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.
As a medical company, you are constantly trying to find the balance between offering the best care for your patients and finding the most efficient way to do things. You want to focus on care for your clients but the hassle of medical billing just gets in the way of the things you would rather be focusing on. This is why you hire a professional to take care of these things for you. Instead of finding someone in house to take care of this, why not hire a medical billing company?
Benefits of Medical Billing Services
There are many benefits to outsourcing your medical billing needs. Among the biggest reasons for this is because it can save you money. One way it can save you money is by not having the headaches of constantly hiring and training new staff. This can be very costly because training takes time as well as money having extra people on staff during the training period. If you have a constant turnover of medical billing staff, a medical billing company could be your best investment.
Other reasons to hire an outside company for medical billing include:
The ability to focus on your patients rather than billing, especially if you are not as skilled with the financials.
You find that you are struggling to make any money and need to decide where this loss is coming from.
Ensuring that you have a highly trained staff.
Better control over your finances.
Often times, you will find that payments are processed quicker through an outsourced company.
You will find that a medical billing services company will relieve a lot of the stress that you may have when it comes to the financials of your practice.
These are only a few of the reasons as to why you should considering hiring an outside company to handle your medical billing.
Choosing a Medical Billing Company
Hiring an outside company for medical billing may seem like an unwise investment, but you will actually see a lot more transparency and efficiency. This is because they hire highly trained professionals that know how to use the best software available right now. If you choose an excellent company, you will notice a big change in your practice’s bottom line. A great medical billing company will not just be able to send out bills and work with insurance companies, but they can also boost the revenue of the practice.
If you are looking for a medical billing company, be sure to find a company that works with the latest software on the market today. The latest specialized software will better streamline the entire process for practices. You practice will greatly benefit from having a medical billing company that can more efficiently work through the billing process so that you can spend more time focusing on the needs of your patients. Outsourcing medical billing will only benefit your practice and your patients. Keep this in mind if you are wondering what you can do about your medical billing situation at work.
A cardiology practice faces special challenges when it comes to medical coding. Coders need to be able to transcribe physician notes and code with a high degree of accuracy. Failure to do so can affect patient outcomes and reimbursements, both of which can be devastating. In order to optimize coding in a cardiology practice, consider the following factors.
Automate Where You Can
Human error is the greatest enemy of accuracy when it comes to coding. When trying to manually record long codes with both numbers and letters, however, it’s easy to make a mistake that can cause claim denials or incorrect reimbursements. To bypass these types of errors, automate coding wherever you can and try to eliminate the need for double data entry.
Make Sure Your Coding Knowledge Is Current
Most medical coding and billing software updates automatically to reflect the most current coding guidelines. These can be extremely tough to keep up on if you have office staff that’s trying to stay up-to-date using books and the internet. Still, be sure to keep the most current books on hand for review purposes and make sure that staff members are reviewing updates to keep their knowledge current, even if only for back-up purposes.
Don’t Skimp On the Documentation
Failure to completely document the events of a patient visit can alter the code that is entered and the reimbursement that’s ultimately paid. When in doubt, it’s always better to document more than less. The amount of time that a patient visits, any procedures or examinations that are performed, and any conditions that are present should be noted every time.
Use the Most Specific Codes Possible
Since coding has gotten so much more specific, there can be a plethora of codes for the same condition and procedure with slight variations. It’s important to review the documentation taken during the visit and carefully match the appropriate code. If applicable, use a diagnosis rather than a symptom to get a more specific and accurate code.
Establish Multiple Check Points
It can help to have multiple eyes on codes in order to spot errors. Having staff members, doctors, nurses, and those doing the billing and coding all double checking documentation and coding can help to reduce the likelihood that an error will be missed or that a non-specific code that can be made more specific will go unchanged. Making it a point to have different people review random codes at certain times can help to ensure greater accuracy.
If your cardiology practice could benefit from medical billing and coding services, call 888-783-7818 today.
Medical billing solutions like outsourcing and software are more popular now than ever before, and for good reason. Shifts in healthcare, insurance, and compliance have made billing more confusing and increased the demands for speedy and accurate information. Implementing software or outsourcing billing can help to keep practices competitive and prevent costly errors and penalties.
Changes in Patient Demands
Patients are better educated now than at any point in the past and expect to have more information at their fingertips. Medical billing software can help to update patient records faster than manual in-house billing. Patients may also have an easier time understanding medical billing when it comes from software or an outsourcing company.
