What type of Reports does your Medical Billing Company provide you to be aware of the revenue status?

medical billing serviceIt is essential for physician facilities to track monetary performance metrics, as every dollar that falls through the cracks can create an adverse and irredeemable impact on the practice. So, the moot question that arises here is, have you set the Medical billing department goals this year? Do you know the importance of medical billing reports benchmark in your organization? If the answer is no, we suggest you to get all the reports from your designated medical billing and coding company to get an idea of your Revenue management.

Creating medical billing reports can help you analyze the strength of your practice. Reports can demonstrate to you how your practice is performing on imperative income cycle metrics, regardless of whether claims are being paid in a convenient manner and how well insurance providers are paying you for key procedures in addition to other things. But, how will you as a practitioner determine which are the best reports to run?

#1: The Accounts Receivable Aging Report (and Follow-Up Reports)

By divulging this report, an accomplished biller can tell whether or not the practices billing department is doing the perfect job. We additionally suggest you to look some other reports as well, namely: the Insurance Payment Trend Report and the Insurance Collection Report.

The A/R Aging Report segregates claims information based on the number of days they’ve been in receivables (meaning the number of days they’ve been unpaid). Most claims, take an average period of about one month to get paid. This report permits you to recognize potential issues from a high level view, while the follow-up reports give you a close-up look at where the issues might be stemming from.

#2: The Key Performance Indicators Report

Key Performance Indicators Report is one of the best reports to get an idea of a medical facilities Revenue cycle. This report is the most helpful, in light of the fact that it provides a step-by-step breakdown of key areas in your practice’s revenue cycle management process, permitting medical billers to distinguish changes and patterns and spot potential issues. Clinicians also agree that this report stands of great importance, as it can help you recognize which encounters and CPT codes are the most productive for your practice.

While this specific report is exclusive, the information it reflects could be accumulated utilizing a variety of accounting and billing reports found in most of the medical billing software programs.

#3: Insurance Analysis Report

Insurance Analysis Report is the most valuable report for helping practices save time and money. This report additionally tracks revenue cycle metrics, providing medical facilities with snapshots of how the general business is getting along.

Insurance Analysis Report tracks the billing, payment and collections of your practice’s top ten insurance providers, which in other words mean the payers and insurance agencies that make up the most part of your practice’s business. The report additionally tracks payments, along with collections and CPT codes and units, permitting the practice to drill down in the Revenue Cycle Management and look for specific CPT codes. This report also provides important information practices can use to negotiate better pricing with payers and insurance companies.

Do remember that if you want to meet operational and financial goals and create a road map for your medical practice in a shifting medical landscape, start tracking these medical practice revenue KPIs.

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Are doctors the best decision makers for the financial health of their practice?

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The practice of medicine is all about specialization. Doctors spend more than a decade of practice necessary for getting specialization in any field of medicine. Plus with the technological advances, ever-changing protocols in the specialty, they need to stay abreast so as to provide the best care to their patients.

But despite of all the hard work and potential, there are many practices that operate below their performance and revenue potential. Why?

Simply because most of the time is consumed in doing day-to-day tasks like submitting claims, reviewing claim status and reports etc instead of focusing on improvements and optimizing their practice. Given the complexity being faced in today’s coding and billing processes, it surely is not something someone can do to fill in the time between scheduling and rooming patients.

There was a time when billing was very simple. Payers used to change their rules and policies once a year and gave plenty of time to practices to adjust to their changing processes. That time, denials were less than 5% of the total claims as against today where if you don’t have sophisticated claim scrubbing software’s, your claim rejection rate may increase to more than 30% and may require extensive as well as expensive follow up, resulting in poor cash flow.

Why financial health is getting hard to achieve?

 The challenges of internal billing operations and complexity of today’s revenue cycle processes does require a specialized skill of medical billing professionals to ensure the economic success of the practice and its compliance with the changing government regulations.

With increasing costs and declining reimbursement rates, the practices often lacks access to financial and clinical performance data which is important for staying competitive and improving the overall financial health of the practice.

What really is required is the ‘right information, the right approach and the right assistance.’

Some of the tips that could help you improve the financial health of your practice:

  • Examine the nature of tasks your practice performs. Segregate them on the basis of tasks that can be done by your staff directly, tasks that can be outsourced or offloaded to a vendor and tasks which can be centralized.
  • Make detailed, structured process of the tasks that are essential for overall financial health of your practice and that need to be performed by your staff accurately.
  • Analyze the time consumed by staff on tasks that can be economically offloaded to a practice management vendor. The right partner can increase your revenue by submitting and reviewing claims in real time, better patient throughput, improving staff efficiency, easy-to-manage reporting etc. Services offered by a practice management partner along with the software can help reducing your time spent in managing paperwork such as remittances and payer correspondence.
  • Technology too is a huge cost center for any individual practice. For example, it’s important to keep the payment tables accurate to ensure proper payments are incurred as per the fee schedules. Similarly, denial management tools are required to track and eliminate the root cause of denials.
  • With the plethora of regulations that now affect billing and collecting, it’s better to hire full time professionals to handle your coding and billing.
  • Follow ups related to unpaid claims is burdensome and time consuming and so is incorrect discounts applied to patients’ accounts. Both these activities lead to loss of revenue.
  • No doubt, hiring and retaining competent staff personnel, who can handle all the billing related work is tough. As per the Society of Human Resource Management, the cost of recruiting, hiring, and training a new employee is approximately $3,500. Utilizing a professional billing company eliminates this expense completely. These professional medical billing companies offer economies of scale, which makes their services less costly than a practice’s internal operation.

