Tips to Maximize your Medical Billing and Collections for Hospital


A reap the benefits of a successful and profitable medical practice is not possible without efficient medical billing and collection processes. However, every year it becomes more challenging to collect payment from both patients and insurance companies. This is mainly because of rising documentation requirements and an increasing amount of patients that are responsible for a portion of their medical bills.

Health systems leave uncollected revenue on the table every day due to process errors in billing and collections – no surprise, since the process is arduous and complex. Requirement complexity is on the rise, new reimbursement models are introduced every year, and biller productivity is difficult to measure and manage. Medical billing companies are facing big challenges and a growing number of denied claims.

How to maximize medical billing and collection for hospital is a growing concern. Here are tips to maximize the same:

Establishing the Clear Collection Process

One of the easiest ways to improve your cash flow is to collect as much as possible from each patient at the time of his or her service. You can keep the patient informed by checking patient eligibility prior to each appointment, handling any services that require pre-authorization in advance and setting expectations with each patient by notifying them of the co-pays that are due at the time of service. Posting signs throughout the office letting patients know that payment must be collected upfront will help as well.

Purchase an Efficient Medical Billing Management Software System

Medical billing software can streamline your collections process by tracking past due bills, automating late fees, and identifying patients who are behind. Although purchasing medical billing software come with a price tag, it could save you a significant amount on internal billing resources and boost your payment collections rate.

Train Your In-house Staff for the Follow-ups

Provide your staff with scripts on how to deal with overdue accounts. Even though staff might be frustrated by repeated attempts to contact the patient, they should always be courteous and respectful. Make sure all front office staff knows when to prompt patients about unpaid bills, and can provide patients with information on practice rates and methods of payment.

Attract Them with the Option of Various Payment Plans

Payment plans can be a good option if your patient population is motivated to pay, but just can’t pay the whole bill upfront. Consider offering this option to patients who are receiving larger bills and say they’re unable to pay the full amount right away.

Contact Your “Slow Payers” Frequently

Re-think how often you contact your patients for unpaid amount. If your staff can manage the task, try doing a follow-up once a week instead of the standard once a month. Consistent, regular contact can demonstrate your persistence and convince patients it’s time to pay up. However, do call or contact during business hours only and always be courteous. You want to be persistent without harassing the patient.

Medical specialties like radiology or pathology may need to change certain parts of this process to better suit their business, primarily because they’re less likely to see a patient face-to-face to discuss billing responsibilities. In this case, procedures must focus more on new-patient orientation, validation, and notification rather than discussion.

Have a Routine Meeting to Review Your Finances

You can’t drive improvement in your payment collections unless you track and manage your results. Make reviewing your payment collections a standard part of your regular financial meeting. Analyze your progress and determine which strategies are working, and which aren’t. Repeat this process at least monthly.

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5 Key Points for Profiting your Dermatology Practice


A solid referral organize is the backbone of numerous therapeutic claims to fame. Be that as it may, it is something that numerous dermatologists underestimate. With a developing number of dermatology rehearses, different doctors have more alternatives than any time in recent memory while alluding to a patient. On the off chance that you are not attempting to develop and deals with your referral organize, you could be welcoming issues and disregarding openings.

The initial step is influencing your dermatology to hone referral-accommodating. Make a key referral advertising design, and execute it reliably. Try not to expect overnight outcomes. It requires investment to create quality expert connections; however, the advantages are definitely justified even despite the exertion.

Develop a network for a dermatology

The center of referral promoting is building a broad and various expert systems. While you might be notable among kindred dermatologists, they are probably not going to be great referral sources unless your training is profoundly particular.

Normally, you expect referrals from essential care suppliers, who experience a skin issue past their aptitude. Be that as it may, they aren’t your exclusive beneficial systems administration accomplices. Dermatologic issues influence all aspects of the body, which implies that basically any restorative supplier can be a decent referral source. Patients may get some information about toenail organism or a foot rash or tell the dental specialist that they need lip growth to go with their lovely new teeth.

Use social media for the benefit

You presumably utilize systems, for example, Facebook and Instagram to associate with potential patients; however, web-based social networking is likewise a decent chance to build up proficient associations. For this reason, LinkedIn is the most imperative system; you ought to keep up a profile and effectively partake in material gatherings. Additionally, search out neighborhood organizes and concentrated gatherings.

Personal Communication

Recognize what specialists rehearse close to your office and attempt to familiarize you. This is particularly gainful when training opens around the local area since they are probably not going to have a current referral arrange. A straightforward “welcome to the area” note or telephone call can open a conceivably productive exchange.

Recognizing the Professional relationship

A referral organize isn’t sans support. Very regularly, these critical expert associations are made—and after that overlooked. The specialist does not know what number of patients has been alluded by a given source, or how every now and again. Maintain a strategic distance from this by recording and following referrals. Track the quantity of patients and sort of cases, and in addition specific advantages or issues.

