Marketing is the hardest part of medical billing for most owners of medical billing services. Billing, entering charges and payments, submitting the claims, following up on denied or unpaid claims, that's the easy part. Getting the clients is usually what holds most people back. Dan Kennedy (a very successful marketing consultant) says that "marketing is not something you learn, it's something you do". He's absolutely right.
We all know ways to market. Some are easier than others, some cost more, some require us to get out of our comfort zone. It's not that we don't know marketing techniques. In most cases it's that we really don't like to market. Nobody likes rejection. I don't think anybody gets up in the morning and says "Yes! I should get about 20 'no's' today!" So we avoid it. But it is a very necessary part of a successful billing service.
Avoiding marketing only hurts ourselves. It doesn't hurt the providers we aren't marketing to. Unless you truly believe that you are the only billing service out there that can provide the service to get them reimbursed all that they are entitled to. Avoiding marketing prevents you from growing, and taking your business where you want it to go.
OK, so we've established that marketing is a necessity to grow your business. So what can one do to make marketing less painful? Well one strategy is efficiency. If you develop your marketing to target providers that will most likely be interested in using your service you will reduce the number of 'no's' you will get. For example, if you specialize in a certain field then you would want to target your efforts in that field since you can use your expertise in that field as leverage.
Another way to make your marketing efforts more efficient is to do some research about the providers you are going to market to. If you have some clients, you can ask them if they have any colleagues that they feel may benefit from your services. Doctors talk to each other. They know who is having issues in their offices. If you are doing a good job for your doctor, they should be willing to refer you to others. Make sure you ask if you can use their name. It always helps to say "Dr. Soandso suggested that I contact you."
The best way to make marketing less painful is to do it smart and make your marketing efforts more effective.
Mother and daughter, Alice Scott and Michele Redmond are coauthors of 14 books on medical billing including "Secrets to Signing Up Your First Doctor". They offer a marketing program, consulting services, a free monthly newsletter,an active medical billing forum and maintain two informational websites on medical billing.
Article Source: http://EzineArticles.com/6535884
Effective Marketing for Your Medical Billing Service
Medical Billing Services: Percentage Vs. Flat Fee Pricing Structures
As the business of running a medical practice becomes more competitive, many practices are turning to a third-party medical billing service for cost effective solutions to maintain maximum profitability. In evaluating any medical billing service agreement there is an array of factors that should be taken into consideration - pricing of services is principal among them. This article compares the two most common pricing approaches offered by medical billing services - Percentage Based Agreements and Flat Fee per Claim - and identifies some of important points to remember when selecting a medical billing service provider.
Percentage Based Agreements:
Probably the most common approach to pricing by medical billing services is the percentage based agreement. In this type of agreement, the medical billing service's fees to the practice are based on a percentage, usually in one form or another of the following:
* Percentage of collections,
* Percentage of gross claims submitted by the billing service,
* Percentage of total collections for the overall practice.
With the first type above, percentage of collections, the medical billing company charges the practice only on net received for those claims in which it has directly assisted in collections (typically excluding monies collected at the office, such as co-pays, deductibles, etc.). This is the purest example of how a percentage based agreement will tie the medical billing service's success to the practice while safely limiting it to that which they have some measurable ability to affect. This type of percentage based agreement benefits the practice by its "self-policing" quality- the medical billing service only makes money when the practice makes money.
In our second type, percentage of gross claims submitted by the billing service, the practice is charged a percentage of the total amount submitted to insurance companies and other payers. This can be tricky for two reasons. First, the rate billed to an insurance company is not always the same as the negotiated rate that will be paid. So a seemingly competitive percentage from one medical billing service can be drastically different from another medical billing service depending on where the percentage is applied. Second, some of the incentive mentioned above is removed for follow up on claims as there is no tie-in to the results of medical billing service's submissions.
With a percentage of the total collections for the overall practice, the billing service charges for the total net received by the practice. It includes co-pays, deductibles, and any other monies collected at the office, not just by the service. This arrangement is most commonly found with full-scale practice management companies who not only handle medical billing but might also administer staffing, scheduling, marketing, fee schedule negotiations, etc. In this arrangement, the medical billing service can be driven by incentive to follow up on claims with payers, but gains some protection to its revenues through the other sources of payment coming into the practice.
Rate Variability within Percentage Agreements:
A medical billing company will consider several variables in defining the rate charged to the practice in a percentage based agreement. Rates can range from as little as 4% to as high as 14% or even 16%! Factors influencing this variability include claim volume and average dollar amount of claims, as well as service considerations like level of follow up performed by the medical billing company, whether or not patient invoices will be sent by the billing company, and many others. Let's take a look at some examples of how these variables influence medical billing service rates.
