Tag Archives: claims

Why Outsource Medical Coding?

Posted on January 31, 2015

Medical coding outsourcing is the easiest way to submit claims quickly and accurately, while enhancing your reimbursements and maximizing your revenue.

It is mandatory for hospitals, clinics and healthcare organizations to submit claims quickly and accurately. The two main factors that go into approving or denying a claim are speed and efficiency. For medical coding to be done right, high accuracy combined with lightening speed in the insurance claims filing process is required.

What is medical coding?

Medical coding refers to the process of documenting the healthcare services provided to a patient by a healthcare service provider like a physician, hospital or nursing home. A medical coder would abstract the details listed in the documentation, assign the relevant codes and create a claim for payment, which would be paid by the patient, insurance agency or CMS.

Medical coding for specialities

Apart from availing regular coding services, your hospital or clinic can also get access to medical coding services for a range of specialities like Radiology, Cardiology, Paediatrics, Physical therapy, Endocrinology, Pathology, Oncology and Gastroenterology to name a few.

Why invest in outsourcing?

Since medical coding is tedious and time consuming, it is best outsourced to professionals. A medical coding service provider in India can not only provide you with quality services, but can also help you to save on precious time, cost and effort which can be invested into your core business functions.

Through outsourcing, your hospital or clinic can get access to the services of certified medical coding specialists who can provide your hospital with a host of services (CPT, ICD and HCPCS (Level I and II medical coding) that will significantly enhance your reimbursements and impact your revenue. With a team of experts coding your claims across varied specialities, you will not have to worry about errors that result in denials, rework or lower reimbursements.

Top 5 benefits of outsourcing medical coding

  1. Avail HIPAA compliant medical coding services
  2. Reduce your current operating cost by a whopping 60%
  3. Stay assured of 99.9% accuracy in your medical coding
  4. Leverage the skills of trained, qualified and experienced medical coding specialists
  5. Get access to the latest medical coding software and best practices

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Six Ways to Improve Your medical Billing Process

Posted on October 31, 2014

Since cash flow is critical to the success of your medical practice, it is of utmost importance to complete your billing process quickly and efficiently. This means submitting correct claims and receiving the proper reimbursement. Here are six things that you and your medical billers can do to ensure a high success rate in your medical practice:

1. Get familiar with LCDs: Ensure that your medical billers are familiar with Local Coverage Determination and their relation with specialities and billed services. By knowing about LCDs, you can understand when a Medicare carrier will cover a procedure and under what circumstance. This can help you ensure that your claims are correctly submitted and reimbursed on time.

2. Review submission reports: You can use and review your submission reports to verify if your claims were submitted and received by the payers. Since these reports will also reveal which claims were rejected and the reason why, you can steer away from potential denials and also ensure that your claims are corrected. With all the errors rectified, you can resubmit your claims.

3. Work on your denials: Both insurance companies and medical billers can make mistakes. At times a claim can be billed correctly, but the insurance company can make an error and deny it. This is why your medical billers should come up with a regular schedule in which every denial should be worked on. Also ensure to continue with regular follow-ups, until all your denials are paid.

4. Make appeals, if needed: Payers may not always follow coding guidelines, so at times, you may have to make an appeal. Take some time off to write out letters, gather the proof and submit your appeal to the insurance company. Based on your appeal, you could receive payment on your claims. Continue reading →