Advocating and Practicing Best Practices in Medical Billing

For years, has been synonymous with medical billing management – helping medical practitioners not only realize their medical reimbursements fully but also optimize their clinical and operational efficiency. While the medical billing complexities have consistently been escalating – owing to unprecedented increase in insured population and the risk associated with managing insurance reimbursements – we have been able to off-set its effect through consistently remodeling our medical billing Revenue Cycle Management (RCM) to the benchmarked industry standards. As a result, time and again, our ingenious medical billing processes have come to fore in mitigating adverse impact on our clients’ medical bill reimbursement, and ensuring optimal realization of reimbursements, clinical and operational efficiency.

Here is a rundown of the “Best Practices in Medical Billing” that we have been advocating and practicing in ensuring optimal realization of reimbursements, clinical and operational efficiency, and compliant processing of medical claims as per the Federal Healthcare norms:

  • Eligibility Verification or Pre-Screening is the foremost on list of Best Practices in Medical Billing; the objective is to determine the patients’ eligibility for the insurance coverage for which the medical intervention is sought. Further, it also ensures knowing in advance what is covered or what in not before a patient is registered and admitted for clinical management.
  • Understanding Coverage:  Understanding how the respective insurance carrier would reimburse the eventual cost of medical services is as important as verifying the patient’s eligibility for the insurance coverage for which the medical intervention is sought. As it is the insurance company that ensures the reimbursement on behalf of the patient, there should be clear communication and clearance from the respective insurance bearer.
  • Billing Competence: Often medical coding and claim submission can go wrong owing to inherent errors while preparing medical bills for the medical services concerned. Therefore, due vigil needs to exercised while preparing bills that form the basis for eventual coding and claim submission.
  • Coding Compliance and Competence: As much as billing competence, coding too hold its importance in flawless claim submission and realization. As the outcome of a medical bill largely hinges on coding compliance and competence, medical bills should invariably accompany ICD and HIPAA compliant coding procedure for medical procedures.
  • Electronic Claim Submission and Follow up: As the system of IT-enabled claim submission and follow up becomes more common, medical claims submission need to be managed through electronic medium for seamless and faster realization.
  • Managing the Revenue Cycle: As the incidence of claim submission become too voluminous, your claims may take a little while for realization. But, as the sustenance and growth of your practice largely hinges on your ability to minimize the Accountable Receivable days as less possible, an effective and efficient Revenue Cycle Management becomes inevitable.’s ( ingenious and credible RCM – comprising Adjudication, Follow Up, Re-submittals, Payments, Adjustments, Secondary Claims, Denials and Appeals – invariably proves to be indispensable to successful Revenue Cycle Management.

The credibility earned from being perpetually committed to “Best Practices in Medical Billing” has been instrumental in expanding our reach to the length and breadth of U.S. Our diverse pool of qualified and competent medical billing professionals has been able offer result-oriented medical billing practices to diverse clientele (ranging from small practices to multi-specialty groups) in varied specialties including Allergy & Immunology, Ambulance Transportation, Anesthesiology, Behavioral Health, Cardiology,  Chiropractic, Dental, Dermatology, Family Practice, Gastroenterology, General Surgery, Hospitalist Billing.

As the success of investing in any business turnaround exercise is measured by the degree of its impact clients’ cost-optimization and revenue maximization, ( too had to verify its executed solutions against actual benefits for its client. Remarkably, the transformation made by our “best practices” has been quite impressive with:

  • HIPAA compliant medical coding ensuring highest authenticity
  • Reduced operating costs
  • Regular monitoring and auditing
  • High accuracy in coding
  • Feedback & custom reports
  • Multi-level quality assurance
  • Quick turnaround
  • Reduced claim denials
  • Faster reimbursement
  • Accelerated revenue generation
  • Ample scope for intensive focus on medical care

Therefore, if you are a medical practitioner seeking to turnaround your practice’s clinical and operational efficiency, may well be your source.