Case Acceptance through Dental Medical Billing


Imagine this scenario – Your patient is in the chair. You’ve just discovered they need some major work. You know it’s in their best interests to accept the treatment. But it’s expensive. You have got to present a case to convince him, can dental medical billing help.

In a way it is hard to make them understand. So, as dental medical billers your call to action should be to weigh up the risks, and the costs, and come to the right decision. But again, it’s tough to convince them, as what really matters to them is the bottom line, which is the price.

They want to look after their teeth, but they often balk at the cost of treatment.

Consider other factors that influence case acceptance, such as emotional and/or financial uncertainty from a patient, or verbal/non-verbal cues from the provider when delivering the treatment plan. Your team members may be excellent clinicians, but poor communicators. In such a scenario dental billing companies can take the onus. They are the experts in providing reasons for every bill and every code, they can do it better.

Additionally, if a team is not able to instill a feeling of trust in keeping with the practice’s desired brand culture, patients will miss out. They will be less receptive to being educated due to their emotional vulnerability, their financial uncertainties, and their fears. Fear is always the back seat driver to perfectionism in achieving optimum outcomes for patients.

There are ways to ensure your practice is successful at gaining an advantage in the trust arena, which leads to increased case acceptance. Here are some critical steps toward obtaining case acceptance for a dental treatment.

Treat every patient as a separate entity

Before you see a new patient, learn some personal things about this individual. According to psychologists when you learn private things about people, you are moving from an impersonal relationship into a more meaningful, professional relationship.

During the case presentation, the dentist should refer some of those personal facts. The practice should learn one new thing about patients each time they come to the office.

By referencing personal factors, you are personalising the case acceptance before it even begins. People feel a connection that leads to a higher sense of trust and value for the practice and the recommended treatment.

Promote all-inclusive procedure

Most patients are potential candidates for any number of elective procedures. But still many dental facilities focus exclusively on the patient’s current needs without keeping an eye on the future. While he doctor’s office should address a patient’s immediate concerns, there also should be a focus on lifelong dentistry that takes a comprehensive view of the patient’s future dental goals. A motivating case acceptance, combined with patient financing and medical billing, can turn an “I’ll think about it” into a “Yes.”

Due to the fear of rejection, some dentists cut back on the amount of treatment they present and focus only on basic dentistry. They assume patients will not have the money for elective treatment. That’s a grave mistake. Patients will say yes, to cosmetic and implant dentistry, but only if you make a strong case acceptance.

It’s not about the cost, but ask them what their easiest mode of payment is

Fees or reimbursement is often an obstacle to case acceptance.

A good way to motivate patients is to accept treatment is by offering some payment options like:

7% discount for full payment in advance for larger cases

Credit cards

Half payment up front, the rest after completing the procedure

Other patient financing options

Providing quality care to more patients is vital to achieve greater practice success. Upgrading your case acceptance skill along with a through dental medical billing and coding process will set you on a course to increased treatment acceptance and robust practice growth. The time is right to improve your case acceptance to experience greater practice income.

Posted in Dental Billing, Medical Billing, Revenue Cycle Management (RCM) | Leave a comment

Reduce Coding Errors for your Chiropractic Practice


Managing a chiropractic facility or any type of healthcare unit is a tiresome job. You require many internal departments to work together for a common goal, including the chiropractic medical billing. This stands important in today’s ever changing health care and insurance laws, where one minute medical billing and coding mistake can turn in loss of revenue.

Having an organized and streamlined revenue management process in the form of chiropractic medical billing companies is crucial for any successful practice, and is a key to a healthy revenue cycle.

Take a look at these following points that will improve your income cycle and lower the coding errors of chiropractic billing.

Identify your problem areas

If your coding errors consistently follow a particular pattern, you may need to create a list of your most commonly-misused codes. This helps you identify training gaps and determine a prevention strategy. At your facility, the problem codes may reflect issues with certain types of insurance, with particular procedures or with types of codes.

The only mistakes many make in chiropractic coding would be pertaining to insurers. That is when you fail to bill adequately for re-evaluations every procedure given.

Many facilities are losing revenue from a missing code, if they are receiving the maximum reimbursement rate. Since the extra code is only used every six to ten visits, it is easier to forget than a code used at every billing.

At some chiropractic facilities, the coding problems to watch for happen with particular insurances. However, some physicians are sharp enough to observe the coding errors, as these have been their number one source for losing revenue.

Practice, practice and practice…

When you code, it is also important to account for every applicable service. Not being specific enough can also create problems.

The biggest mistake many in house coders make is to not code enough. At times, its gets so worse, that a physician start to worry as to; are his coders certified. Keep in mind that if you have any doubts regarding the in-house coders, you always have the option to outsource chiropractic billing services to the experts. They are cheap, they certified and yes, they help you gain profits.

