Claims Reimbursement is the backbone of medical practice, but the last five to ten years have been impacted by various trends and healthcare industry changes. To name a few, Medicare and Medicaid have started reducing physician reimbursements; Third-party payers have negotiated fee-for-service contracts with physicians resulting in reimbursement at less than 100 percent of charges.
Acts such as the Administrative Simplification provisions of the Health Insurance Portability and Accountability (HIPAA) have tightened claims data submission requirements. With new Federal governing rules set to impact healthcare, the emphasis on healthcare fraud and abuse, and compliance have heightened the importance of accurate billing and coding. Owing to such issues ignorance in AR management and medical coding is sure to eat your practice revenue.
AR Management and RCM
A disrupted revenue cycle management specifically influences income for the healthcare providers and practitioners predominantly because of the long cycle of collecting payments from the payers and the inconsistency related to it. An end-to-end medical billing and coding company manages the complete revenue cycle right from the patient’s admission, treatment, and subsequent discharge, followed by submission of claims and billing.
For productive working of a physician’s facility, a timely Revenue Cycle Management is particularly fundamental. Expert medical billers and coders provide extensive and financially savvy Revenue cycle administration to clients spreading across various specialties. A dedicated coding agency can help you streamline your outstanding claims by following up on the insurance company and get speedy settlements. They leverage the expertise in medical charging and coding and increment the possibility of payment and increment the collection ratio.
Impacts of a Professional Billing company on your Income cycle
- Improved cash flow
- Streamlined operations
- Acknowledgment of quick revenue
- Patient satisfaction on the rise
Overview of services in outsourced Revenue Cycle Management
- Pre-admission process check
- Eligibility verification for Insurance
- Enrollment Affirmation
- Administration of patient stay
- Clinical documentation
- Charge capture
- Medicinal coding and billing
- Claims audit
- Payment posting
- Denial Management administrations
- Accounts Receivable services
- Following up on outstanding claims
- Analyzing the claims denials for better Revenue acknowledgment
Also, when you have aligned the services of an offshore billing company they also take care of various payers such as:
- Third-Party liability
- Repayment towards insurance providers
- Favored provider company
- Workers compensation and Managed care
As a component of RCM dedicated medical coding agency likewise submit customized reports of:
- The Aging AR report.
- Payer mix
- Adjustments in payments
Follow-up of receivables, so your revenue isn’t eaten up
Professional medical billers embrace various ethical ways to recoup the receivables and exceed expectations in aging AR clean-ups and bad debt reduction. The services in Accounts Receivables include:
- Handling the refunds
- Filing the secondary claims
- Follow up of insurer and the insured (patient)
- Appealing for disputable claims
- Indexing the claims and billing documents
- Submitting personalized management reports
What will you as a medical practitioner gain from partnering with a billing company?
- You as a specialty practitioner can save up to 80% of operational expenses
- You can benefit from end-to-end revenue management services of the medical billing and coding company
- They fast pace your revenue collection with shrewd follow-up of outstanding bills
- They follow proven processes for HIPPA consistency and deliver high-quality revenue management
- The efficient team will also provide a 24×7 customer service and quick turnaround time
Offshore billing and coding organizations stick to the business rules to deliver high-quality revenue cycle management services with faster collections, minimum denials, and reduced accounts receivables. They deliver flawless revenue cycle management solutions to ensure revenue maximization.