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How to Manage Clinical Reporting and Patient Debt Challenges in Medical Billing

Medical BillingThe demand for medical billing outsourcing is growing. With the increasing rate of treatment need, physician practices are already busy places. Having an in-house team to perform billing and coding tasks can prove quite expensive and resource consuming. Medical billing outsourcing can help healthcare practices manage their claims processes and get the reimbursements they are entitled to, while they focus on enhancing the quality of care.

The Challenge with Clinical Reporting

Changing clinical reporting practices cause inconvenience to healthcare providers, particularly when the healthcare industry is moving towards result-based payments. The EMR software is a positive step though, and most practices have implemented it or are moving in that direction. It has helped bring down documentation and clinical errors, and thereby bring down the number of rejected claims.

It is important to have a good billing team that would always update itself on rule changes and adaptations to insurance payment laws. It would help handle claim submissions efficiently. The billing team can also keep generating more efficient processes and methods of successful claim filing. A professional medical billing company does just that with its team of trained and experienced billing professionals.

The Menace of Patient Debts

With insurance claims, maximum reimbursement must be ensured. Claims must be processed quickly and accurately. If a claim form is incomplete or inaccurate, payment will be delayed.

Patient debts need to be controlled. Some healthcare practices carry out the practice of grouping accounts belonging to a specific time period to bill them. There are various follow-up methodologies that are made based on the debt value and the time from when the debt has been outstanding.

An account being unpaid for more than four months is an indication that a mistake has probably been made by the insurance company. According to industry experts, nearly 19% of denied claims are caused by an insurance provider’s mistake. For most providers, more than 10% of debts extend to more than four months, after which they end up written off and not paid.

Professional medical billing services are aggressive about getting debts recovered. They end up being successful where in-house healthcare practices’ billing teams do not succeed. Shorter billing cycles and higher revenues are the expected results of outsourcing to an efficient medical billing company.

Professional Medical Billing Services

An efficient medical billing and coding company will offer the following billing solutions:

  • Patient Scheduling and Reminders
  • Patient Enrollment
  • Insurance Enrollment
  • Insurance Verification
  • Insurance Authorizations
  • Coding and Audits
  • Billing and Reconciling of Accounts
  • Account Analysis and Denial Management
  • AR Management
  • Financial Management Reporting

The comprehensive medical coding solutions the company provides will generally comprise

  • Hospital / in-patient coding
  • Emergency room e-code evaluation
  • Medical coding audits
  • Backlog coding resolution services
  • DRG/ICD-9-CM coding validations
  • CPT medical coding
  • ASCs – Ambulatory Surgical Centers Coding
  • ICD-9 coding based on AMA and CMS guidelines

Outsourcing to a medical billing and coding company can help healthcare providers save time, reduce overhead and increase collections and get their rightful payment from the insurance carrier. They can focus more on taking care of their patients, fully confident that their medical billing company will help them get reimbursed for the services they have provided.

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