Your Medical Billing Company Should Do Much More Than Just Submit Claims

What We Need to Worry About Before Choosing a Medical Billing Company

There are a lot of different medical billing companies out there

So how do you know which one is right for you?

Here are a few things to consider when looking for a medical billing company:

1. Does the company have experience with your specific type of practice?

Some medical billing companies specialize in certain types of practices, so it’s important to make sure they have experience with yours.

2. What is the company’s reputation?

Ask around and see what others have to say about the medical billing company you’re considering.

3. What do the company’s fees look like?

Make sure you’re getting a good deal and that the company’s fees are reasonable.

4. What is the company’s customer service like?

You’ll want to make sure you’re working with a company that is responsive and easy to work with.

5. What kind of technology does the company use?

Make sure the company you’re working with is using up-to-date technology so that you can be confident your billing is being handled efficiently. By considering these things, you can be sure to find a medical billing company that is a good fit for you and your practice.

Why do Medical Billing Companies do much more than just submit Claims?

As a medical practice, you have a lot of things to worry about without having concerns about your medical billing. That’s why it’s so important to have a reliable medical billing company that can handle everything for you. But, what exactly should your medical billing company be doing for you?

At a minimum, your billing company should be submitting claims to insurance companies and following up on those claims. But, there’s so much more than a good medical billing company can do for you. For example, a good company will also keep track of your payments and make sure that you’re getting paid on time. They can also help you appeal denied claims and work with insurance companies to get claims processed more quickly.

In short, a good medical billing company should be a true partner in your medical practice, working to help you run your business more efficiently and effectively. There’s no question that submitting claims is a primary function of medical billing, but if you leave it at that, you will lose a lot of potential income. There is more to the claim submission process in medical billing than just filling out a form and sending it in, and the additional steps are things that a billing company can do for you.

Claims Must be Scrubbed Before Submission

Even if you are doing your own claims instead of contracting with a billing company, “scrubbing” medical claims should be part of the process. An experienced biller should be reviewing all claims after the coder enters the information. They need to check informational details like:

  • verifying correct dates
  • ensuring patient name

All Rejections and Denials Should Be Managed

Reworking claims that are denied or even rejected without being processed due to missing or incorrect data can be time-consuming—however, dropping these claims has resulted in billions in revenue being lost. Medcare MSO excels at reworking claims because we have developed a system that allows our billers to quickly determine what the problem is and get it corrected. Any medical billing company that is handling your claims should be prepared to deal with all claims that do not get paid and keep track of them until they are resolved. It takes skill to do so effectively so that the process doesn’t cost more than the value of the claim, but having an efficient system and trained staff makes it possible.

Accounts Receivable Should Not Be Abandoned

Another area where huge losses of potential revenue occur is old accounts receivable, or old AR. The longer a bill goes unpaid, the less likely it is to get paid, but that doesn’t mean you should give up. Often, the reason patients don’t pay their bills is that they don’t understand what they are being charged for. Or they may not know why their insurance didn’t pay it.

How to Choose a Medical Billing Service?

A medical practice management system should include a process for tracking old AR accounts and providing clear communication to patients that will help them understand their bills. Again, the secret to success is to have a system in place that makes it simple to stay on top of bills and reach the responsible parties. A medical billing company can take care of that for you.

Insurance Verification and Approvals Can Easily Be Outsourced

Seeing a patient without making sure that their insurance covers the visit or any treatments given means you won’t get paid. Checking on each patient, every visit, is time-consuming, but necessary. Let your medical billing company take care of it. The medical claims process really starts here, with verifying that a claim can legitimately be submitted. Medical billing staff in a company outside your office can focus on just this task, unlike in-house staff who must also take care of patient business. Likewise, preauthorization, or precertification, is a necessary part of the medical practice management system that can take away from giving attention to patients. A good medical billing company will have trained staff who are familiar with the process of dealing with insurers and obtaining the necessary authorizations.

Get Help with Credentialing for Insurers and Government Payers

You not only have to be confirmed as being qualified to deliver medical services before you can get paid, but in many cases, you also have to be approved to be “in-network” with the payer. It is a process that can drag out over a long period of time, but it doesn’t have to. The credentialing process is just more paperwork, but it can be confusing for someone who isn’t familiar with all the documentation that is required.

Failing to submit any of the necessary information or forms will derail the process, and unless someone can stay focused on getting it done, you will continue to lose revenue. Medical billing companies like Medcare MSO, which provide additional revenue cycle management (RCM) services, can take care of credentialing and ensure the process is completed. Medcare MSO is a full medical revenue cycle management company with a great track record in increasing revenue for our clients and providing outstanding customer service. In addition to a large team of medical billers, Medcare Force is our specially trained team providing all aspects of both front and back-office services. Give us a call today at 863-640-6409 to find out how we can increase your revenue and help you enjoy your medical business more.

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