Providing enough detail is in your best interest. Take specific notes and code for every service you actually performed, whenever possible. Even very small billing discrepancies may add up over time to a significant loss if your clinic creates a pattern of under-billing. Since you may not always receive full reimbursement, you may want to avoid billing too little intentionally.

Good training is the key to reduce coding errors

When medical coders are graduated, they for the most times know very little in terms of chiropractic coding and documentation. This leads to ton of mistakes. But having self-education by purchasing the coding manual, reading it over and over several times can resolve the issue. This is when you start to understand how documentation and coding were interrelated and how to properly code.

Also, you can attend seminars and reading regularly about coding and documentation issues and strategies. Staying up-to-date with coding is vitally important and well-worth the effort, according to chiropractic medical billing experts.

If you have in house staff involved in coding, you may want to encourage them to take an active interest in staying informed as well. Providing access to seminars or even finding freely available information and sharing it with your staff and coworkers may help reduce errors by encouraging knowledgeable coding.

Finally to avoid coding errors invest in prevention

Preventing costly mistakes should be a high priority for every chiropractic facility. With these strategies, you may be able to minimize errors and avoid the possible consequences.

Posted in Chiropractic Billing, Medical Billing, Medical Billing Company, Medical Billing Services, Practice Administration, Practice Management, Revenue Cycle Management (RCM), Staff Issues | Tagged , , , , , , , , | Leave a comment

Technology can help you Promote Value-based Reimbursement


Before we understand that how technology can improve your Value-based reimbursement we have to understand what a value-based reimbursement means for hospital billing. Hospital revenue is currently going through a turmoil of value-based reimbursement you have to satisfy the following criteria

  1. Risk-adjusted mortality
  2. Risk-adjusted readmission rates
  3. Low-cost structure

Along with this, we have to stay in-line with Centers for Medicare and Medicaid (CMS) rulings for 2015 hospital inpatient prospective payment systems (IPPS) in value-based reimbursement the regulations will hold the financial impact for your hospital.

Value-Based reimbursement for hospital is divided underpayment models

  1. Bundled Payment

Medicare is looking towards quality patient care with low cost. To see this across all providers, CMS opened a new submission period from Jan 2014 and closed it in April. During that period organizations completed bundled payment applications for an entire episode that included financial and performance. Four models were created in which model 2 and 3 received maximum applications.

  1. Physician payment system

An individual or group of physicians are affected by physician payment system. The regulations would mean that the physicians would have to meet the required quality of patient care. The significant part that would decide the reimbursement number is requirements of Physicians Quality Reporting System (PQRS) because adjustments would mean a -4.0 percent penalty.

  1. Hospital Inpatient prospect payment system

CMS for hospital inpatient laid down the final structure through different programs: – Hospital Reduction Program (HAC), Hospital Value-based purchasing program (HVBP), Hospital Inpatient Quality Reporting program (IQR) and Hospital Readmissions Reduction program.

  1. Commercial Payers

Commercial payers are looking to shift towards value-based reimbursement. Commercial payers would lay down a mix of deductible and co-pay in value-based reimbursement. According to the study, 90 percent of the payers and 81 percent of hospitals have shifted towards a mix of value-based reimbursement.

As the shift takes place from fee-for-service to value-based reimbursement hospital would now be shifting towards more sophisticated billing software to keep track of claims. This would mean a better tracking and proactive approach towards data. Data Analysis can shine through almost all aspect of healthcare you see- for provider performance, cost, procedure, and in a procedure review.   Data Analysis could help the innovative growth of the delivery strategies, high-performance provider organization, and integrated clinical services.

As providers are struggling to define the data-enabled outcome and it’s after effects. Doctors are also troubled by how do we collect the data, analyze and draw conclusions. The major challenge today in technology is interloping the developments through them into our practice.

Dr. Soris who is a leading physician in Ohio and also holds a board member in one of the major hospitals in Ohio said that “Though Data can really help you in analyzing how your hospital is performing the major problem for us comes when we have to really make the use of data. Doctors today feel that through technology can help how can they extract the real meaning.”

Currently, Hospitals are utilizing the data to predict the average reimbursement for each claim according to the procedure. They also analyze various factors due to which patients seek a provider and which of the procedures need improvement. Data standardization through Electronic Health Record (EHR) will help better analysis and prediction for doctors.

As the new innovation takes place through data it’s time for you to reduce your claims errors and channelize hospital billing. Medical Billers and Coders (MBC) with 18 years of experience in hospital billing with team certified coders and skilled billers to reduce your average AR age.

Posted in Accounts Receivables, Claims Denials, Medical Billing, Medical Billing Company, Medical Billing Services, Medicare Medicaid, Revenue Cycle Management (RCM) | Tagged , , , , , , , , | Leave a comment