Regulations and Compliance
Medical offices and hospitals are under pressure to comply with a whole set of regulations that is being altered and updated on a continual basis. The rapid shifts in compliance requirements can be difficult for an in-house billing team to keep up with.
When billing is outsourced, the billers and coders are experts. When billing software is used, the software automatically updates and both takes care of changes and educates staff.
ICD-10 Coding Switch
The ICD-10 coding switch was completed towards the end of 2015, but contained an overwhelming amount of information for many in-house billing and coding departments. Switching to outsourced billing or software may now save more time than before, which can be good for the bottom line.
Using these options can also help to prevent errors that may cost the office money, frustrate patients, or result in compliance issues.
Increased Patient Volume
With more patients having health insurance than ever before and a greater population of seniors than at any point in the country’s history, many practice offices have experienced an influx of traffic. Implementing medical billing software or outsourcing the service can help offices to deal with increased volume and spend more time on customer service. This could contribute to growth and expansion.
May Improve the Future of Care
Medical billing and accurate coding using the new ICD-10 codes make it possible for statistics bureaus and the Centers for Disease Control and Prevention to obtain more accurate statistics and data regarding medical health than disparate records. By being able to glean information about different health conditions, treatments, and outcomes using codes, it may be possible to extrapolate information that could assist with research and education.
If you are considering obtaining software or outsourcing your medical billing needs, call 1-888-783-7818 today.
Any medical practice depends upon its medical billing in order to generate revenues from the services rendered. Medical billing challenges can inhibit a practice’s ability to collect money owed, which can hamper the practice’s ability to grow and potentially put the practice in jeopardy. Understanding common medical billing challenges can help practices to solve them before they affect revenues.
Incomplete or Inaccurate Patient Information on File
If a patient’s correct insurance information and personal information are not on file, it can result in claim denials and make it more difficult for a practice to collect any money owed by the patient. It is very important that practices ask the right questions in order to collect all needed patient information. After this information is collected, it should be verified and input into the medical billing system immediately.
Failure to Provide Patient with Accurate Quotes for Services
Changes in the health insurance landscape have resulted in a huge shift towards insurance plans with higher deductibles. As a result of this shift, patient responsibility for medical bills is often higher than it was in the past.
Unfortunately, many practices have failed to adapt to this shift and provide accurate quotes for services based on the higher deductible amounts. When patients receive bills that are much higher than what a practice quoted for services rendered, patients are generally less likely to pay the bill promptly.
By taking the time to research what different insurance providers may pay, figure out what patient responsibility will be, and train front office staff to provide quotes accordingly, it may result in better collections. Bills should also be easy to read and closely reflect the way that a quote was given.
Patients that can rely on a practice to provide accurate quotes and not surprise bills will be more likely to pay their bills – and also to stay loyal.
Inefficient Claims Management Processes
Filing health insurance claims is a complex process that is constantly evolving. Relying on an inefficient claims management process can result in more denied claims while wasting staff time. Inefficient processes usually involve manual medical billing or outdated automated systems. Claims management processes can be made more efficient with outsourcing or medical billing software.
Medical Billing Errors
Medical billing errors are a common reason for claim denials, but can also make a medical practice more likely to be flagged for an audit and possibly cost a practice money if claims have been paid for codes that turned out to be erroneous. Since many codes have recently changed and there is now a much larger catalog of codes to be applied, automating medical billing can help to ensure medical billing accuracy.
Implementing medical billing software can help a practice to overcome many billing challenges. If you feel that medical billing software could benefit your practice, contact us today.
There have been many exciting changes in the healthcare field in recent years that have been fueled by technology. While it is easy for doctors to see how things like EHRs and medical billing software can improve patient outcomes, billing accuracy, and engagement, patients might not totally understand the changes. As such, it is important to support patients through changes so that they can see the benefits.
Talk to Patients while Entering Information
Since EHRs have become a healthcare standard, it is very important to enter all patient information in during the visit. However, patients may not understand why you are typing away on computer or tapping on a tablet during their precious office visit time. As you enter information, tell the patient what you are doing and how this helps to keep records together to improve care.
If you utilize a computer or tablet to look up symptoms from a database or consult EHRs for medical history that may provide clues into an issue, also walk the patient through these steps. Talking to a patient about your process may help to increase feelings of trust while mitigating concerns that you are simply browsing the internet for symptoms as they would at home.
Sell Your Patient Portal
Patient portals are a great idea that can put patients in charge of their health in a real way and improve healthcare communications. Unfortunately, patient portals have not garnered the excitement that was expected and adoption rates are relatively low for most practices. Patients are busy and many practices simply provide pamphlets about the patient portals that may be overlooked.
