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


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.

Posted in Medical Billing, Practice Management | Tagged , , , , , , , , , , , , , , , | Leave a comment

Will Medical Billing Reports And Dashboards Make Medical Practices Profitable?


With never ending pressure to have a profitable medical practice, one requires to have everything streamlined right from patient medical care to reimbursements. Enhanced medical billing reporting plays a vital role in offering financial stability to a physician.

Unlike in-house medical billing, physicians are choosing to outsource their medical billing reporting to professional medical billing service providers as they are proved to be the most sought after in providing accurate medical billing reporting which not only gives zero error reporting, but also gives a boost in revenue of a medical practitioner.

A professional medical billing reporting and dashboard comprises of all expert resources and business intelligence tools that are responsible in making medical practice profitable.

Will medical reports and dashboards make medical practices profitable? Yes, certainly. Let’s see how…

#1 A well-constructed medical billing dashboard improves patients care

In regards to patient’s health care, dashboard analytics provides better healthcare and lifestyle decisions based on present data which assures supreme patient management by adapting care specific for every patient.

Medical billing reports and dashboard analytics can decrease medical errors, regulate care and help medical practitioners to predict and prepare for large scale infectious disease events.

#2 It automates billing hence, error free reporting

The most challenging part of medical revenue management is the coding errors, eligibility, denials management, and self-pay collections. If a medical bill is charged correctly, it doesn’t get denied the first time, so it accelerates cash flow forward and decreases the amount of work on the back end.

With the right kind of medical billing reporting automation to complete that, you increase efficiency and you decrease the chance of the claim getting lost in the AR.

#3 When performed correctly, medical billing dashboards optimizes the productivity

Medical practices with automated medical billing dashboards can create streamlined workflows that help to shift the staff’s time and focus from routine to exceptions that require their attention. As a result, they become more productive which in turn boost revenue.

#4 Business Intelligence at your fingertips

With medical billing dashboards you are able to view daily performance views of crucial processes. You are able to monitor the results, offering real time face based decisions support. It quickly produces reports for unique information requests made. Not to forget, it provides consistent monitoring of contract reimbursements.

#5 Stay connected on the go

Medical billing service providers offer convenient access to medical practitioners. Physicians can stay connected on the go by choosing from multiple preset dashboards. The dashboards can be customized as per specified medical practitioner’s requirements.

These dashboards have everything automated. It automatically send a scheduled monthly dashboard report via email to medical billing providers comprising with productivity comparison charts and monthly projections using any number of metrics such as visit counts, work RVU, new patients, days to bill, gross charges, payment per visits etc.

Closing Thoughts

Healthcare is ever evolving field. Medical billing reports and dashboards built using latest technological trends offers physicians an ability to be responsive in their approach when it comes to analyzing and using data.

Dashboards built using state of the art technology are easy to adapt and scalable in healthcare industry which is in constant need to improve the quality and minimize the costs. It comes equipped with the required demands of today’s healthcare analytics solutions. Combined with an interactive, healthcare-specific dashboard are easy to use and offers near real-time data.

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

Impact of Trumpcare on Physician’s Practice

medical billing and codingDonald Trump against all odds has finally managed to become the President of United States of America on the promises of ‘Making America Great Again.’ Now that he is in White House, the promises he made to citizens before getting elected are slowly but surely, taking a shape.

Be it about building the wall on The Mexican border, banning immigrants from certain Islamic nations or scrapping the Obamacare, with his very own Trumpcare, President Trump is taking huge strides in fulfilling all the poll promises.

However, Healthcare industry, which comprises of Physicians, Insurance Providers, Third-party administrators, offshore medical billing and coding companies and the overall commercial Healthcare ecosystem, is still trying to predict the future and benefits of Trumpcare.

A recent research conducted by the Commonwealth Fund with RAND Corporation using simulation analyzed his plans and came up with probable impacts.

The Affordable Care Act

Donald Trump and the GOP are in mood to completely repeal the ACA and supplant it with something new, named ‘Healthcare Reform to Make America Great Again.’ However, the aim is to accomplish a superior law with a few sections of ACA included.

