

Accounts Receivable collections: Medical billing service providers are experts in chasing payments not received from insurance providers and patients. Experienced billing specialists work on all unpaid and partly paid claims till they are reimbursed.

Well-equipped to Provide Quality Medical Billing Services

A professional medical billing company would have what it takes to provide efficient solutions for claims management.

  • Team of skilled professionals: A reliable service provider would have a team of skilled professionals on board. The pool would include medical billing specialists, AAPC certified medical coders, and a dedicated AR analysis team. This would ensure that your medical claims are processed accurately and efficiently.
  • Stringent QA: All processes – billing, claim submission and coding – incorporate stringent multi-level checks to ensure error-free results.
  • HIPAA compliance: HIPAA compliance is ensured for all activities related to medical billing. HIPAA advocates electronic submission of bills. The organizational structure, administrative procedures, technology and human resource pool of reliable service provider companies would be compliant with HIPAA privacy and security norms. So you don’t have to worry about compliance issues when you assign your medical billing to them.

By reducing the burden of paperwork for your staff, cutting overhead, and ensuring proper and timely reimbursement, medical billing management services can pave the way for the growth of your practice. The ideal provider would be one that provide service without long-term annual contract and save you at least 30% to 40% of your operational costs.

Article author

About the Author

Outsource Strategies International (OSI), a reputable medical billing company in the US, offers comprehensive medical billing management solutions.

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