Talking up your patient portal and letting patients know how easy it is to see test results and records, schedule appointments, and view bills may help to increase interest. Let patients know that it is possible to ask questions through the portal that may help them to save travel time while engaging with medical professionals free of charge.
Be Patient When Recommending New Health Technology
If you decide to recommend a health app or other telehealth services to supplement care, be patient when walking patients through how to use the service and why it is helpful. Some patients will inevitably feel skeptical and hesitant to use to the recommended technology. Taking the time to allay their fears and really connect with them can improve satisfaction, engagement, and potentially outcomes.
If you are looking to implement new technology in your medical practice, call 1-888-783-7818 today to find out about top quality solutions.
Electronic Health Records, or EHRs, give physicians an easy-to-follow snapshot of a patient’s health history. Systems also make recommendations and offer reminders based on specific details of each patient’s record. Additionally, EHRs can be viewed by patients, enabling patients to take a more proactive approach to their own care. There are many ways that EHRs help medical offices to improve the quality of health care.
Provide a Comprehensive Picture
EHRs provide a comprehensive picture of a patient’s full medical history. In the past, paper records had to be faxed from relevant specialists, general practitioners, and other professionals in order for a physician to get a clear picture of a patient’s health. This piecemeal approach left room for errors as the physician had to make decisions based on limited information that may be missing critical elements.
Improves Communications between Medical Professionals
Physicians can see a detailed profile of who is treating their patients and what medications and treatments are being prescribed using EHRs. If necessary, medical professionals can contact other care providers to discuss specific aspects of patient care and formulate a more strategic plan. EHRs can essentially help separate medical professionals become a team of care providers working together for the best interests of the patient.
Can Help to Reduce Errors
When physicians are able to review all medications and treatments that a patient has been prescribed, it greatly decreases the likelihood of medication errors and contradictory treatments. Physicians may be able to see treatments that would have otherwise been overlooked by both patients and physicians, such as medications prescribed by a dentist or therapist. EMR software may even recommend examinations and treatments based on given information.
Increases Patient Engagement
Patients can view their own health records online when offices use EHRs, which may help patients to feel more empowered and engaged. Patients can get a peek behind the curtain and see the reasoning behind the prescribed treatments. Patients can also do research on their own time based on the information in their records, allowing a more complete understanding.
Enable Statistical Analysis to Improve Future Care
EHRs not only put all of each patient’s information in one place, they also put information about all patients that are being cared for by the office in one place. This may make it easier to compile data and use it for statistical analyses that can help physicians to spot trends to improve future care. Being able to quickly and easily report medical statistics and information may also improve the quality of information available to the general public regarding health and risk factors.
Pediatricians help to keep children healthy and safe, which is no small feat. A pediatrics practice is different from other types of medical offices in several ways. These differences make medical billing services even more helpful and beneficial for pediatrics offices than for other types of practices.
Pediatricians Spend More Time with Patients
Pediatricians tend to spend much more time with each patient than doctors in other practices. Since the patients are children, pediatricians cannot depend on patients to understand how to communicate medical issues or to understand recommended treatments and lifestyle changes. Parents are often worried, so explaining diagnoses and treatments may take more time. Additionally, doctors may need to observe patients for several minutes to assess development and try to spot issues.
For all of these reasons, doctors may spend a large amount of time with each patient. Medical coding varies depending on the amount of time spent in visits and the way that the time in the visits was used for the particular patient. These differences in coding can mean big changes in the amount that is paid out for the insurance claim, so having assistance with medical billing can help to ensure that a practice is properly reimbursed for time spent.
Parents See Pediatricians without Patient
If a child is diagnosed with a condition or illness, it is not uncommon for the parent to see the pediatrician without the child to follow up. This time can and should still be billed to the insurance company. All components of each visit should be documented with the amount of time spent so that the service can be properly billed. It may get confusing and a single error can affect the amount of reimbursement or even the claim acceptance status, so a medical billing service can help.
Insurance Transitions Are Necessary for Newborns
Pediatrics offices face special challenges in transitioning newborns from the mother’s insurance to a separate policy. The process must be executed properly and all coding must be input properly every step of the way to ensure prompt payment. A medical billing service can help save the office time and frustration trying to figure out exactly how to perform transitions and bill properly, which is time that can be better spent taking on more patients or providing great service to existing patients.
