There are a lot of medical billing companies to choose from and most medical providers don’t have a lot of time to invest in researching them—but hiring the right one will make a huge impact on your bottom line, so getting the information you need is certainly worth the effort.
Medical billing is very interesting to us, but we understand it isn’t that intriguing to most people, so we’d like to give you some useful information that will help you make the right decision when you are ready to hire a medical billing service.
The Top Requirement for Efficient Medical Billing
Like any business that you partner with, there are many characteristics that medical billing companies must have: integrity, communication, expertise, etc.; but the unique aspect that is required for success with medical billing, in particular, is an efficient system for revenue cycle management (RCM).
The primary goal of medical billing companies should be to get the maximum possible total reimbursements for services you provide to patients. There are many processes involved in this business overall, and each has multiple steps where claims can be dropped, with the result being that you never get paid for that service.
Medical billing companies must have a proven system for processing and tracking all claims from first patient contact until the bill is paid by the insurer, and the patient if there is any remaining balance due. This requires having multiple experienced billers and management roles that are responsible for keeping track of claims and making sure someone follows up and resolves any rejections or denials.
Working with a medical billing company that has a system in place for tracking claims from beginning to end has two major benefits. One, it gets the maximum reimbursements for your services. Two, the system ensures that payments are being handled, so you are free to return your attention to providing care for patients.
The Ideal Medical Billing System
Every medical office will have some unique requirements and each specialization has some codes and procedures that are unique to it, but the medical billing company’s system should be designed to cover all the common aspects and be customizable to meet the specific needs of any practice.
The most important part of the system is a method for tracking claims. Most medical billing services will have a process for filing claims. The best ones will have a system that gets claims completed, scrubbed and submitted in a short amount of time. Ideally this will only be 24-48 hours from the time the patient is seen, so that it is easy to get questions resolved and there is little opportunity for the record of the appointment to be lost before the claim is filed.
Claims Must Be Tracked After They Are Filed
Having each claim scrubbed by an experienced medical biller before it is submitted will cut down on rejections and make reimbursements come much more quickly. For a number of reasons, there will still be some rejections and denials. The best medical billing system will include tracking each claim.
Medical practices have been found to lose up to 25% of potential income due to unpaid claims, many of which were simply abandoned when they were denied or rejected. Even a tiny error, such as a misspelled name or incorrect date, will result in a claim being rejected. It takes some time to find the error and resubmit the claim, but it is an important part of medical billing.
An efficient system will include a process for checking each of the most common errors to quickly get corrections made. When a claim is denied by the payer, resolution is usually more involved than simply finding a small error, but, again, a good system will include steps to be followed that help an experienced biller determine what the issue was and obtain the correct coding to appeal the denial.
Employing the services of experienced medical billing companies like Medcare MSO has proven to increase revenue and reduce stress for medical practices of all kinds. There are many questions that should be asked in determining which one is right for your practice, but ensuring that the billing service has a system in place for tracking claims and reporting results to you is a must.