After some time, you will have the capacity to recognize your most imperative associations, and in addition spot potential issues. You will likewise presumably find a few associations that you have not gotten notification from in months, or significantly more. Connect with them and effectively sustain the relationship. In the event that it winds up obvious that you won’t get more referrals from this source, expel them from your rundown.

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Collaboration between Primary Care and Chiropractic Care


Doctors of the chiropractic practice work in a diverse environment which leads them towards the diverse medical settings. The medical settings of chiropractic work with the close proximity of the medical billing service providers this has led to a diverse role for chiropractic specialty physicians looking towards the conventional healthcare facilities. Here are some the cases through which we can understand the collaboration between the primary care and chiropractic care physicians affecting the billing.

Chiropractic care has reported a range of effectiveness when it comes to managing the musculoskeletal disorders, in which you have to go through the spine-related pain and disability. Over last two decades, the public health care delivery system in the United States has integrated chiropractic care as one of the offered services. The private care is also stepping in to understand different requirements of the patients and how they can manage the primary care and chiropractic care to effectively induce patient care in the process. The recent survey of the chiropractic examiners practices we saw that 9 percent of the chiropractic doctors practice privately other than chiropractic offices, which also holds 7.8 percent who work in an integrated healthcare facility.

In a collaborative model which has been proposed to deal with the complexity underlying the different human conditions. The models can be complex, varying, with a structure, process and with different outcomes.

  1. The use of a collaborative approach results in the blurring of certain roles and responsibilities for the treatment of patients and when it comes to dealing with different billing scenarios.
  2. An inter-professional process of communication means that we have to deal with decision making which enables the process of communication for the decision making.
  3. With interaction, there would be an increase in the inter-professional skills for the communication and decisions making that enable spreading the shared knowledge and skills.

Although for the  chiropractic practice there is a growing evidence that collaborating with a growing number of primary care physician or with an integration of the of multidisciplinary care environment we could successful result into a co-management of the patients which results into environment which can help in engaging the good communication, patient interest, and openness to discussion. With the co-management, it has also been found that under a human condition of musculoskeletal condition we have better cooperation between the parties.

There also have been reports of patient care being affected when it comes to collaborative care. The setting has made patients reluctant to approach the care as the poor information setting sets in through which patient information get fragmented and quality of patient care tumbles down.  Though a collaborative approach can be a better form of patient care we still need to adhere to various factors where we can convey the required information when the requirement arises or during the time when a patient goes through a treatment phase.

 Medical Billers and Coders (MBC) has initiated various collaboration process when it comes to catering the needs of patients and physicians. For communication and billing, we have maintained an open channel where both the parties can express their view without being adhered. This has resulted in the increase in revenue by 20 percent for chiropractic physicians.

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Maximize the Value for Your Ambulatory Surgical Center in 2018


Ambulatory surgical center were invented about four decades ago. The centers have proven exceptional abilities to improve customer care and quality facility which have been provided along with simultaneously reducing the costs. With the time when majority of the shift witnessed in the healthcare industry with the technology advancement which is expensive; ASCs have been an exceptional case of offering affordable services.

So how ASCs can maximize the value and avoid becoming just another statistic? Long term, the answer lies in increasing the number and nature of procedures that can be safely performed in an ASC. More immediately, there are steps providers can take to increase current volume and profitability.

Maximizing the profitability at the Ambulatory surgical centers

Increasing the volume of patients that can be seen at the ASCs is an important step to sustain for any center, but it is not the sole thing. The centers need to ensure that they are collecting all of the revenue they are due and managing costs effectively. An expert medical billing company offers it’s consulting to Ambulatory surgical centers for maximizing and improving profitability, they usually look at four important areas:


  • Are all procedures broken out by the cost for each case type, with and without labor?
  • How often the medical billing and coding is reviewed? And how often are codes compared across the practice to ensure consistency among all surgeons?
  • Have cases ever been reviewed by costs, then coding—and then compared to managed care entity payment?

Revenue & Billing

  • Is administrative staff collecting copays and deductibles at the point of service?
  • Are ancillary services, such as intraoperative monitoring, being billed separately?
  • Have managed care contracts been reviewed to determine reimbursement allocation?

Costs & Supplies

Can surgical instruments be put on consignment and paid for only when used or opened?

Costs & Staffing

  • Does the healthcare staff being cross-trained regularly?
  • Is your staff practicing at top-of-license?
  • Is it cost advantageous to the contract out implants to the 3rd party company for billing?

