Healthcare providers and physicians face professional challenges, but from the previous years handling hospital billing services has become a complex task as the US healthcare sector shifts to value-based payment models from fee-for-service.
However, managing billing and coding tasks manually requires a lot of time and effort. Moreover, when billing is done manually, it also increases the chances of human errors. So, there is a need for an efficient management system that can help you to optimize your billing and coding procedures efficiently.
Moreover, healthcare practitioners should stay up-to-date with the latest regulations and accurately receive complete payments from the insurance carrier. It is also crucial to manage claim denial management and optimize the revenue cycle processes efficiently.
Therefore, outsourcing hospital billing services could be a profitable decision, as it provides many benefits to improve the financial health of your business effectively;
- Establish the most effective billing and coding procedures.
- Full account receivables management and reporting.
- Comprehensive collection and billing services.
- Expert analysis to identify problems.
- Fast electronic processing of your claims.
- Fully compliant with HIPAA regulations and standards.
Medcare Billing professionals help your medical practice work on top potential and provide efficient hospital billing services to eradicate costly errors. They have extensive experience in claim processing and in-depth knowledge of insurance eligibility verification. Thereby, they help your practices maximize the net profit margin without losing money, time, resources and affecting customer satisfaction.
Here are the following benefits of outsourcing hospital billing and coding services to boost your reimbursements;
Insurance Eligibility Verification
When you outsource, Medcare billing professionals reduce the manual billing hassles and automate the entire procedure of prior-authorization and insurance eligibility verification. They check the eligibility criteria of patients if, according to the recent policy, there are further requirements for referral or pre-authorization, and they are eligible for the insurance benefits.
Once they check the eligibility verification process, verify the authenticity of medical claims and confirm the patient’s active coverage with payers. Billing professionals provide optimized hospital billing services to reduce the rate of costly mistakes and help you receive maximum reimbursements on time.
When the front-end office staff collect the necessary patient personal, financial, and demographic information such as; name, date of birth, age, gender, address, ID identity, race, marital status, ethnicity, employment, income, education, etc.
Then expert billers and coders access the required data from your existing practice management system. Medical coders go through different sources within patients’ documentation before the coding process initiates, such as; imaging reports, doctor′s transcription, diagnostic test reports to verify the services rendered. Throughout the entire medical coding process, the same coding method is followed to maintain consistency.
Moreover, expert, professional coders stay updated with the new transition of ICD, CPT, HCPCS codes and help you get familiar with these latest coding norms. They are certified and have the vast industry experience to handle the HCPCS level II, ICD-9-CM, CPT coding.
Medcare Billing specialists help practitioners to avoid under-coding and upcoding errors. They verify the assigned codes for compatibility and assign codes in line with the defined standards.
Furthermore, coding specialists analyze every step of the coding process and ensure high accuracy by preventing down-coding or up-coding errors and conducting several rigorous audits.
In this way, billing experts provide streamlined hospital billing services and prevent further discrepancies before any error occurs.
Automate charge Entry
It is the very first step in the hospital billing cycle. When you hire a reliable medical billing company, medical billing teams ensure that this step has a process in place and improves the health of the revenue cycle. They identify appropriate codes and assign medical codes to process the charge entry.
So, they use an integrated practice management system that helps you to streamline the billing processes efficiently. Medcare Billing experts automate the whole process and enable you to reduce the stress of manually handling charge entry processes significantly.
Moreover, the quality assurance ((QA) team thoroughly audits the claim before submission to the insurance payer through the clearinghouse. In this way, they ensure the 101% error-free medical claim submission to insurance companies and help practitioners get reimbursed promptly.
Claim Denial Management
Claims not filed on time, non-specific claims, illegible claims, claims below payer standards, claims with missing information, increase the denial rate. Due to the increased administrative burden, the administrative staff doesn’t focus on the denial management process. So, they face huge revenue loss due to increased claim denials and rejections.
But when you outsource your hospital billing services, expert billing professionals help practitioners appeal the rejection according to the provider contract, uncover a trend by one or several insurance carriers, and investigate every unpaid claim efficiently.
Moreover, if the claim gets rejected due to problems like; shortcomings on the patient’s side and lack of adequate information. Medcare Billing experts perform a thorough root-cause analysis and follow the four-step strategy to provide effective denial management.
They identify, handle, monitor, and avoid billing and coding errors that delay reimbursements. They take corrective actions, fix the particular issue by adopting the right billing solution, and refile a denied claim to get reimbursed promptly.
Take an Initiative
Medcare MSO is a reliable Medical Billing Company in the United States. Our dedicated medical billing experts provide efficient hospital billing services to boost your reimbursements significantly. Visit our website today!