As a healthcare provider, giving your patients the best possible medical care is your number-one priority. But you also know that there are dozens of distractions and details that are part of running a practice that occur daily.
Some are emergencies over which you have little or no control, while others may result from lack of planning or good organization. One thing that you do have control over is how you choose to handle your medical billing and its role in your revenue cycle management (RCM).
Working with the Right Medical Billing Company Makes a Difference
Healthcare providers spend considerable time and effort in researching the most suitable company from among numerous medical billing services, and once a decision is made and a company selected and contracted, it’s time to get down to business.
What elements make for a good working relationship between providers and billing services?
What can a physician or other provider do to keep things running smoothly for everyone involved?
Good Communication Is Vital to the Medical Billing Relationship
Perhaps the most important element of any business or personal relationship is communication. If they are a local company, your new partner will meet with you in person.
Otherwise, they will schedule calls and may even have a video chat to establish rapport and answer any questions you have. They understand that you’re very busy and often have numerous daily interruptions and concerns and so will do their best to keep interruptions and inquiries on their end to a minimum.
It’s important for both parties to clearly communicate their expectations and needs for processing claims and managing the revenue cycle. You’ll need to agree on how best to do this, whether by email, text, phone call or other means.
If there’s a question about a claim, the billing company needs to be able to reach out to you. Failing to stay in communication can mean delays in filing claims and getting reimbursed.
Sometimes providers forget that medical billing services handle claims for many other providers, so being accurate and “thinking like a biller” can keep the process moving along and reduce the number of inquiries from your billers.
For example, there was a heart surgeon who would draw a picture of whatever surgery had been performed and would take the time to explain any extra steps that might not have normally been taken. He would ask the billing service up front whether those extra steps were billable, while being confident that the company would investigate and if so, would then bill according to CPT and payer guidelines.
Medical Billing Companies Know the Codes but Also Need Your Input
A billing service shouldn’t expect a provider to be aware of every nuance in the coding process: as an example, atrial fibrillation (AFib) was formerly indicated with a single code in the ICD-9 system. Now, ICD-10 offers several choices, meaning that if the provider hasn’t designated the appropriate code, the coder has to select one which is believed to best fit a procedure. This can create problems if the payer is Medicare, which no longer considers AFib a payable diagnosis for an echocardiogram.
Since provider notes don’t always use wording in coder’s terms and may even use terms that differ from the codebooks, when savvy coders and billers don’t simply “assume” but check back with the provider as to which code best suits the procedure or treatment performed, they may find that just one or two small details make the difference between a payable claim and one that isn’t.
It’s a Relationship, Trust Is Required
The best relationships are also based on trust. Keeping your word is paramount in maintaining good teamwork between a provider and the medical billing service. It doesn’t matter whether you’re dealing with national medical billing services in Wyoming or medical billing services in California or elsewhere, while some state and local regulations may vary, providers should be able to trust that their billing company will be current with the latest changes and updates, with no delays or obstacles to collecting their payments due.
In turn, the billing company should be able to trust the provider to give them the most accurate and detailed patient treatment information necessary to enable assigning the most accurate codes and sending the bills out on time for fast and complete payment. Any missing information can result in delays and denials, with more time lost in resubmissions.
So, when setting up an account with your medical billing service, you should be able to expect that:
- Claims will be processed and filed quickly as well as accurately.
- Payments received will be promptly posted.
- Claims will be worked on daily, with notes being recorded in each claim record as needed.
- Claims with patient balances due should also be noted to enable your staff to follow up (unless you have contracted for AR management, in which case the medical billing company may handle the collection process).
National Medical Billing Services Use the Latest Software
Having the latest compatible technologies is one key to keeping in close touch with your billing company and keeping revenue processes flowing smoothly.
One of the reasons providers outsource their medical revenue cycle management and billing is to better manage the patient-provider relationship. It’s extremely difficult and time-consuming for a practitioner or healthcare organization to provide top quality care while juggling standard RCM services such as scheduling, case management and other related tasks.
Having an integrated EHR/EMR system can save time and money in the long run. Outsourcing your claims to national medical billing services means those companies’ systems can “talk” to your system. Make sure the company you work with uses the latest, most powerful billing software available. These are generally capable of interfacing with most practice systems currently in use.
Respect Your Biller’s Expertise—and Share Yours
Both medical billing services and providers should remember to have respect for each other’s areas of expertise. You know best how to do your job as a provider and you’ve entrusted your billing and other areas of revenue management to your chosen service. A provider knows which treatment steps need to be taken and why, but if there is a question about coding a given procedure or using the correct modifiers in the coding, they will need to question you about some procedure details.
Professional billers are aware that healthcare providers can’t be expected to know all aspects of the billing/coding sides of healthcare. Sharing billing expertise with practices to educate them and their staff on which documentation is needed, for example, can go a long way in boosting cooperation between provider and billing service while reducing delays and mistakes and getting the claims paid faster.
Use Feedback to Stay on Track
Getting and giving feedback is a good way to maintain positive relations between businesses over time. Your medical billing company wants to do a good job, so if they send surveys or call to ask about your satisfaction with their services, take the opportunity to discuss any concerns you have.
It is also important to be open to receiving feedback. If your team is giving them wrong information, the billers won’t be able to get you paid. Training is ongoing for medical billers, so if they have info to share with your staff, make a point of passing it along.
When medical billing services work together with good communication, trust, respect and cooperation, everyone wins.
Medcare MSO has earned a reputation for being transparent and accessible by making it easy for our clients to contact us directly. They don’t have to fill out a ticket and wait to see if someone will address their questions any time soon. We assign a manager to each client so there is always a knowledgeable member of our team available who knows about your particular business and can answer your questions. Give us a call today at 800-640-6409 to learn more.