Some of the Planned Changes are:

  • Prior Condition Clause will remain. As the Republican Plan “The Better Way” dated 22nd June 2016, President Trump plans to continue with it, as no American should be denied on the basis of pre-existing medical conditions or demographics.
  • Removing of Individual and Employer Mandate, as nobody ought to be forced to purchase medical coverage.
  • Lessen the growth rate of Medicare spending and execution of new fees and taxes.

Financing Medicaid through block grants

Under the present law, Medicaid gets joint financing by the elected and state government. The federal government contributes 50 to 75 percent of the aggregate expenses and the rest is contributed by the states.

Some of the Planned Changes are:

  • The President wants to fund Medicaid everywhere throughout the nation through block grants.
  • Under this, the government would give a fixed amount to states and let them subsidize their projects.
  • The need for doing so is because the state governments know best about their populace and should have the sole authority on how the amount of cash ought to be spent and will fare better without elected organization overhead.

Effects of Changes

Since Trump has chosen not to nullify ACA; there is a great deal of vulnerability in the matter of what will precisely happen and what the effects of his healthcare arrangements will be. However, a few things, like the pre-existing condition clause or young children getting their parent’s cover will stay. There might be more to it which makes it hard to say how many people will be insured after the plan is fully implemented.

But, few things are for sure:

  • The health saving account program allows citizens to put their cash in a special fund, exclusively for their health coverage, without paying any government taxes.
  • The arrangements in HSAs are adaptable and secure, which could be an awesome advantage to everyone who enroll for it.
  • If Medicaid block grants are as per pre-ACA levels for inflation, it would just somewhat increment the burden on the deficit, by half a million.
  • The cost of premiums would go down once an aggressive market is built up.

The Road Ahead

In his pitch for Healthcare, the President has concentrated on making the system voluntary rather than mandatory, where taxpayers/citizens can buy as much coverage as they need. However, it goes without saying that it is too soon to be analyzing impacts of the plan which is not even clear yet.

Posted in Medical Billing | Tagged , , , | Leave a comment

How do Wound care center efficiencies energize growth?

woundcare billing serviceThere are developing numbers of wound care centers being opened in the United States. Their emergence signifies the need for more patient centric chronic wound centers that deal with minor to major bodily injuries. A methodical approach to deal with the improvement and execution of a comprehensive wound care center depends on many critical elements such as the ambience of the physician’s facility, the waiting period, type of treatments given, and medical billing and coding requirements.

A wound care facility can take shape in any form, from small clinics to huge hospitals, based on the patient influx. Despite the physical area, the most critical component for the success of any wound care center is having strong and efficient core team members that will strive hard to fulfill every aspect wound care and achieve maximum patient satisfaction. The ability to adequately deal with specific injuries can be constrained by the absence of key specialties in the group. The physical space and monetary support from financial institutions are likewise vital elements of your wound care practice, similarly to a outsourced wound care billing agency that looks in to streamlining your income cycle.

Below are some critical points to develop a wound care center that efficiently energizes growth:

Hierarchical structure

Wound centers are organized in different ways that can be free standing clinics as well, housed inside a hospital or an outpatient center. In today’s practice, many wound care centers are a part of a regional human services system or a national healthcare management group. These centers are staffed with mixture of part time and full time service providers and support staff, plus mixture of part-time and full-time practitioners that support the work force. Committed officers supervise every day operations, also looking into the prerequisites of the billing department ensuring appropriate documentation and quality control.

Multidisciplinary work force

The multidisciplinary approach to deal with wound care is the most vital component to the success of a wound care center as no healthcare provider is sufficiently prepared with the knowledge, expertise, and experience to give extensive care to complex injuries. The multidisciplinary way to deal with wound care has resounded and has led to more than 50% improvement in results by diminishing both amputation rates and wound related difficulties.

 Wound care facility

There are some essential necessities relating to the physical space expected to house a wound center. The parking area ought to contain abundant handicap spaces with easy access to the building. The building ought to incorporate wide lobbies and lifts to suit wheelchairs, stretchers, and walkers. The waiting room should accommodate with necessary things for patients to cut down time. Do remember that the number of treatment rooms ought to mirror the number of physicians staffed for that day.

