The Role of Medical Billing Consultants in Assisting Physicians

The recent dynamism in the healthcare industry has not just revolutionized the way in which various medical processes are carried out but have also led to an explosive information boom due to new policies, regulations and a complete overhaul in the health care industry. The ability of providers and other healthcare professionals to keep up with such changing regulations and policies is becoming increasingly limited due to escalating workload and demand in addition to shortage of supply of providers. Moreover, the steep learning curve required in some aspects that have accompanied the health reform has made it clear that physicians can benefit due to external billing consultancy services as far as their financial and departmental processes are concerned.

The requirement for external consultancy services arises not just due to the changing healthcare industry trends and increasing workloads as well as reduced time to keep up with the changes taking place in regulations and laws. The huge expenditure and financial losses on a national scale in the healthcare industry also makes it imperative that such fiscal losses be avoided by employing consultancy services that can boost providers’ bottom line as well as assist on a macro level to reduce costs of healthcare. These services can support in achieving regulatory compliance and ensure that provider revenue is not affected due to glitches in complying with policies and procedures in addition to ensuring that billing compliances such as, but not limited to, HIPAA compliance and ICD-10 implementation are accurately achieved.

The analysis of revenue cycle management (RCM) and providing customized solutions is also a part of RCM consultants. Medical billing consultants can analyze and pinpoint the areas where improvement can be achieved and losses curbed. This type of scrutiny and analysis can assist in preventing errors such as those in registration or pre-verification of insurance coverage and ensure accurate collections in deductibles or co-pays. Moreover, analysis of Accounts Receivables (A/R) is an important part in optimizing the revenue of providers through a holistic approach involving patients, payers and other entities involved In A/R. Moreover, medical billing consultancy service providers have the advantage of specialization and are aware of the financial as well as legal trends in the industry. This advantage of specialization and up-to-date knowledge of changes in the health industry can reduce cash flow problems and provide a complete solution to providers’ RCM and A/R needs.

Browse All: Physician Billing Services

Medical consultants can assist in many fiscal sectors as far as provider revenue is concerned and avoid losses, legal actions, and numerous other hurdles arising out of errors or otherwise. For instance, the Affordable Care Act extended the RAC program to Medicaid, Medicare Advantage (Part C) in addition to the Medicare prescription drug program (Part D). In order to avoid RAC audits, medical billing consultants can point out cases when overpayment has been done and avoid complications when it comes to such other technicalities. Medical billers at can perform all these functions related to consultancy in addition to streamlining processes related to denial management, interaction with payers, and integration of innovative IT functionalities such as Electronic Health Records (EHRs) in order to ensure compliance and also to smoothen out various departmental processes.