Role of Medical Billing Firms in Maximizing Medical Claim Reimbursement

Earlier, medical billing was something quite deterring to healthcare professionals with busy practices to run. Now, things have changed and medical billing has become smoother and swifter, thanks to billing services. Mainly, small / medium clinics and individual physicians are mostly benefited through billing services. However, large hospitals and healthcare centers are also benefited by the services of billing companies, as they provide cost-effective and hassle-free medical claim reimbursement services. This is why billing services are getting popular these days, among all healthcare entities. In this article we will look at the benefits of hiring a billing services provider.

100% Satisfying Claim Management with Medical Billing Outsourcing

The medical claims submitted to insurance payers have to be accurate in all respects if you are to receive correct reimbursement. Checking the insurance papers and getting the claim amount from the insurance companies through regular follow-ups can be time consuming, as well as budget intense. Mainly, small healthcare clinics may not have a separate accounts department, as it is cost consuming. On the other hand, handling the claims can be time-consuming as you need to follow-up with the insurance companies regularly for the claimed money disbursement.

From claim management to billing and coding, according to the laws of states, a billing company renders all the required services. Here are the services that you can avail of from a reliable billing company:

• Checking the patient's insurance terms and conditions and investigating the validity of the insurance papers. This will lead to easy payment reimbursement from the insurance companies.


• Following up with the insurance companies at a regular interval to make sure that there are no unnecessary delays in payment disbursement.


• Handling the situation efficiently, when a claim has been denied. Competent providers of billing services follow up on denied as well as delayed claims, making the necessary modifications and providing valid information. They make sure that their clients receive maximum reimbursement.

Expand Your Business - Provide High-end Services

For a healthcare unit, seamless healthcare management and cutting edge services for the patients are the main objectives. This will help the clinic to become popular and thus, provide a chance for business expansion. With billing outsourcing, management teams of small healthcare clinics get more time and peace of mind to think about providing better services to their clients. They can focus more on quality services, without having any sort of anxiety regarding the payment.

Medical billing firms thus have an important role to play in helping their clients maximize claim reimbursement. Their value-added services will help healthcare entities eliminate those costly errors in billing and coding. Accurate claims will bring accurate reimbursement and help in maintaining a steady revenue cycle.

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What does a doctor expect from his medical billers & coders

A significant challenge that care providers face in the US today is unrealized account receivables stemming from rejected insurance claims by Medicaid and Medicare officials. Physicians often find this challenge daunting because it requires them to handle what they are not meant to: administrative responsibilities

The medical billing and coding cycle requires thorough knowledge and deft handling of the entire process and related procedures including familiarity with electronic platforms and the ability to handle sensitive medical data.

The above scenario, if broken in terms of skills doctors expect their billers and coders to have, will demarcate the following areas:

• Knowledge of billing life cycle
• Theoretical and working knowledge of data collection, data entry, paper claims, creating and editing reports, patient demographic forms, etc
• Usage and understanding of codes
• Knowledge of electronic platforms in use

This makes medical billing and coding among the most knowledge-driven and challenging disciplines which needs keeping up with the changing trends of the industry to effectively handle billing and coding responsibilities for care providers, so that they can concentrate on quality of care even as they enjoy a steady flow of revenue.

Accuracy vs. Productivity – Medical Coder 

Recently, AAPC conducted a survey to find out from billing and coding professionals which among the two (accuracy and productivity) is preferred over the other by billing and coding managers and the survey revealed a mixed response establishing the supremacy of neither of the two over the other, leading to the conclusion that a billing and coding manager expects his/her team of billers and coders “to efficiently produce accurate work”.

Medical Coding with MBC

MBC believes, that when it comes to billing and coding, certifications help bridge this gap. Most of MBC’s billers and coders are certified in CPC, CCS which CPAT, all of which require passing a coding certification examination which involves questions to examine the ability of billers and coders to accurately apply CPT and HCPCS procedures and supply ICD-9-CM diagnosis codes. This helps MBC’s coding professionals to refresh and renew their skills and be assured of them.

Top 5 Reasons to Become a Medical Billing and Coding Specialist

Do you enjoy working with computers, pay exceptional attention to detail and aspire to work in the healthcare industry? If so, a medical billing and coding specialist position may be a viable option for you, and can lead to a rewarding career. To give you a little more insight, here are some of the top reasons for becoming a medical billing and coding specialist:

1. There’s a Demand for Qualified Medical Coding Professionals – The U.S. Bureau of Labor Statistics (BLS) reports that job prospects for medical records and health information technicians, which includes medical coders, appear to be good in the coming years. Employment rates for this field are actually expected to increase 20% between 2008 and 2018, which is much faster than the average for all occupations.*
2. Education Can Be Completed in Less Than a Year – Some medical billing and coding training programs can be finished in as few as 10 months, or about a year-and-a-half for an associate degree. Take time to explore your education options and choose a quality medical billing and coding training program. Ideally, the program you choose should also prepare you for industry certification, such as the Certified Professional Coder (CPC®) designation from the American Academy of Professional Coders (AAPC).
3. Availability of Online Medical Billing and Coding Education – Thanks to the convenience and flexibility of online medical billing and coding degree and diploma programs, you can accomplish your healthcare education goals without the common barriers of time and location. You’ll want to select a reputable, accredited medical billing and coding school with a specialized curriculum. These primary qualifications can help ensure that you receive a quality education.
4. Ability to Work in Healthcare Without the Typical Physical Demands – Many healthcare workers have to work extremely long hours and are required to move patients, stand or walk for long periods of time, clean up after patients and so on. As a medical billing and coding specialist, you will be able to assist healthcare providers and patients alike, all while working from your computer.
5. Potential to Work at Home and Set Your Own Schedule – Some healthcare providers outsource their medical billing and coding workload to fully trained specialists. This option gives you the opportunity to build your own home-based practice. As an independent medical billing and coding specialist, you have the freedom to decide what hours you would like to work and create an environment that fits your personal and professional needs.