 In a perfect world, a wound care center is housed inside a doctor’s facility since it allows access to normally used ancillary administrations, such as, radiology, phlebotomy, and pharmacy. Further, the chronic wound patient with multiple comorbidities can receive all of his or her medical services in one location because his or her care requires close follow-up with different specialists. The capacity to streamline the patient’s medicinal condition turns out to be progressively critical if patients are experiencing complex reconstructive treatments in the operating room. As specified above all of this plays a vital role in efficiently energizing the wound care center.

Posted in Wound Care Billing | Tagged , , , , | Leave a comment

Impact of Digital Consultation on your Medical Practice – What do you expect here?


Social media is no longer the domain of the young and fit, even seniors are now on the net and their apps, forming and sharing information across groups. The impact of this is often seen in discussions between patient and physician. Patient often Google search their symptoms and problems, discuss across groups, join forums, etc to know more about their illness. But are they getting their right information on their illness? If having to explain about the prognosis and diagnosis based on their symptoms differ from their Google search takes up most of your time, you as a physician would be seeing a lesser amount of patients and thus a fall in your revenues could affect the Revenue Cycle Management (RCM) process. There are both disadvantages and advantages to this, but how can you make the best of such digital consultation that the impact is positive?

The older population—persons 65 years or older—numbered 46.2 million in 2014 and represented 14.5 percent of the U.S. population, about one in every seven Americans. By 2060, there will be about 98 million older persons, more than twice their number in 2014. How will you deal with that many footfalls?

Remote video consultations between clinician and patient are technically possible and increasingly acceptable. How do these and the introduction of wearable devices impact your consultation? Well here’s looking at the positive impact digital consultation can bring and what you can expect:

  1. Helps to bridge the gap between patients and clinicians. It provides a change in how patients can be monitored
  2. Better delivery and speed of diagnostic information
  3. Can help deliver high quality care and on-time treatment
  4. Helps in Promoting self-management of chronic diseases
  5. Broadens the scope to reach out to those living in rural areas and others who need distance care and monitoring
  6. Wearable devices help create better intervention plans in conjunction with clinicians
  7. Costs related to capital, transportation, parking, and time away from work are reduced
  8. Reduces number of in-person visits and decreases delays in diagnosis and treatment — thereby avoids long-term complications and hospitalizations. Treatment can be initiated much more quickly via a video call or just by sending photos of the external condition, rather than waiting for an appointment.
  9. Patient satisfaction is on the anvil when you offer convenient, high-quality service without additional cost, especially in today’s world of high deductibles and out-of-pocket expenses
  10. The ability to see more patients daily and achieve a better work-life balance can be realized

So just let the positive effects in, instead of procrastinating and thinking what the negative impact is, after all its patients and their needs that comes first- once that is satisfied, the revenues will walk in automatically. But yes, keep in mind the privacy issues of the patients when foraying into the digital world- security and privacy needs to be maintained at all costs!

Posted in Medical Billing, Practice Management | Tagged , , , , , , , , , , , , , , , | Leave a comment

Medical Billing Company: A Central Pillar for Healthcare Practice in California

medical billing service

With the Affordable Care Act (ACA), medical care has become accessible to many uninsured Americans. In California, it is estimated that there are nearly 750,000 people who remain uninsured. The continually growing population suggests that this number is only going to grow higher. As a medical practitioner your priority is to provide quality service for all your patients. This is where a medical billing company comes in service. An efficient medical billing service ensures that your practice is always fully reimbursed making it possible for you to offer your patients quality medical care.

Helping medical practitioners meet the demands of a value-based payment climate

With the changing emphasis on value-based payment, healthcare organizations are faced with the challenge to reduce operational costs while still providing quality care services. Working with a medical billing company helps to both decrease operational expenses and to also increase revenue.  More and more medical practices are beginning to see that outsourcing their medical billing services could be an efficient way to avoid penalties and scale down on costs – necessary factors to keep up with the changing norms and regulations.

