If there is one issue that frustrates physicians about their practice, it is delivering medical services and not being paid for it. If there are issues with software, billing and coding or accounts receivable follow up, money will leak out of the system, often not to be recovered. Once your account receivables have reached 120 days, your chances of recovery have dwindled to near zero. If your medical billing operation is properly organized and the team dealing with it is knowledgeable and proactive, this situation should never occur.
On site billing personnel are being asked to address complex issues presented by private and public insurance companies. The rules are changing all of the time and the payers don’t always make it easy to sift through the requirements. With the new EMR and EHR requirements on the horizon, medical service organizations must adapt or face financial hardship. When talking to doctors about the state of their medical billing operation, I am usually greeted with many complaints that are directed towards the barriers posed by the insurance companies. Most MDs have no training in this area, and their office staff doesn’t have the support to help them solve these problems. Unfortunately, this side of the business usually decides the financial success and potential growth of the practice. Usually the only solution is to outsource the medical billing to address the issue.
If you decide to pursue this option, how do you go about making an informed medical billing decision?
First of all get some insight into how the outsourcing group analyzes your accounts receivable for problems. You should be able to provide some examples of claims for analysis and see if the solutions that are offered make sense. The consulting group should be able to spot issues with eligibility, problems with coding, or data entry, timely filing issues, lack of documentation etc.. Take a look at the capability of the prospective firm to work with your systems and medical billing software, as well as the tools they can bring to address your problem areas.
It makes sense to let an outside agency conduct an analysis and explain the findings. Their recommendations should provide a step by step plan that provides clarity and a clear path to resolution. Their system should be able to easily track all past and pending billing activities and provide an up to date report of the status of your accounts receivable. They should have a good grasp of all of insurance groups and their policies. Most problems with claims are solved with up to date information about the payers and their requirements.
Medical Billing Services with Medcare MSO Are A Solution
Medcare MSO prides itself on providing analysis for practices and focusing on problem solving. Our success is dependent upon our ability to unravel any bottleneck holding back your funding. Look to a service provider that will be an effective partner in your business. It is too important to your success not to.