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 →
Should we outsource medical billing to a third-party service provider or perform it in-house? This is one of the most important business questions that physicians of today ask. While some physicians feel that outsourcing is the best option, others want to maintain control over their collections through in-house medical billing. So, how do you know for sure if your medical practice or hospital should outsource medical billing?
Here are five signs that your hospital requires medical billing services. If your healthcare clinic is facing one or two of the following scenarios, then you may want to consider outsourcing medical billing services to India.
1. A high staff turnover: The problem of turnover is something that every industry faces, but turnover in the billing department can be very damaging. Since claim processing is integral to the lifeblood of a practice, replacements or new additions to your billing department will unavoidably lead to a slowdown in the processing of your claims.
2. An inefficient billing process: If your hospital has been seeing your collections drop, while the time to collect them keeps increasing, your clinic may be facing issues in your medical billing department. If you outsource billing to an experienced service provider in India, you can successfully reduce the number of rejected claims and also decrease the time it takes for your hospital to receive payments from payers.
3. A lack of technology know-how: If you are to carry out effective in-house billing, then you will need to make investments in the latest practice management software. Apart from buying and regularly updating the software, you will also have to provide adequate training to your staff. If your hospital does not want to handle technical issues or software upgrades (which can take up valuable time and effort), then think about outsourcing claims processing. Continue reading →