Finally, remember these two golden rules – First, “Do what you do best and outsource the rest” and second, “Do not spend your time and energy on anything that can be done by someone else more efficiently and at a lesser cost”

Posted in EMR / EHR / Health IT, Healthcare Reforms, Medical Billing, Medical Coding, Practice Administration, Practice Management, Revenue Cycle Management (RCM), Why Outsource Medical Billing Services | Leave a comment

5 Advantages of Using Orthopedic Billing Outsourcing Services

5 Advantages of Using Orthopedic Billing Outsourcing Services

Orthopedic billing is a crucial process of any orthopedic practice. To keep your practice running smoothly by minimizing claim denials and cash flow problems, It is important to keep in mind few aspects while billing:

  • Double check patient information,
  • Verify insurance coverage,
  • Use the right code and
  • File your claims quickly.

How Does Orthopedic Billing Work?

Orthopedic billing begins with proper documentation before, during, and after a patient’s visit. It’s important to pay proper attention to coding during the full extent of services. Why?

  • One, for maximizing reimbursement and minimizing claim denials and
  • Second, for year-end service cost analysis

Simple errors like missing or incorrect patient information such as name spellings, date of birth can result in a rejected claim. Apart from errors, it’s important to know insurer preferences and deadlines. With ICD-10, coding has become more precise than ever. So, it’s important to train your staff completely on the changing rules, regulations and practices to avoid severe fees and penalties. If orthopedic billing and coding is mishandled or small details are overlooked, it may result in disastrous consequences for practices. Even small errors or inefficiencies may lead to reimbursement delays and denials or audits. No doubt, failure to comply with payers is less detrimental than compliance with HIPAA and state regulation.

Orthopedic provides an extensive range of services for patients that includes injury prevention, correction in the joints, muscles, and ligaments etc. When it comes to handling medical billing and coding services, it surely translates into a complex process. But if you have no time to train your in-house staff or feel that your billing management is too complex, it’s advisable to outsource your orthopedic billing services to reduce your stress and increase reimbursements.

Advantages of using Orthopedic Billing Outsourcing Services:

  • Outsourcing your billing to Orthopedic Billing professionals with the experience and knowledge of perplexities of orthopedics eases all your efforts required for updating your staff and systems. These professionals have the required knowledge of the complex rules utilized by carriers to adjudicate claims and the ever-changing CPT codes and associated modifiers applied to ensure proper reimbursements.
  • With certified medical coders and Orthopedic specialized billers, these billing services can help you identify past billing problems and denied claims. The professionals evaluate the underpayments and submit claims appeals with correct documentation. They bill appropriately using correct ICD, CPT and modifier codes, ensuring maximum reimbursement.
  • Outsourcing billing services helps in reducing the overall cost of regular trainings and education of the staff, ensuring the staff focuses on the tasks they are more experienced and comfortable at and providing valuable care to the community.
  • Since all the information and coding of all the charges are correctly processed at the very first time, reimbursements are quick and your practice gains the added benefit of lower than industry average accounts receivable balances.
  • Apart from that, these trained and experienced professionals track each claim meticulously until the payments are received. They do the required A/R follow up with payers and patients.

Outsourcing your orthopedic billing services can actually increase your net revenue and ensure that you receive the maximum amount covered by the insurance companies while minimizing any out of pocket expenses for your patients.

It’s important to be sure that the company you hire understands the orthopedic specialty while getting you every dollar you deserve!

Posted in Accounts Receivables, EMR / EHR / Health IT, Medical Billing, Medical Billing & Coding jobs, Medical Coding, Orthopedic Billing, Physicians/ Doctors, Revenue Cycle Management (RCM) | Tagged , , , , , | Leave a comment

How do medical billing companies help medical practices to update contracts in credentialing?

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Credentialing is the process that comes before your first medical claim is submitted. Not able to cope the contracts in credentialing surely brings financial loss. For the majority of the medical practitioners, credentialing is a complex process that involves completing applications, getting all the paperwork in line and waiting for the representative to take it further.

Credentialing is an important process, a verification of your expertise, experience, and willingness to offer a medical care. Without a successful credentialing provider reimbursement for medical services can be delayed and even denied.

A medical billing company can help expedite to update the contracts in credentialing.  The service provider offers an easy and quick way to securely update and submit credentialing information to multiple plans and network by entering information just once.

Learn how medical billing companies help medical practices to maximize appropriate reimbursements:

It helps you with revenue projections – The medical billing company’s professional are able to predict the payment per case. With an updated contract in credentialing it helps in providing information to plan budgets and make business decisions.

It educates your on-going staff – Medical practitioners do not have time to learn complex medical billing rules and regulations. Medical billing companies educates their ongoing staff so your personnel become more effective and efficient at verifying insurance information , collecting copayments , checking for referrals, locating demographic data.

Always there to support and advice – The medical billing professionals obtain new information regarding urgent care billing and ever evolving regulatory requirements which ensures regular updates.

They notify their clients regarding these changes regularly and whether it is Accountable Care Organization (ACO), or ICD-10, they work parallel by your side to ensure that your urgent care center is ready for the changes.

Outsourcing to medical billing company saves money and increase reimbursement

When your urgent care center has outsourced the medical billing, you save thousands of dollars in benefits and annual salaries. Additionally, you do not have to deal with office supplies, purchasing, medical billing software, or computer equipment. The medical billing company charge a flat rate, so it is less expensive than having medical billing and coding staff in-house.

Billing interruptions in urgent care facility takes toll on the timeliness of reimbursements, and not to forget your cash flow. Using a medical billing services will allow you with a regular update on credentialing, zero errors, and boost in revenue. As claims go out, there is rise in revenue. A steady cash flow is necessary for the health of your urgent care practice.

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