One may ask why practices require medical billing specialists. A crucial reason might be that taking up the services of a medical biller or a coder may lower overhead costs and expenses but definitely will help the physician to collect more revenues. Physicians across all states are constantly facing difficulties in insurance coding and payment reimbursement in terms of their insurance claims. For them optimizing reimbursement is accompanied with a lot of complexity since there is flux in the medical billing rules and regulations frequently.

Engaging the services of professional medical billers will help the providers to effectively steer their clinic’s operations towards other functions which can help them grow their practices. Hiring professional services will give the providers an opportunity to manage and organize their business in areas that require critical attention including better patient care, healthcare documentation needs, marketing their own practice and increasing the number of new patients they can retain.

Now, before hiring medical billers, a particular practice should take into considerations a few aspects such as:

1. Experience of Billing Specialists-

A thorough and deep understanding of medical billing in terms of multiple specialties is a necessity for any biller to have a holistic view of the insurance industry. Their experience in handling various processes such as insurance eligibility and benefit verification, charge capture, payment posting, claims transmissions, denial management and follow up on account receivables gives you the confidence to rely on them. [Prerna Gupta] The number of years of experience definitely counts when complex billing situations arise.

2. Medical Billing Software experience -

Before hiring a medical billing service, providers should consider that they are appropriately trained in the usage of medical billing software used in your clinic such as Medisoft, Altapoint, NueMD or any other software. An important characteristic to look for in a medical billing software is that it should easily and effectively process both insurance as well as patient billing and should have the capacity to handle different types of claims. These may include secondary or third party claims and workman’s compensation.

3. Flexibility-

The term ‘flexibility’ can apply not only to the software but to the billing specialist as they must be willing to learn more. This will be demonstrated by his/her ability to process different types of insurance claims and at the same time handling a number of medical billing situations while dealing with insurance companies and patient queries.

4. Certification-

Certification does not mean everything for a Medical Biller but most Billers who undergo certification process are confident about their knowledge. They also develop the best industry practices and apply them for your clinic. The most popular certification organization, AAPC – American Academy of Professional Coders holds CPC exams across the United States to determine the authenticity of billing and coding professionals. The American Health Information Management Association (AHIMA) also provides most of the certifications and advocates the correct application of CPT, HCPCS procedure and supply codes and ICD-9-CM diagnosis codes. Having certified personnel on board guarantees error free billing for you.

5. Their Network

It is important for Medical Billers and coders to network with as many professionals as possible specializing in different specialties and billing software. If a particular biller is not confident about the reason for denial or other nuances of the specialty, they could refer their doubts to their peers and seek solutions faster. These Billers are also willing to grow and advance as professionals.

6. References-

Reference can help medical billers to go a long way towards building a healthy client base. This can help providers to trust a medical billing specialist to handle their billing requirements for them. Along with the list of the credentials, a crisp resume, references from former employers or seniors can help the provider to make sure that the medical biller is experienced and trustworthy.

These aspects can be taken into consideration only if you find appropriate candidates to interview, the question arising here is where to locate them? It is best to take the help of medical billing consortium which show the billers willingness to learn, network and grow. is one such consortium with its reach in all the fifty states of the United States and at the same time provides trained medical billers and coders to physician groups without a fee.

Going to is a welcome step because it can help physicians to locate Medical Billers and Coders in their city, state, specialty and having experience in their software. is one of the easiest way to find the best medical billing specialist, just log on to the website and match your requirement with the available profiles. It is a consortium having hundreds of billers and coders for your preference. They are a specialized lot having experience almost all the specialties including cardiology, dental, dermatology and general surgery.

This consortium was created by specialists of the healthcare industry for the convenience of the healthcare providers keeping in mind the best criteria to shortlist the best medical biller or coder in your area.

Published By - Medical Billers and Coders
Published Date - Aug-29-2011 Back

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