A medical billing service is the answer for those looking to make their medical practice more effective. It provides all types of administrative help in managing billing. They are HIPAA approved, manage your entire billing process, track your accounts, submit claims to the claims clearing houses and pursue the rejected claims.
What are the benefits of hiring medical billing services?
Medical Billing Service is an efficient alternative to processing billing in-house. It saves you time and money. Following are some of the reasons you should hire one.
It saves money by reducing your costs and increasing collections of delinquent account.
It reduces the time your staff spends on processing claims. You may be able to eliminate most of the staff and thus save expenditure on their health care, salary, insurance and training.
It usually performs better than the in-house staff. They keep their staff updated on insurance regulations and codes. It lessens number of denied and rejected claims. They are also quick to resubmit the claims returned from clearinghouses.
Their turnaround from clearinghouses is faster as they process large number of claims with them.
They have bigger incentives to increase collections as they are paid a percent of the amount they collect.
How does a medical billing service work?
Your staff sends patient details like insurance, diagnosis, procedure codes to the medical billing service. They check the data for any errors and submit the claims to the clearinghouse. If the claim is approved, you receive the check and explanation of benefits (EOB). The checks can also be directly deposited to a bank lockbox for faster processing. Rejected claims are returned to you so that any errors may be fixed and claims resubmitted. In some cases when the claim is problematic, it is the responsibility of your service provider to troubleshoot and resubmit the claim. Hence it is important to ensure that medical billing service provider has adequate staff to diagnose and fix such problems.
What kinds of services are provided by an outsourced Medical Billing Service?
Following are some of the main services provided by a Medical billing service.
They process medical claims and follow up on rejected or problematic claims and resubmit them after rectifying any problems.
Medical billing service generates reports with details of payments and claims. Comprehensive reporting helps you adjust your billing practices and improve cash flow. They may also provide you with software to generate reports. Ask for a demo to make sure it is easy to use.
Medical claims from Insurance companies can sometimes get delayed, putting pressure on your cash flow. In such cases, your service provider can lend against account receivables or can introduce you to companies that do so.
There are many ways to send claims information to the medical billing service provider. You should prefer one that accepts claims information via a web browser or a software system hosted on your computers. Such data transfer is secure, efficient and less prone to error. Sending claims information on paper or via email is highly inefficient and error prone.
Your provider may also offer Medical practice management (MPM) and Electronic medical records (EMR) software. These are significant buying decision and you may want to consider them separately from your decision to hire a billing service provider.
What else do I need to know before hiring a medical billing services provider?
Consider the following before making the final decision.
How much experience does the provider have?
ASP hosted billing software is preferable over one that is hosted on your computers. You don’t have to worry about maintaining ASP software.
Good software system is important but so is expertise of the staff in handling difficult claims. How much experience does the staff have in medical billing services?
How is their track record? Ask them to show some examples of difficult claims that they have successfully completed.
Ask them to show you the reports they would generate for you.
Are they 100% HIPPA compliant. Make sure their billing and reporting software too complies with HIPPA and SSL security to ensure patient information secrecy.
Can they handle the NPI or National Provider Identifier system?
Are they willing to train your staff to use the billing software?
Make sure their references are stellar.
How much does a medical billing service cost?
Pricing depends on the level of service and your location. Major portion of the payment is in the form of commission. Low price is important but it should not be the sole criteria in hiring a medical billing service provider. Consider someone who is an expert in collecting denied or difficult claims.