EXAMPLE 1:
Regarding claim volume and dollar amount, let's consider the example of practice A and practice B. Both are looking for a medical billing service offering claim generation, carrier follow up, patient invoicing and phone support. The average claim for practice A is $1000 and they average of 100 patient encounters per month. Practice B has an average claim of $100 with 1000 encounters per month. While the gross amount billed is the same, the difference is staggering for the billing company who will need to project nearly 10 times the staff hours for practice B to yield the same return as from practice A.
EXAMPLE 2:
With respect to services offered, let's consider practice C and practice D. Both practices average around 1000 claims per month, and each claim averages around $100. Now, practice C is looking for a billing service to handle complete claim lifecycle management- carrier follow up, submission to secondary and tertiary insurances, patient invoicing and support, report analysis, etc. Practice D collects patient balances at the office so they don't require invoicing services, and they plan on doing the carrier follow up themselves. Thus Practice D only requires the medical billing service generate and submit initial claims to carriers, and maybe submit a few secondary claims each month. In this example, the gross claims submitted is roughly the same, but practice C might anticipate a fee significantly higher - potentially double that of practice D - due to the extensive work involved in providing these other support services. (Keep in mind practice D will also need to consider additional staffing to perform these activities in-house, which will most likely not offset the cost of allowing the professional medical billing company to manage the process.)
These two examples clearly demonstrate the basic factors that influence the rates when considering percentage based medical billing services. While there are numerous negotiating points where a practice can save on general costs, they should consider what other costs may arise later to manage the services not provided by the medical billing company.
Pros of Percentage Based Agreements:
* Percentage Based Agreements directly tie the success of the billing company to the success of the practice if they based on collections.
* Practices can often choose which services they require for potential short term savings.
Cons of Percentage Based Agreements:
* Short term savings garnered by keeping some billing activities within the practice can lead to long term costs in additional staffing.
* Small claims may not be addressed as vigorously. For example, consider a $5.00 patient invoice with a medical billing service charging 8% on collections. The medical billing service would actually lose money in pursuing the claim. Adding up the cost of postage, envelope and paper, as well as staff time for printing, stuffing and mailing, it would be more than the $0.40 that would ultimately trickle back to the service.
Flat Fee per Claim:
Another common approach to pricing offered by medical billing services is what we'll call Flat Fee per Claim. With flat fee pricing the medical billing company charges a fixed dollar rate for each claim submitted, regardless of the size of the claim.
Similar to percentage based agreements, flat fee per claim pricing can vary significantly depending on the volume of claims and the extent of services provided. In its most basic form, a fee per claim medical billing service might provide only claim generation and submission services for as little as a dollar or two per claim. In this case it would be the practice's responsibility to follow up on claims. Of course flat fee per claim pricing can also include other services such as follow up with carriers, patient invoicing, etc. With these additional services, practices might expect costs to increase to $4, $5 or even $7 per claim or more.
Dependent on the practice, the flat fee per claim can be cost effective, but should be considered carefully. Follow up with insurance carriers and the bureaucratic problems should not be overlooked. In some cases, once the medical billing company has submitted a claim, they might make a phone call or two; but they've done the submission and the transaction is billable to the practice, regardless of how it's paid out. Fee per claim pricing doesn't have the inherent incentive like some types of percentage agreements. Nonetheless, it can be the solution if you have the resources to manage the follow up, or if your familiarity with the medical billing service is strong enough to trust in their follow up.
Pros of Flat Fee per Claim:
* Fee per claim pricing has the potential to be more cost effective, particularly on higher priced individual claims.
Cons of Flat Fee per Claim:
* If carrier follow up is included with this service, the medical billing company has little incentive once the initial claim has been submitted. Moreover, it can be near impossible to evaluate how rigorously a medical billing service is following up.
* If carrier and payer follow up is not included with the service, the practice must manage it in-house. Inevitably, hiring and training new staff or allocating time of existing staff leads to increased overhead, often offsetting the benefits of using a medical billing service in the first place.
Hybrid Approach:
The final example in this discussion is what we'll call the Hybrid Approach, which takes advantage of percentage based agreements and flat fee per claim approach. Through this pricing method, a medical billing service might apply a percentage to certain insurances and patient balance bills, then apply a fee per claim for others. This approach is usually siloed by carrier or claim type, in that it would use the percentage for all claims to carrier X, and flat fee for all claims to carrier Y.
The hybrid approach has become more common in certain areas of the US over the past several years as some insurances frowned upon percentage based agreements. An example was seen when the state of New York rendered percentage contracts on state Medicaid claims illegal, requiring medical billing services use the flat fee per claim option. The principle concern arises from a few unscrupulous billing services who believe "up-coding", or submitting false claims for higher priced services, is the easy way to increased profits. While these few services threaten to tarnish the reputation of an entire industry, those bona fide medical billing services seeking long-term growth and profitability clearly realize that small gains won from illegal activities are no way to sustain a successful business.
