Healthcare providers are often deprived of their hard-earned income because of rejected claims and inadequate follow-ups. Almost 20% of medical bills go unpaid because insurance companies reject claims based on bureaucratic errors and medical providers give up on the collection. Third party medical billing services have the necessary expertise, personnel and technical tools to ensure higher collection of bills, thereby increasing the revenue of medical providers. Following are some of the details a healthcare providers should know of a medical coding and billing provider before hiring it.Type of medical billing provider
There are many medical coding and billing services in the market vying for clients. Healthcare provider needs to assess their own needs first, and then look for a billing service that serves their purpose. Most providers offer only billing services; they collect bills by submitting claims accurately and follow up on the payments. Some providers work only for small businesses, which are usually individual setups that offer specialized medical services. Large practice management companies offer comprehensive medical billing packages that include administrative services for running the medical practice effectively.
Policies of the billing services
A professional medical billing provider follows business practices that ensure high quality of services. Healthcare providers should check the processes followed to ensure effectiveness of the service:
Persistent follow-up of bills
The billing service provider must follow up on payments aggressively and persistently. Insurance carriers are very fussy and reject or deny claims on administrative technicalities. The provider needs to ensure forms are filled in correctly so that insurance carriers do not get an opportunity to reject them, monitor government programs to ensure accurate payments and pursue all billing collections with tenacity.
Compliance with regulations
The Health Insurance Portability and Accountability Act (HIPAA) mandates the privacy, security and protection of patient data. Medical billing providers are also privy to confidential patient information, and should comply with HIPAA regulations.
Timely submission of claims
Medical billing providers should be well versed with the billing system, types of forms and the deadlines for each type of form. Claims must be filed within specified timelines or the insurance company will reject them.
Cost of the billing service
Medical coding and billing service providers charge a flat fee for their services or a percentage of the claim they collect for the healthcare provider. The healthcare provider should examine which fee structure suits them best, and select a billing service accordingly.
Specialization
Some billing services providers have a specialty focus in a particular billing protocol. They promise better collections than general medical billing providers do.
Communication with healthcare provider
The medical coding and billing provider and the healthcare practitioner should communicate openly and clearly to have an effective relationship.
Skills of the workforce
An efficient billing provider should have trained staff that is skilled in billing. Healthcare practitioners need to verify the following about the billing provider's workforce:
* Are the agents trained in medical insurance coding standards?
* How much experience do the agents have in the medical billing field?
* Are the agents updated about changing billing processes through regular trainings?
* Are the agents familiar with both Windows and UNIX based medical billing systems?
* Does the billing provider work with employees or contractors? A provider that supports its own staff is preferred.
Technology adopted by the medical billing provider
Medical billing providers have a better chance of getting results if they are supported by latest technology and tools. Electronic submission of forms is more effective and less error prone than manual submission. Incorrect forms are one of the main reasons claims get rejected by insurance companies.
Billing services can potentially increase the revenue of medical practitioners by almost 30%. An effective medical billing provider frees healthcare providers from the burden of administrative tasks and allows them to focus on patient care.
Author:Daljeet Sidhu is Co-founder at TradeSeam Business Network. Connect with customers, suppliers, partners and service providers online and start receiving qualified sales leads to grow your business. Find, Compare Prices and Save on vendors and suppliers for your business needs. Power up your business by leveraging the Tradeseam verified seal to build trust with customers, partners and suppliers and receive more qualified sales leads and business opportunities. Read our medical billing service advice. Compare psychiatric billing quotes.
Source: http://EzineArticles.com
