How to Increase Practice Revenue through Thorough Medical Billing Process?
Considered one of the crucial invisible engines in health care facilities, Medical Billing is really indispensible – without this, care providers can hardly expect to get paid for the services provided by them. Not to mention patient payment collection woes, medical billing is to be handled very diligently in order to achieve practice success!
Health Care Industry keeps Evolving – same is needed of billing services and payment collection
For successfully running a health care facility, one of the primary essentials is having an efficient billing system that facilitates effective payment collection. Payment collection from patients is one major hurdle in the life of a medical practice. Any effort aimed at improving the billing and collection system in practices translates to improved operations and increased revenue.
Billing services need to transform according to the evolving nature of health care segment and its payment modes. Changing insurance practices, reimbursement methods, and other financial factors are creating challenges to medical practices. Along with efficiency and interoperability, practices must focus on payment best practices for accomplishing financial wellness.
Common Habits that lead to Effective Medical Billing
By following certain best practices, medical practices can greatly improve their medical billing process and enable efficient payment collection while increasing rate of insurance claims approval.
In the present insurance setting with increasingly complex and confusing processes and rules, underpayments and denials abound. Not all medical practices can claim to achieve collecting everything that they have earned. Following steps needed to be followed by practices so that they do not lose out on reimbursements:
- Doing things right the first time: When a claim doesn’t get paid upon submission for the first time, the chances of it being paid goes on diminishing – care must be taken to submit claims without chances of denial
- Getting full payment: It is not strange that practices get paid with different amounts for same services – according to the type of individual contracts physicians have with payers – sending alerts when actual payment received doesn’t match with specified payment helps in knowing when you are underpaid- software helps in this
- Detailed Reporting: Setting up an intuitive software system which facilitates creation of reports at required intervals for an on-going analysis and generation of custom reports when particular information is required quickly helps optimizing the practice
Best Practices in medical Billing
- Conducting audits on medical billing
- Providing increased number of payment channels
- Improve Data Security and focus on data
- Improve interoperability and increase efficiency
- Make use of system intelligence
Why Numinatrans?
Numina Transcription Services, Inc. has been providing accurate and reliable medical billing service to global health care facilities. We ensure that your revenue cycle is managed in an effective manner so that the financial stability of your practice is assured.
Medical billing plays a crucial role in the overall satisfaction level of patients in a medical establishment. Employing the skills of an efficient outsourcing service provider is one way of leveraging best practices in medical billing!
How Does Medical Billing Differ From Coding?
Although there are similarities between the two, medical coding and billing are in fact two separate processes. Contrary to common belief by people, they are not one and the same. In both the processes, professionals happen to work in health care setting, gather health information from the patients, and confer with physicians and insurance companies. The similarity ends here.
Fundamental Functions of Medical Coders
Medical coders are entrusted with the determination of the procedures that have been performed by the physician, surgeon, or other member of the health care team. They then assign the diagnosis code or proper procedure code for the corresponding services provided by the medical professionals to the patient.
Medical coders make use of Current Procedural Terminology (CPT) for allocating codes related to procedures received by patients; they refer to International Classification of Diseases (ICD) for choosing the diagnosis code for labeling the concerned physician’s diagnosis about patient’s condition. Coders are expected to assign perfect codes as these will be used as base by insurance providers toward patients’ insurance claims.
What do the Medical Billers do?
Medical billing involves entering codes into specific software and then processing insurance claims. Medical billers use special billing software that lets them enter the codes that are assigned by coder as well as other relevant information- facilitating sending the claim to insurance company for payment.
Entrusted with the process of dealing with insurance providers, medical billers are expected to have complete knowledge of the claims process and all requirements that need to be submitted for processing claims. The responsibility of handing proper insurance claims lies with them too. In this connection, they must ensure that correct billing format is followed, all fields have been answered properly, and all supporting documents are included in the file.
Distinct Processes in Medical Coding
It is the medical coder’s responsibility to decipher documentation of patients’ interaction with care providers such as physicians, surgeons, or nurses – they determine appropriate diagnosis and procedure codes for reflecting the services provided.
Exclusive Tasks in Medical Billing
Medical biller takes the assigned codes along with necessary insurance data, inputs them into the specific billing software, and submits claim to the payer (which is mostly an insurance company) for payment. Moreover, billers need to follow up on the claim as and when required.
To put it shortly, medical coders and billers are entrusted with the task of collecting information, coding claims, and arranging payment for physicians in timely manner. Both these roles are crucial for practice cash flow.