Medical billing services offer a tantalizing proposition: healthcare providers
leave the billing legwork to the experts, and watch their collection ratio increase
as a result. Besides benefiting financially, the provider gets to focus on what
matters most--patient care. Its no wonder third-party medical billing services
are quickly becoming the industry standard. Heres what to expect when signing
on with a medical billing service.
A Closer Look at Medical Billing Services
billing services range from simple claim submission to comprehensive
practice management. Home-based and smaller professional organizations may
limit their service to billing-specific tasks. Practice management companies
take a more holistic approach, offering everything from marketing to scheduling
Standard billing services include:
Insurance claim submission. Typically, the provider will use electronic billing
software to transmit patient demographic, insurance, and encounter data to
the insurance carrier.
Insurance follow-up. This is where most clinics realize the value of a third-party
billing service. A good service is experienced and tenacious in following up
on the claim with the carrier, which has, as one expert puts it, an enormous
effect on reimbursements.
Reporting and analysis. Billing
services typically prepare a monthly report
and can make recommendations on how to increase profitability. These reports
offer a deeper and more customized look at key metrics, helping businesses
identify strategies for growth and cost savings as well as greater billing
Patient invoicing and support. Billing
services take care of the logistics
of sending bills and fielding patient inquiries.
Extended Billing Services include:
Medical coding. Some billing
services will take over this initial step, coding
the diagnosis in preparation for entry into the medical billing software program.
Transcription. Transcription of medical records precedes the coding stage.
Though transcription is not a billing process, many billing
this related administrative service as well.
Credentialing. A real asset to new clinics, credentialing services take care
of the paperwork needed to initiate a relationship with an insurance carrier.
Practice Management Services include:
Financial services. Insurance claims collection is just the beginning of a
practice managements financial services. Accounts payable, bookkeeping, tax
planning, and budgeting are available extensions of the standard billing
Contract negotiation. Negotiating with managed care representatives and hospitals
can strain a private practices resources. Practice management companies have
the expertise to negotiate effectively on their clients behalf.
Human resource services. Payroll, benefits program design, staffing, and employment
contracts can be outsourced to a full-service medical management service.
billing services offer small private practices, clinics, and hospitals
a cost-effective way to handle the increasingly complicated administrative
tasks associated with insurance and patient collections. No healthcare provider
is sorry to see these onerous tasks go. Especially given that in this case,
the reward for passing the buck is a boost in revenue.
American Medical Billing Association
Medical Transcription Daily
Preferred Health Resources
Using Medical Billing Companies