Steps to maximize value for Ambulatory surgical centers in 2018

  1. Optimizing the operational efficiency

There are 2 biggest expenses for ASCs; they are staffing and the cost of medical supplies and equipment. Technology that captures pre-op information of the patient and schedules cases efficiently can drastically reduce the additional staffing needs and minimize turnover time between procedures.

Technology plays an important role in inventory management. By eliminating manual inventory management processes and minimizing unused supplies, ASCs can benefit from lower expenses, greater efficiency and a profitable bottom line.

  1. Managing your success with KPIs

Key performance indicators which we widely known as KPIs remain important, factor in telling you where you stand and where there may be breakdown in the revenue cycle management which you need to work and improve.

To successfully manage your revenue cycle in this new reality you’ll need to monitor the KPIs frequently and keep up reporting, with end of day reporting, weekly soft closes and a monthly score card.

  1. Build a strong technology foundation

Gaining efficiency, monitoring KPIs and measuring outcomes require easy access to operational, clinical and financial data with an ability to analyze that data. This is only possible when data is stored digitally in systems that are connected and enable workflow automation.

  1. Gaining insights with the analytics

Analytics lets you to streamline processes, benchmark performance and dynamically make adjustments. In value-based programs, the ability to continuously learn, improve and adapt makes you a more responsive.

  1. Engage your patients

An important shift in value based care is that patient experience is tied to reimbursement and patients often bear greater financial responsibility. Satisfied patients are more likely to pay and become advocates for your facility. Engaging with patients by creating an effective communication connection will help build confidence, satisfaction and loyalty and, ultimately, drive profitability.

As organizations prepare for value-based and site neutral reimbursement, Ambulatory surgical centers will be essential for offering high quality clinical care at a lower cost for patients. But to remain competitive in the year 2018, they’ll need to maximize both volumes and profitability.

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Structure of Urology Medical Billing you should understand


Urology medical billing is the process by which healthcare practitioners bill insurance companies for services provided to patients. In order to complete this formality, medical billing and coding experts assign designated codes to various procedures to restructure the process of billing certain procedures.

Medical billing companies assist in healthcare facilities to optimize the revenue management cycle, fast pace the payment circle and ensure that a facility never runs into negative bottom line at the end of each month.

Under the latest ICD-10 system, new categorizes of procedures have been designated into a seven-digit code made up of alphanumeric characters. Thus while undertaking urology billing, a procedure can be specifically categorized according to its type, with what part of the body being affected, and what equipment are used when conducting the procedure, plus the body part being affected, and any other notifications that help to pinpoint its exact purpose, all this without actually listing the patient’s diagnosis in the code.

Urology Medical Billing Procedures – What has changed?

Urology billing and coding is very much similar to other medical services. Stating under the Medical and Surgery category, the billing codes for urinary-related procedures starts with ‘0T’ – and will continue based upon the type of procedure is being performed.

For example, if the procedure is to insert an artificial sphincter, equipment used to help with incontinence, into the patient’s urethra, the perfect billing code would be 0THD0LZ.

The ‘0T’ here denotes it is a surgical procedure of the urinary system. The ‘H’ implies that the root operation is Urology medical billing an insertion. The ‘D’ symbolizes the part of the body in which the final operation is to happen; in this case it is the urethra. The ‘0’ specifies that the approach to the procedure is an open one.

An open approach is performed when the patient is cut open to perform certain procedure. The ‘L’ suggests that the equipment being injected is an artificial sphincter, while the ‘Z’ signals that there are no additional qualifiers by which to define the procedure.

Understanding the Structure of Urology Medical Billing and Codes

Keep in mind that Urology billing codes differs based upon the procedure the patient is having.

For instance, if the patient is to be treated for his right kidney repair, the code would be 0TQ00ZZ.

Here again ‘0T’ places the code into the category of surgical procedure of the urinary system. The ‘Q’ entitles the root operation as a repair.

The ‘0’ denotes that it is the right kidney which is under treatment or being repaired. The next ‘0’ means that it is an open end procedure. The ‘Z’ is there to show that the approach to the healing is an open approach, and it denotes that there are no other qualifiers for this procedure.

After entering the procedure codes the entire thing is then transferred onto a billing form which is then sent to the insurance company. The insurance payer then converts the code to figure out how much of the procedure is covered by a designated insurance plan the particular patient has.

From here, the insurance payer will reimburse its designated amount to the urology practitioner or facility, which will then bill (any) remaining balance to the patient. Patients hardly, if ever, see the specific billing code that is assigned to them for any procedures they may have. So, all in all this meant for internal use and documentation.

Urology billing and coding for procedure can be problematic for those who do not know the specific codes for precise procedures. Once you know the pattern and the codes, it is stress-free to identify the procedure being performed, which further allows the billing to become streamlined exercise. In the end, remember that to get fully reimbursed the key to success lies in the accuracy of your codes and documentation.

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