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Keep yourself updated on healthcare news regarding practices and medical software. The new regulations and trends in the health industry and all that you need to know.

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Can a practice successfully outsource medical billing before the ICD-10 deadline?

Less than 140 days are left for one of the biggest changes in US healthcare industry to take place. Yes, ICD-10 is hiding just around the corner, waiting to pounce upon us on October 1. About now, most physicians are finally convinced that they cannot run from ICD-10 anymore, and many medical practices have started taking appropriate steps in preparing for the new coding system. The only problem is that they don’t have enough time left! Credible sources such as Cecil Bohannon, consultant at CTG Health Solutions, have also come out to state that the ICD-10 implementation will not be delayed any further. Statements such as Cecil’s are growing by the week.

medical billing  company

Upgrading an existing medical billing system is one of the biggest hassles currently faced by numerous practices in the healthcare community. The software and training are going to cost both money and time, and practices rarely have enough of either as it is! Industry experts have advised small and medium practices to outsource their medical billing to third parties instead of going through the trouble of make the changes themselves. The question which remains now: Can a practice successfully outsource its medical billing before October 1?

Although some physicians have given up on the idea by now,  you must know that it’s still achievable. Physicians should first make a list of Medical Billing Services that have experience dealing with specialties similar. The selection process would take a couple of days because practices must be careful while choosing their vendor. The medical billing vendor you choose must have good online reviews and ratings. That’s because if current clients aren’t satisfied with their services, there’s little chance that you will be. It should also have a well trained team of coders and billing specialists who are up-to-date with the recent healthcare and coding regulations. Most of all, the vendor must increase the practice revenue by reducing the number of claim denials.
Once the practice has entered a contract with a suitable medical billing service, the next step is to formulate a plan for ICD-10. The plan must be divided in two phases; pre ICD-10 and post ICD-10. The practice and medical billing service must collectively decide on timelines for each step of the phase. These steps include patient data transfer, documentation training for physician and office staff, coding training for billers and pre-testing of ICD-10.

It is confirmed that medical practices will suffer from a direct revenue loss after ICD-10 for some time, which is why it is necessary for practices to make plans for post ICD-10 as well. The plan for post ICD-10 includes managing the financial budget as well as keeping a follow up plan for the ICD-10 workflow strategy. This way, any loopholes in documentation or billing process that are affecting practice revenue can be identified and improved.

Outsourcing medical billing is the best current alternative for physicians who own small practices and cannot afford in-house billing in such a short period. As mentioned earlier, ICD-10 is set to be implemented this year, so medical practices must starting looking for suitable vendors immediately to meet the deadline.



Outsourcing Medical Billing Services – A smart move for small practices

Changes in the healthcare industry have put a lot of financial pressure on small practices that has made management of clinical and medical billing department a daunting task.

In order to reduce costs and manage day-to-day workflow efficiently, small practices should outsource their Medical Billing to professional companies. Following are some benefits that small practice physicians can reap from outsourcing their billing services:

More time and focus on patients

Unlike large practices and hospitals, a small practice has limited human and financial resources to carry out different functions of the practice. This burdens the staff and they are not left with enough time to attend to the patients.

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By outsourcing billing services, physicians manage to reduce half the workload of their staff. They don’t have to sort out bills, create charge and submit claims on time. This gives them enough time to focus on providing quality care to patients.

Save your practice money

Outsourcing billing costs significantly less than paying salaries of a designated in-house biller and accountant. You can also save the cost of space, which can be rented out to another physician. There will be no hassle of maintaining a desktop computer and updating medical billing software.

Reduced errors result in increased revenue

Medical billing companies have professional, certified billers who are experts in their work. They know which code is correct and how to create accurate claims that have minimum to no chances of being rejected or denied.

These professional billers are familiar with intricacies of billing process and know requirements of different specialties. A professional billing company will have separate billers for different parts of the process, so that they create accurate claims and maximize payments for the practice. This will result in timely insurance payments that ensure steady growth in the revenue of the practice.

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Improve Medical Billing Process to increase patient satisfaction

A carefully designed and efficient medical billing process not only affects practice revenues, but also patient satisfaction. Medical practitioners should ensure an effective payment procedure, so that patients are provided with satisfactory customer service.

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Ensure high percentage of claim acceptance

If your medical billing department submits clean and accurate claims, then there is high likelihood that you will be paid within 30 days. There are certain exceptions like HMOs, but majority of the accurate claims are accepted and paid on time.

Similarly, if you closely analyze the paying habits of the payer, then you can alter your front-desk’s payment collections procedure accordingly. This is particularly important for creating error-free claims.

There are several reasons claim are denials due to an inaccurate claim. Most notable have been incorrect patient’s demographic and/or insurance details. While making appointments on the phone, make sure to take complete insurance information, so that you can verify it and have a medical billing plan ready for the patient when he/she arrives at the practice.

Sometimes, the front-desk staff – unaware of the patient’s insurance plan – charges lesser co-pay than determined in the insurance contract. When he will be sent a billing statement including remaining amount of co-pay, he is not going to like it.

The front-desk staff should make it a habit of verifying demographic and insurance details of every patient – including recurring ones. There have been several cases in which patients have been billed on their old home or office address that result in late payments and unnecessary hassle for patients and practices.

The billing system of a practice, big or small, is complex and requires lot of effort. However, these simple and effective changes, if implemented, can make the medical billing system efficient and increase customer service satisfaction.

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Outsourcing medical billing to comply with HIPAA

The changes providers must go through to ensure that their practices are in compliance with HIPAA are extremely challenging. How do outsourcing medical billing and collections help satisfy these HIPAA requirements is a simple process; but one many fail to understand.

Here’s an overview of how outsourcing billing can help your practice overcome these hurdles and become HIPAA compliant.

With the distraction of insurance claims and billing, common problems numerous practices encounter are those of dissatisfied physicians, employees and patients. With outsourcing, your practice is free from those distractions and all its employees can focus on ensuring enhanced patient care and managing other aspects of your practice.

The revenue cycle management company to whom you have designated this service possess both the tools and the knowledge to ensure that your billing and collection is done in a HIPAA compliant method.

A suggestion to you would be to select an Electronic Health Record (EHR) and Practice Management (PM) software vendor that offers the billing service. This way, many compatibility and functionality issues can be avoided.

Privacy is another concern many practices have when outsourcing the billing service. For that, you need to carry out a bit of research about the billers to see if their system has a central dashboard for maintaining privacy history and patient authorization management; these ensure that privacy-related patient information is organized properly and there are less chances of data mismanagement.

Moreover, the software should have a user tracking log to identify who accesses what data. Additionally, patient privacy summaries for all patients will indicate the up-to-date privacy statuses of all patients.

Furthermore, outsourcing companies help with compliance forms and reports which in turn help practices track compliance activity.

Other HIPAA-related benefits of outsourcing billing include the organization of all migrated data to HIPAA-compliant transaction formats. This helps ensure speedy and clean transmission and processing of claims. Payer, clearinghouse and billing guidelines are followed by these companies to make sure that changes to code sets, rules, and other payer requirements are satisfied.

These are just a few of the ways in which outsourcing medical billing will help your practice comply with HIPAA. To find out more, do give this whitepaper a quick read.