In short, the hybrid model allows honest billing companies the chance to tie their successes to that of the practice while respecting the concerns of those insurances guided by formal legislation.
Summary
When medical providers and practices consider teaming with a medical billing company, they have an array of options. Flat fees per claim may appear more cost effective in the short-term, but the potential for revenue interruption due to poor follow up by the medical billing service provider, or the need to hire and train additional in-house practice staff to handle the follow up on its own, will undermine the initial cost savings to the practice. Agreements based on a percentage of collections are self policing and ensure the medical billing service will pursue reimbursements rigorously.
Learn more about pricing by medical billing companies through Diversity Technology, Medical Billing Services [http://www.DiversityTech.com/]. As a leading provider of medical billing services for healthcare practices across the US, Diversity specializes in percentage based medical claim lifecycle solutions.
Article Source: http://EzineArticles.com/81239
Where to Acquire Medical Billing and Coding Certification
Medical billing and coding refers to the process of making claims on insurance companies and following up such claims to cover the medical expenses of the policyholder. Most medical coders are employed by hospitals, private healthcare organizations, and other agencies that offer healthcare services. Medical coders typically earn a lot, which is why a lot of people want to explore this kind of career path. Those seeking employment as a medical coder has to acquire a medical billing and coding certification first before being qualified for the job. While there are some people who manage to secure employment as a medical coder without a certificate, having one will give you an edge over others, as most health institutions prioritize those with certificates.
To qualify for a medical billing and coding certification, you will first need to pass the coding certification examination. The test will cover everything you need to know as a medical coder, these include codes, HCPCS procedures, as well as ICD-9-CM so that you can properly accomplish your duties. Most medical coders are required to undergo formal training and education in the field of medical billing and coding. You can opt to get your education online if you don't have the time to attend formal classes, as a lot of educational institutions offer programs online.
There are a lot of employment opportunities for those with a medical billing and coding certification, especially since the demand for medical coders both employed by public and private institutions are expected to experience a steady growth over the next decade. While you can't expect to earn so much when you are just starting out, you can opt for positions with higher salaries once you have enough experience. It is also a lot more likely that you would be paid more if you had proper medical billing and coding certification by an authorized educational institution.
Since there is a lot of technicality involved in medical coding, it is better to acquire formal education to get a good grasp of protocols and procedures. It is worth noting, however, that you can choose to get your medical billing and coding certification from different agencies, which includes; American Health Information Management Association or AHIMA, Registered Health Information Association or RHIA, and Registered Health Information Technician or RHIT. Medical billing and coding certification from AHIMA is typically acquired by those who are relatively new to the industry, as acquiring certification from this agency does not require much experience. If you have enough experience as a medical coder, then getting certification from the Professional Association of Healthcare coding specialists will be a great asset to you, as they issue certification for those who have experience with specialty coding. Professional medical coders who have high levels of expertise when it comes to specialty coding are highly in demand, as they are not as abundant as those with AHIMA certification.
There is a wider range of career options for someone who has a medical billing and coding certification, as this certification means that they have pursued their education in this field and have passed all qualifying exams to prove that they are eligible to practice as medical coders.
Times are tough!
If you are looking for a new career and wanting to find out more about Medical Billing and Coding Certification click on the link or go to our website about Medical Billing Schools
Article Source: http://EzineArticles.com/?expert=Eric_Dean
Medical Billing Services
Medical billing services are companies that take the pain of collecting money out of the doctor's office. A good service will maximize a doctor's receivables, while keeping their cash flow consistent. The key is choosing the right medical billing service.
A great service will submit insurance claims timely (preferably electronically), track the payments, follow up on unpaid claims and deal with all denials. They will not let any claim go unpaid.
Representatives of the service will attend insurance company seminars, advise the doctor of changes in their field and provide them with regular financial reports. They should not only handle the billing needs, but should act as consultants for the doctor, advising of fee structure, coding practices, and other ways to improve the office.
An obvious way a doctor can save money by outsourcing his billing is in the savings he will generate through payroll, equipment, software support, updates, postage, forms, etc.
Outsourcing medical billing produces more than cash savings. A good service can maximize what the doctor actually brings in by collecting more money than an in-house staff can. In most offices, the in-house staff does not have the time, or the knowledge to handle the problem claims and the doctor ends up not getting reimbursed anything for those services.
By outsourcing, a doctor is hiring a professional. Medical billing services have the expertise to submit claims accurately, collect on all claims, even those that have been denied by the insurance carrier. This helps the doctor's patients by avoiding billing the patient for a claim that should have been paid by the insurance carrier.
A doctor should avoid choosing the wrong service by carefully checking references. A doctor should call several other doctors who might be using a particular medical billing service.
