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Managing Medical Billing Accurately

Apr 18, 2020

A timely and accurate payment is crucial to be able to provide the thorough health care and attention each patient deserves. Pay systems also help fuel health institutions – so it’s a bummer for everyone if ROIs aren’t met due to billing inaccuracies.

How can you make sure that your medical billing is being managed accurately?

Proper Documentation

Billing becomes inaccurate if codes are not properly documented. From the name of the procedure up to the medications administered, everything should be logged in meticulous detail. Even information such as the administering physician or vital signs and ongoing monitoring notes – everything must be documented.

Medicare Restrictions

If Medicare fails to cover certain procedures, the patient needs to be informed right away and presented with options so as not to cause any delay in treatment. The biller has a duty to be thorough once Medicare stops paying on services by a specific provider. They need to investigate why Medicare payments ceased and resolve if Medicare has erroneously halted payments. Patients should be fully educated on these restrictions. An efficient health care practitioner discloses this matter and tries to verify eligibility before appointment to ensure that the patient has coverage.

Summarizing the Bill

If vital information goes missing, expect a delay in insurer payments. Electronic health record software helps prevent delays by sending urgent alerts on any missing data. Payment summary only tracks collection of the patient copays and coinsurance. If the staff won’t be able to check if claims are billed out, it’s possible for them to be overlooked. “Centers for Medicare and Medicaid Services (CMS) has already updated rules for EHR (electronic health records) so this means reducing reporting burden among providers. Most concerns relating to software implementation and information exchange readiness have already been addressed, and improvements in software capabilities are made every day.”

Working with Certified Electronic Health Record Specialists

With the increased use of EHR, there has also been a noticeable rise in Certified Electronic Health Records Specialists (CEHRS). They make sure to communicate with patients, keep track of vital information, and interpret terms related to new legal requirements, medical diagnosis or tests, and clinical procedures. Most importantly, CEHRS focus 100% of their time on maintaining medical billing needs for providers and patients alike. Wondering how else you might benefit from hiring a CEHRS? Other common tasks in their job description can include:
  • Managing patient visits
  • Arranging follow-up care
  • Issuing prescriptions
  • Explaining to patients the significance and use of medications for disorders and treatments
Successfully managing the medical billing process can be tedious, but it’s a necessity of a healthy healthcare practice, providing patients with an accurately-summarized bill and providers with a well-maintained revenue cycle to continue providing care.

For informational purposes only.