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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5 Main Revenue Cycle Issues Spurred by Healthcare Reform

The third year of healthcare reform is only a couple months old, but there are five revenue cycle issues that will impact hospital executives throughout the remainder of 2013, according to a report from consulting firm Pyramid Healthcare Solutions.

1. Reimbursement and cash flow pressures. Healthcare reform will lead to decreased Medicare payments, more Medicaid patients and a larger percentage of high-deductible health plans, which will put more costs on commercially insured patients. These pressures lead many hospital executives to believe there will be a decline in patient revenue and days cash on hand, meaning revenue cycle teams will have to work harder to reduce days in accounts receivable and improve front-end collections, according to the report.

2. Business office operations. Consolidation among hospitals, physician practices, post-acute care and other providers will drive a consolidation of business office operations.

3. Innovative payment models. Accountable care organizations and bundled payments will impact existing patient accounting systems, most of which are not built to handle these types of new CMS-sponsored payment models.

4. ICD-10. This will be a big year for providers and ICD-10, as it is the final full year to formalize the transition. Revenue cycle teams will have to invest resources and time to master the new coding system, which will affect reimbursement trends and electronic health record implementation.

5. Outsourcing. As hospitals attempt to prioritize their various challenges, many are looking to outsource certain operations, including the revenue cycle, to handle and navigate the various deadlines.

New York Physicians' Monthly Collection Enhanced by 32% in the First Month by Medical Billing Services of Medicalbillersandcoders.com!

Wilmington, 12th February, 2013

MBC by applying innovative medical billing solutions has successfully helped individual physicians, physician groups and hospitals across the State of New York - with its specialized team of billers and coders managing to enhance most of their physician’s monthly collections by 32% within the first month itself of taking up the account.

Recognizing New York Practitioner’s billing needs

Though the Medical billing requirements coincide in a certain way or another, each State’s billing needs are unique in their own way and MBC’s team endeavors to ascertain these State specific needs of all our clients. New York Physicians and especially Cardiologists find it tedious to balance patient care and admin needs mainly due to the large number of patients they need to cater to amidst time constraints.
MBC’s billing experts are aware about this crucial factor and New York practitioner’s requirement for both timely posting and follow up of claims to help maximize revenues. Additionally the health care reforms are likely to have considerable amount of impact on the New York’s Medical billing and hence physician’s revenue, for which the NY’s medical practitioners need to constantly update themselves.

Health Care Reform: will affect New Yorkers differently than other states

With the Federal health care reform there are to be changes to public and private health coverage in New York, including increased integration. Additionally advances in technology are likely to facilitate improved coverage and help streamline processes.

However with a number of prime consumer health insurance protections already in place in New York State it is likely to go through less transition than many states with respect to these reforms, never theless the number of insured will increase and MBC’s team is prepared to handle this situation for its clients and prevent them from struggling to balance these changes with patient care.

How we manage to collect more for you?

Running a medical practice in New York and maintaining an efficient medical billing department can be quite challenging. Generally denials can run up to 30% or more of a practice's billing; however MBC works towards a much lower denial rate and higher collection rate - with the principal of getting paid only when our clients get paid.

By and large the last 20-30% charges are not paid on first submission- requiring up to 10 times more effort to resolve, most practices or billings services have limited resources to do this work. MBC due to its large set-up can routinely and consistently apply collection efforts to these claims to generate higher and more consistent collections.

Guiding New York physicians towards better medical billing practices

MBC has been helping providers with all their medical billing needs located throughout New York, in major cities such as New York City, Rochester, Buffalo, Syracuse and Albany. MBC experts constantly update themselves about the health insurance systems, managed care systems, medico-legal and ethical responsibilities, confidentiality, drugs, and prescription records along with other industry changes – with an aim to achieve higher collections.

Get more information: New York City Medical Billing, Rochester Medical Billing, Buffalo Medical Billing, Syracuse Medical Billing, and Albany Medical Billing

Keeping in mind the large number of patients their New York practitioners attend to everyday Medicalbillerandcoders.com have been working diligently and also have a dedicated department for our providers based solely in New York. Providing comprehensive medical billing and practice management services for over a decade; our professional billers know the ins and outs of medical billing practices, regularly updating themselves about the changing procedures and legislation that affect New York providers.

MBC invites all providers across New York to access our services depending on their needs – of professionals to handle the practice’s entire billing process or during a temporary staff shortage. Our well-informed billers are constantly applying new methods and trends are available to help you enhance your collections.

