The medical billing process can be complicated and time consuming for healthcare professionals, who are busy taking care of patients full-time. It’s important to outsource this task in order the practice has more energy left over after providing quality patient service! The best way is through a professional medical accountants which takes care of all your back office tasks while you focus on what really matters: delivering excellent client outcomes by focusing solely on their needs.
Outsource your medicare billing and collections with the right company. We’ve made it easy for you by providing a step-by-step guide on how to choose, so make sure that when choosing an outsourced partner they have some particular characteristics that we have listed in this article.
But first it is significant to understand what a medical billing service is. And how these medical credentialing services work and what benefits you will be enjoying by utilizing their services.
Table of Contents
- What is a Medical Billing Service?
- How does Online Medical Billing Service Work?
- Why Choose Best Outsource Medical Billing Services?
- How to Choose an Online Medical Billing Service?
- 1. Find a Company that Communicates Effectively
- 2. Choose a Company with Experience and Expertise
- 3. Determine if They Have a Proven Track Record and Positive BBB Rating
- 4. Do They Have Current Claims Processing Certification?
- 5. Do They Have Insurance Contracts that Match Your Practice?
- 6. Do They Manage Claims in a Proper Manner?
- 7. How Will They Handle Compliance?
- 8. Does the Company Immediately Handle Denied Claims?
- Wrapping Up!
What is a Medical Billing Service?
Medical billing is a process of generating claims or bills for services provided by physicians, physicians groups, clinics, hospitals etc. These are then submitted to health insurance companies or agencies that are responsible for reimbursement. Medical billing services include patient insurance verification, claims processing and payment posting. It is important to find a good medical billing company because it’s like having a virtual employee to handle billing and collections.
How does Online Medical Billing Service Work?
In order to understand how to choose the best online medical billing company, you must understand how these companies work.
In the first instance, a healthcare services provider will contact you and offer a special deal on your medical bill. After accepting their terms for payment every month to cover those charges with no more out-of-date due dates as part of this agreement; they are responsible only until such time that any expenses incurred from treatment happen or if something were ever lost during transmission (such as records).
In neither situation does it make sense for them being left footing all responsibility themselves so when these things arise – let’s just say there’s insurance money waiting.
Medical billing is a complicated process that can be difficult to understand. The way it works, in general terms anyway, starts with you as the patient and your claims being assigned for coding by either an individual or team of people who work from one classification system which may change depending on what service they are providing at any given time (e.g., orthodontist- braces; primary care physician – chronic illness).
Once this happens all information pertaining specifically towards diagnosis/condition has been recorded along with associated costs including co pays & coinsurance amounts if applicable before finally outputting onto paper wherever necessary afterwards using generic codes like “V Sabancimpdat” etc.
Why Choose Best Outsource Medical Billing Services?
All structures and sizes employ in-house staff to handle billing, which means timely, accurate, and organized billing is responsible for this method. As many practice managers are considered, this process is full of challenges and is an important non-medical stressor for the financial and organizational health of the practice.
Medcare MSO is a medical billing company that provides medical billing services to practices of all sizes. We are an independent practice management company that specializes in providing medical billing and coding services for healthcare organizations, physicians, clinics, and hospitals. Our team is knowledgeable about the changes in the healthcare industry and we can help you navigate them.
We offer full-service medical billing support with insurance claims and patient statements.
Medcare MSO is one of the leading medical billing service providers in the United States. Our goal is to give you the best possible experience so that you can focus on your patients and not on your billing.
How to Choose an Online Medical Billing Service?
With so many medical credentialing services there, you will have to select the one which is perfect from every respect. In this regard, the first step to take is to have a good idea of the services you are looking for!
You should not choose one company over another solely based on their prices or other factors, but also consider your insurance contracts. It is impossible to change overnight from paper-based systems to electronic billing so it is important to be aware of the process and timetable for implementation.
Start with making a list of your requirements, such as:
- Do you need to include Medicare Collections?