Devising smart strategies for increased revenue cycle

Apart from cutting down costs, a professional medical billing service can also help speed up the claims cycle. The 24/7 services offered by such companies is valuable in accelerating the revenue cycle of a medical practice. It is also helpful to note that the detailed financial information provided by a medical billing service is a major tool for medical practitioners to make accurate revenue forecasts, seal revenue leaks, and strategize carefully.

Coping with a lack of resources and time

Working with a medical billing service provider allows healthcare systems to eliminate the cost and effort necessary to train their own staff, along with the expensive billing software needed. Currently, the Health Insurance Exchange (HIE) also poses a hurdle for practitioners across California, as do the other changing rules and regulations of the medical industry. Medical billing practices assist healthcare organizations in keeping up with new changes.

Further, unlike the fixed salaries of on-site employees, medical billing companies only charge a percentage of the medical practice’s overall collections. The correlation between billing costs and revenue is a major incentive for both medical billers to work industriously on your behalf, and for medical practitioners to ensure more value for money spent.

Employing the services of a professional medical billing company is advantageous for both small medical practices, as well as large healthcare organizations. Small medical practices receive the much needed assistance in billing efficiently while still cutting down on costs required for computer equipment, billing software, office space, and fixed employee salaries. Large medical care systems, on the other hand, benefit from professional medical billing companies by saving up on labor and huge costs for medically necessary equipment. Either way, medical billing companies are a pathway for medical care services in California to increase revenue while cutting down on costs to ensure that their patients are given the best possible care.

Posted in Medical Billing | Tagged , , , , | Leave a comment

How can Good Customer Service change the Face of Your Practice?

medical billing and coding

In the overall business world there is a very popular phrase which goes like “it costs five times more to attract new consumers than to retain the old ones.” This very phrase stands applicable in the physician business as well, where good customer service in the form of right treatment, hospitality, patient satisfaction and proper medical billing and coding stands vital.

Here are eight good customer service habits to change the face of your practice:

  1. Ensure each one of your employees is fit for making a decent first impression. This is significantly more critical for the front office employees in charge of welcoming the patients either over the phone or when they visit the doctor’s facility.
  2. Stay faithful to your promises. If you or your staff says “I will get back with you today” do it. Regardless of the possibility that you don’t have the appropriate response, a quick ring to tell them you are still working with it is always a very good customer service practice. Always be truthful with your responsibilities, regardless of how small they are.
  3. Exhibit gratitude and appreciation to your patients. Thank all your patients in a meaningful and thoughtful manner every time they visit your facility. It is not that hard just say thank you and smile.
  4. Prepare solid training ground. Awesome customer service is not just pleasing the patients, but is much more than what you imagine. It will be very much beneficial if a practitioner before starting to attend patients provides the in-house staff with solid ground training and follow it up with practical lessons of attending the patients.
  5. Listen and act when your patients grumble. Manage each complaint, as dissensions can be chances to fabricate a lifetime of dependability from a patient. Ensure that you listen to their grievance, check the validity, make a move to resolve it, and afterward let the patient know how it was settled. For ex. there might be an issue that the patients’ medical billing that is wrongly calculated and it is your accounts department who has to look into that as soon as possible.
  6. Go well beyond what your patients anticipate. It is better if you over the board to help patients and satisfy their queries. Ensure you are addressing your patient’s needs, and then attempt to surpass them by giving careful consideration to everything about the delivery of your administrations.
  7. Make it simple for the patients. Make the patient experience in your office as simple as possible, with minimal wait times, maximum comfort, while providing beverages like espresso/tea/water when possible. Additionally consider the patient’s flow through the center to ensure they have an easy navigation through the facility.
  8. If mistakes are made, admit them. Forgot to get back to a patient? Overbooked the clinic? Be straightforward and apologize, and offer options to repair the issue.

If your in-house staff follows the above mentioned activities, your facility and practice will witness an up surging success. Do remember that you and your staff ought to do these things consistently to make the patients that visit your center feel that they have settled on the correct decision, and set yourself apart from other physician facilities. This makes your patients feel like you are all on the same team, are more apt to send referrals, and more willing to make sure you are paid for the time and effort you have spent on their care.

Posted in Medical Billing | Tagged , , , , , | Leave a comment