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Managing Payer Denials, Cuts & Delays at Your Practice with a Medical Billing Service

August 16, 2012

An increasing cause of worry for almost every doctor in USA is payer denials and delays which invariably result in potential loss of revenue for the physicians. With the introduction of reimbursement cuts in medical bills, physicians and medical practitioners now face various payment challenges and a more uncertain future. Considering the increasing expenses acquired with the recent health reforms, it is important for physicians to receive payments on time, so as to cover their expenses and also be able to efficiently provide necessary services to their patients.

Conversely, as health insurers tighten eligibility requirement, filing claims have become more complicated and the chance of claims being denied have increased substantially, consequently claims are filed with high possibility of being denied, with increased providers struggling to balance patient care and billing. Industry standards state that high performing practices depicted denial rates are below 5%; while other practices denial rates were between 10%-20%, reducing denials by 5% can increase a practice’s revenue tremendously.

The current economic climate in healthcare is that of ambiguity and uncertainty. The economic cuts proposed under the Medicare system by Congress is leading to economic crunches have forced such doctors to carry on their medical practice at the cost of their personal assets. On an average, one third of the patients who come to a clinic are on Medicare, in addition private insurers who follow Medicare rates prove to be plummeting further. This situation makes it very difficult for an independent practice to survive and may even result in closing down of clinics along with causing shortage of medical resources.

Additionally various documentation issues like -  incorrect patient details, inaccurate coding, incomplete claims, lack of communication, submitting claims to wrong insurer or not following up due to lack of AR process can lead to claim delays and denials. In the face of these numerous challenges large numbers of physicians to increase their bottom line are turning towards the facility of medical billing service. Being specialists in their field medical billing companies provide a safe and secure way to overcome all these issue and guarantee timely payments.

Hence outsourcing the denial process successfully creates a unique and safe platform for doctors as well as medical institutes to manage their billing cycles, and also allows practitioners to concentrate on their responsibility of providing healthcare. Industry experts believe that up to 40% of the costs of payments to hospital and physicians can be saved by using medical billing companies.

Medicalbillersandcoders.com serving healthcare community for more than a decade now across all 50 US states provides the advantages of medical billing services by offering a dedicated and specialised team of experts who excel in the denial management, along with coding specialists who ensure correct coding of claims in compliance with HIPAA norms. MBC’s specific billing model uses planned billing software and methods which are fast and accurate so as to deploy claims within a short span of time with minimum possibility of errors.


Category : Practice Administration