- Is there special billing software needed for providers who are Mac users?
- How many patient accounts do you have on average per day?
- Does this company communicate well with you and your staff?
1. Find a Company that Communicates Effectively
You will need to contact the company regularly, and it is important for them to respond quickly and efficiently. If you find yourself waiting on hold for longer than 5 minutes or finding information difficult to obtain, these are red flags that they do not provide the level of customer service you deserve.
2. Choose a Company with Experience and Expertise
Many companies offer medical billing services; however, very few may specialize in getting claims paid on time while maximizing your reimbursement rates. For example, if your business handles workers’ compensation cases, look for a company that specializes in this area of healthcare providers.
3. Determine if They Have a Proven Track Record and Positive BBB Rating
Not all medical billing companies are the same! Some billers provide great service, but do it at a lower price than you can obtain by hiring an additional staff member for your practice. The best way to determine which company meets your needs is to speak directly to some of their clients.
4. Do They Have Current Claims Processing Certification?
This is one of the most crucial things to consider while selecting one of the medical credentialing services. The best indication that a company has the necessary knowledge and expertise to handle your claims is if they are certified by URAC or ACHC. These accreditation demonstrate that the company follows appropriate standards for the industry, maintain updated training programs for their staff, and are evaluated on their performance.
5. Do They Have Insurance Contracts that Match Your Practice?
It is important to find a company that specializes in your insurance contracts. If you have lots of Medicaid patients, it does not make sense to work with an agency only familiar with Medicare! By the same token, if you see insurance payers such as Blue Cross and Aetna, their contracts will include some different language than plans like Medicaid or Medicare.
It is important to find someone who understands your requirements and who has the knowledge and experience to get your claims paid accurately and on time!
6. Do They Manage Claims in a Proper Manner?
The process of submitting insurance claims, even for things that should be covered by your plan can take weeks. This is because there are so many errors in medical billing and coding practices which result from mistakes made during the recording process or incorrect information being inputted into the computer system at one point or another–80% on average according to studies done!
It’s easy enough when everything goes smoothly but if something gets rejected due simply having an improper code then providers have no choice but wait until they get back their corrected data before resubmitting again only this time making sure it has been correctly coded this time around.
This should be a straightforward process, but sometimes insurance companies refuse to pay claims. Make sure you double-check your information before submitting the claim and contact them if anything doesn’t make sense or looks wrong; they might need more info from certain fields on their end!
After you’ve put in all of this work up front (and notifying other parties like landlords), stay informed about any errors that may arise – these could disqualify your entire case completely so keep an eye out for those telltale flags!”
7. How Will They Handle Compliance?
It is important to select a billing company that understands the risk of penalties related to compliance. If you handle Medicare, there are specific rules for handling claims, and your company should be prepared to demonstrate their understanding of these requirements.
8. Does the Company Immediately Handle Denied Claims?
Rejected claims are those that haven’t been processed due to the discovery of one or more errors. A denied claim is when an insurance company has already processed your bill and determined it can’t pay out because there’s a violation in their patient-payee contract, which means they’ll return your claim with details about what went wrong so you may fix any issues before submitting another request for payment.
Denied claims must be appealed before re-submission, and a rejected claim can only be corrected with hassle.
For claims to be approved, they need to follow strict guidelines and regulations. When there is an error in the paperwork submitted by your company’s staff member(s), this can cause delays or rejections from payers’ initial approval process if not handled properly with care — which we know isn’t always easy during these busy times.
As soon as you notice any discrepancies within a claim form (either before submitting them altogether) get back in touch immediately so we may clarify any problems before it gets worse than expected at worst- case scenario: appeal time increases significantly when things aren’t straightened.
Finally, you have got all the factors or things that must be considered while choosing an online medical billing company or medical credentialing company. The above specified factors play a vital role in the selection process, so you may end up with a company which is reliable, advanced and perfect from all respects.
You may also read: Unexpected Benefits of Using Physician Answering Services