About Medicalbillersandcoders.com

Medicalbillersandcoders.com is the largest 'Consortium of Medical Billers and Coders,' across the US. The portal brings together hundreds of billers, with experience in different specialties (anesthesiology medical billing, radiology medical billing, dermatology medical billing, oncology medical billing, Optometry medical billing, cardiology medical billing, ob/gyn medical billing, urology medical billing), on the same platform to service physicians in their local areas. This network of coders and billers is growing rapidly and is currently servicing over 40 specialty physicians, across the US with the most prominent being Cardiology Medical Billing and General Practice.

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Medical Billing Blog

Medical Center - Implementing The Most Up-to-Date System In Medical Billing Practice

The medical billing together with the coding course of action require supplies a large amount of assist to health care experts to supply timely and correct reimbursement from insurance agency. Experts in medical coding designate the correct codes for services and treatments, even though medical billing authorities bill these properly. By: medical centre

These positions have been completed with sufficient care given that faults may possibly result in denial of claims and badly affect the reimbursement observe. Due to this why most healthcare businesses outsource these services to a expert medical billing company. The medical coding and billing solutions presented by a dependable service service provider may also help conduct the coding and billing system efficiently, and ahead exact medical expenditures and claims in the intended cut-off date. 

Performing collectively with an expert medical billing specialist allows the medical services to streamline medical billing method, and advantage from effectively arranged coding and billing services which reduce declare denial and ensure of utmost refund. Medical coding and billing services are supplied to groups of physicians, clinics, medical centre, acute treatment services, free standing diagnostic centers, long term treatment services and many other individuals. 

The new medical billing system furnished may possibly start from cost entry, registering affected person information, recording, insurance verifications, payment publishing services, code evaluation and checking, claims/patient billing transmission, collection managements, authorization to appointment rescheduling and scheduling, AR follow-up. The medical middle coding workforce would have expertise in CPT coding, emergency home e-code assessment, DRG/ICD-9-CM and HCPS coding, medical coding audits, and a great deal additional. 

The medical middle be certain that they have effectively streamlining all the processes include from enrollment to insurance verification to AR collection. The new program has aided healthcare exercise to flourish its services and expand. It's got furnished the very best medical coding and billing services, advance billing software, progressive technologies, latest devices along with some others that are essential in executing medical billing service. 

The medical middle today have the most recent and freshest medical codes and standards, insurance and governmental regulatory benchmarks, and payer-specific coding desires. It is important to decide the medical middle that applies the most recent technologies in medical billing and coding to be capable to get your insurance reimbursement quickly and precise. An qualified medical billing and coding company can assist you deal with all sorts of medical billing difficulties simply. Make certain you get the job done with a trustworthy company which focuses on the action program, excellent assurance, full-time specialized enable, common reports and prompt service. By: western suburbs doctor brisbane

5 Tips for Improving Anesthesia Billing Practice

Medical practices face complex challenges in order to maintain a healthy bottom line. Billing for anesthesia services can be even more complicated. These particular challenges can be overcome by monitoring and streamlining the advanced processes involved in maximizing revenue. Here are 5 tips for improving anesthesia billing practices.

1. Monitor Contracts And Be Familiar With Payors: Anesthesia billing can be more complicated for billers and payors. If a contact is particularly difficult to manage claims can be processed incorrectly, therefore it is crucial to closely monitor contracts and follow up with payors to be certain they are processing claims correctly. Billers need to be familiar with each contract and its cycle, and know what they should receive for the claims.

2. Collect From Patients Up Front: The collection process is an area where many anesthesia providers need improvement. In the last few years, collecting payment from patients has changed dramatically. Billers used to charge the payor and send an invoice. Receiving payment was less of a worry because patients had better means to pay and their deductibles weren’t as high. Billers today have to be much more aggressive to receive payment. Some practices are now requiring payment before services are performed.

It is important to educate patients about the costs of the services they will receive so that they are well informed about what payments they will be responsible for. Discuss a payment plan with the patients who cannot pay in full up front so you both can expect the bill to be paid off quickly.

3. Maintain Effective Collections: An anesthesia biller’s number one priority is to completely capture everything for the day. Ask yourself how long it takes for charges to be entered after service, and how long it takes the practice to submit the claims to the clearinghouse. Charges should be entered within 24 hours of service and claims to the clearinghouse should be made nightly.

Billers should always be sure that the correct payor is being billed, that any and all modifiers are added and that the payment policies of the payor are being adhered to in order to get a claim paid.

Also, be vigilant in monitoring how long unpaid services remain in A/R. Most of your accounts should be in the 30 day range. If you have unpaid services in the 60 or 90 day range you have room for improvement.