Common Services Can Be Costly
Common services that are performed at pediatrics offices, such as vaccines, can be costly for the practice. Billing even a few procedures incorrectly can have a big impact on the revenues. Medical billing services can help to mitigate errors and make sure that the highest claims reimbursements possible are obtained for each service. This can have substantial benefit for a pediatrics practice, ensuring a good return for services performed.
If you feel that your pediatrics practice could benefit from medical billing services, call 888-783-7818.
It is no secret that increased patient engagement can lead to better overall care and more effective treatment. When patients take a proactive role in maintaining their own health and well being, it can make it easier for physicians to collaborate on care and can lower the costs of care. By focusing on ways to improve patient engagement, physicians and other healthcare professionals can work to align themselves with the goals of Meaningful Use Stage 2, improve patient satisfaction, and secure their own relevancy.
Since technology has helped to improve nearly every other aspect of healthcare, including treatment and medical billing, it makes sense that technology could be the solution to the patient engagement dilemma. The following recommendations may help to better engage patients. However, it is just as important as ever for HCPs to actually speak to patients in person to find out how to foster engagement and cooperation.
1. Make EMRs Available Online
Allowing patients to access their own medical records online can instantly make patients feel more included in their own wellness and/or treatment plans. Research has shown that patients who are able to view their own health information take more responsibility when working with their physicians to make health decisions. In surveys, patients have even reported that they would switch physicians if it meant they would have access to their own information.
2. Recommend mHealth Apps
mHealth apps give physicians a way to set patients up with highly intricate care plans and programs that are broken down into fun and easy-to-use programs. There are many different types of mHealth apps that physicians can prescribe to individuals based on their specific health needs. Whether health needs include better stress management, increased physical activity, a change in eating habits, or condition management-there’s an app for that.
3. Forego the Phone in Favor of Modern Communications
While phone calls have long been the favored form of communication for doctor’s offices, many individuals now view phone calls as disruptive and intrusive. Studies show that many individuals prefer communications through text, email, or even social media. While these communication methods may not be the best option for delivering important health news, they can be highly effective for simple check-ins and information sharing.
Communication preferences may vary widely, especially among different age groups, however. Instead of completely outmoding one communication method in favor of another, it may be best for HCPs to ask patients directly what type of communication they prefer. This will have the added impact of making patients feel that their views are valued, while also inspiring engagement.
4. Create an Online Presence
Creating an online presence can help hospitals and medical facilities to improve patient perceptions and foster greater engagement. When patients can visit a HCP’s site and read blogs, browse reviews, and connect to portals that allow EMR access, it can build trust and establish a high quality image. This can help the medical facility to generate new business, as well as improving engagement with current patients.
Medical billing can be complex for any type of practice, but can be even more difficult to understand when it comes to mental health services. Insurance companies are quick to deny bills that aren’t coded properly. Even tracking down patients can be difficult when there is just a small office staff – or especially if there is no staff at all. Outsourcing medical billing may help a small mental or behavioral health practice to operate more efficiently.
Assists with Time Management
When staff members or counselors are working on filing claims and sending out bills, that time is directly taken away from more lucrative endeavors. Counselors could be seeing patients and earning revenues. Staff members could be scouting new patients, working on marketing, or taking care of existing patients. When medical billing is outsourced, counselors and staff members are free to take care of the tasks that will help the practice to grow and thrive.
Can Help You Collect Money Owed
When services have been rendered and money has not been collected, it actually costs the practice money. Mental health practices have notoriously low rates of return for services compared to other types of medical practices. Outsourcing medical billing may help to increase the rate of return for services. Insurance coding is apt to be more accurate and the medical billing service has more time to spend calling patients and insurance companies to inquire about payments.
Allows You to Accept More Insurance
Some mental health practices stick to a cash only policy or only accept insurance from a few providers, hoping to “play it safe.” Unfortunately, this strategy may deter patients that have insurance that will cover counseling services, as they will look elsewhere and go to an office that does accept their insurance. Insurance companies will often pay less than the full cost of a regular session, but working with them can help to bring in greater numbers of patients. This could help to grow your business.
Can Yield Faster Insurance Payouts
Medical billing takes time, so outsourcing it can help you to get the bills in the mail faster. The bills are more likely to be accurate and accepted instead of denied, so you may save untold hours not having to re-file or dispute denied claims. These advantages may help you to actually receive the money for your services faster, especially if patients begin seeing you regularly and the bills begin to be submitted at about the same time.
Call 1-888-783-7818 today if you are thinking about outsourcing your billing.