4. Be Aware Of Compliance: Providers are  accountable for compliance with the Health Insurance Portability and Accountability Act. There are countless opportunities for HIPPA violations everyday, so medical practices, anesthesiologists and billers need to keep aware of the rules and have a plan for staying up to date on changes. Changing laws have dramatically increased the ability of the U.S. Department of Health and Human Services (HHS) to impose monetary penalties for these violations. HHS is expected to take more formal action when there is willful neglect involved in a violation. Four recent changes that will have a significant impact on providers are:

• Business associates and their subcontractors are now liable for breaches of personal health information (PHI).
• Rights of patients to obtain electronic copies of their records have been enhanced
• Rights of individuals to request restrictions regarding disclosure of their PHI have been enhanced
• Any disclosure of PHI is now presumed to be a breach under the breach notification rule

Technology can be your best friend when it comes to compliance. Our coding system includes regulatory compliance checks.

5. Pay Special Attention To Post-Op Pain Blocks: Failure to properly document and bill for post-op pain blocks (POP) can result in a reimbursement issue and a compliance issue as well. Practices need to take the time to ensure that their entire billing staff is aware of what is needed for post-op blocks.

A surgeon and anesthesiologist will frequently use the same document to record the anesthesia event and the POP. This usually results in a denial of the claim by the insurance company the first time around. A second form is good practice to clearly separate the POP from the anesthesia delivery used for the surgery itself. It is vital to document the surgeon’s request for the block and a second reason for why the POP was administered.  If the request is not included in the patient’s record, it can be appealed, which will prevent timely payment.

Because billing for anesthesia and POPs is so complex, billers should not assume that all of the documents are complete. Doing so can be just as bad as up-coding. Put a specific plan in place for how your staff will handle the documentation of these procedures.

Is Outsourcing Your Medical Billing the Right Choice?

Many medical practices consider outsourcing billing at some point. There are a lot of reasons why a practice might opt for outsourcing, but the truth is that it isn’t for everyone. The best way to decide if outsourcing is for your practice is to analyze the pro’s and con’s and ask yourself a few basic questions about your business.

First answer the following:

1. Are you a new practice?
2. Is billing for your specialty especially complex?
3. Have you had a high turnover of billing staff or is there a lack of qualified billing staff in your area?
4. Are your billing processes inefficient (i.e., high denial rate, high A/R, low patient collections, etc.)?
5. Would you rather focus more on patient care and less on business management tasks?

If you answered “yes” to most of these questions then outsourcing might be a better fit for your needs. However, there are pro’s and con’s to both ways of doing your billing. Simply put, in-house billing allows you to have total control over your billing processes but it also means managing staff, paying more for full time employees, and opening yourself to problems ranging from poor training and job performance to embezzlement.

On the flip side, if you use a reputable billing service, you should see lower costs with a good return on your investment. Generally, you can expect a certain level of results and consistency in performance. The downside is that you will have little control over the process and the cost may vary based on your claim volume at any given time.

To assess the pro’s and con’s for yourself use this simple checklist:

1. Would you prefer to hand over control over the daily billing process?
2. Are you concerned about the time and cost involved in managing more full-time staff?
3. Are you worried about the possibility of embezzlement or negligence in your billing?
4. Would you rather pay a small percentage of your claims than a full-time salary?
5. Are you comfortable with the varying cost of outsourcing billing tasks?
6. Are you looking for more comprehensive reporting and substantial analysis of your business?
7. Are you concerned about staying on top of changing reimbursement and compliance issues?

If you answered mostly “yes” again, then it is probably time to consider an outsourcing solution. Watch for our next post on outsourcing your billing, Ten Questions to Ask Before Hiring a Billing Service.

Facts about salary differences in medical billing and coding

The salary of medical billing & coding is basically depends upon the type of medical field you have selected for your career. In addition, the certain set of skills and talents is also required in that field. For instance, the average expected salary for the post of medical billing assistant is around $ 45000 or more per annum while in other intricate fields of medical, the salary for the same post can reach at around $ 60000 per annum.images

If you are searching for the salary of billing assistant in Canada, you may search for this in the major cities like Toronto, Ottawa, Vancouver, Edmonton, Montreal and Calgary online and you can see the top companies that are hiring the candidates. Now, you can search for the best healthcare units that hire the people for the job of medical billing and coding and their salary structures.

How medical billers and coders work?

First of all, you will gather the relevant information so that you can start with the pc by inputting all the information. After inputting all the information required by you, the statement or claim will be transferred to the insurance agency. In case, the claim is rejected by the company, this is the duty of the coder to investigate about the reason of rejection. After the claim is accepted, the medical bill will be produced and sent. All these things are considered at Medical Billing & Coding Training.

Source: http://www.schoolmedicalbilling.com/facts-about-salary-differences-in-medical-billing-and-coding/