When a doctor interviews a potential service, what is his overall impression of the people who will be handling his income? During the interview, he should pay attention to how they answer his questions. Are they confident in their answers? Are they correct in their answers? Does what they offer make sense?
Like many other fields, there are good and bad billing services. But medical billing services can be a great resource for a doctor if they are careful to choose the right one.
Michele Redmond is co-owner of Solutions Medical Billing and has been in business since 1994. She has a bachelor’s degree in Computer Information Science and is responsible for the electronic claims submissions for over 50 providers. For more information on clearing houses and other alternatives for electronic claims submissions visit her website at http://www.solutions-medical-billing.com
Article Source: http://EzineArticles.com/172592
Electronic Medical Billing
Electronic medical billing is fast becoming the standard of choice in medical offices for many reasons. The old medical billing process using paper invoices is not suited to the demands of the modern medical office, and so is going by the wayside.
Doctors are being squeezed financially with all the demands and expenses of the modern medical practice. Electronic billing is one area in which they can reduce their paperwork and increase their profits.
Medical electronic billing has a number of distinct advantages over the old way of doing things. Let's take a look at some of the reasons that electronic medical insurance billing is a vast improvement.
* Electronic medical insurance billing eliminates paperwork and the errors associated with it
* Cuts way down on rejections by insurance companies
* Integrates aspects of the billing process between hospitals and insurance companies
* Medical electronic billing reduces paper costs
* Reduces the need for administrative personnel which increases profits
* Speeds up the process allowing for claims to be paid more quickly
* Able to securely store and retrieve patient information
* Support for mobile computing devices allowing work to be done outside the office
* Ability to generate varied reports, track payments, establish schedules, ect.
* Scalability and increased efficiency in the billing process
* Easier compliance with data security and medical data compliance standards
Electronic medical billing is rapidly replacing paper based billing and brings with it a whole new set of advantages, but also some challenges. As a medical billing and coding professional, you depend on the systems you use to meed the standard of proficiency that your clients require.
There are two forms of software application that you must be aware of when dealing with electronic billing. These are called client server and application service provider. Both of these software models offer full functionality in the billing process, but you need to become familiar with the differences and those the one that best suits your business model.
You must choose the system you use wisely, and must research all of the commercial systems and their software before making a choice. Seeking the advice of colleagues in the field who have had experience with medical electronic billing is a good idea.
Electronic medical billing will completely replace the old billing systems in the next few years. As a medical billing and coding professional, you will need to be familiar with all aspects of it, and be prepared to maximize its efficiency and functionality to better serve your clients, and position yourself to win more business and maximize your profitability!
George Parigian Jr. is age 56 and has lived and worked in the Boston area all of his life. He is a 1978 graduate of Northeastern University, and a personal trainer. He writes and consults on the topics of antiaging, health, and exercise.
Article Source: http://EzineArticles.com/6502409
Outsource Medical Billing - Boost your Refund
Outsource medical billing service is the solution for them who want to make their medical and health care practice well-organized. Outsource medical billing services useful because it optimizes medical billing process, maximize profits, reduce administrative costs for hospitals, pharmacies and other providers of health care, increases effectiveness and allows to give more focus on business.
Outsource medical billing services such as:
- Insurance enrollment
- Insurance verification
- Insurance authorizations
- Scheduling
- Coding
- Billing and reconciling of accounts
Importance Of Medical Billing Services
The medical billing is the process interaction between a health care provider and the insurance company. Medical billing is the process of collecting fees for medical services. A medical bill is called a claim.
The purpose of medical billing is to ensure that the provider a fair remuneration for the services receives. Medical Billing is essentially an interactive process between the institutions registered physicians or other service providers in health care and insurance legitimate. So, this is the presentation and monitoring of medical billing by the former to those countries deal with financial compensation.
In recent time hike in outsourcing of medical billing medical institutions or practitioners typically face loss of control--specifically, the ability to know at any given moment the precise amount billed or collected and the amount outstanding.
The successful medical billing business alliance on the use of complicated medical billing software, designed specifically to handle the processing and the contact management associated with the process.
With the advent of the computer age - and the growing demand for medical conduct online billing fulfill several computers and a software company develops specialized medical billing software to this potentially profitable segment of the address of health services on the market.
Medical billing specialist is responsible for accurately recording and processing data about patients, such as treatment records, insurance information, bills, and received payments. Medical billing specialist may work in different place such as hospital, doctor's office, physical or mental treatment facility, or any types of other health care institution.
Features of Medical billing services:
• Speedy and easy access to the individual or businesses;
• Efficient follow-up processes;
• Convert superbills to claims, with proper charge application, taxes and discounts
• Manage patient data – demographic and incurred charges
• Bill patients for deductibles and co-insurance And many more
With the speedily changing needs of the accounting and settlement, employees of the Medical Billing provider’s security and trust, outsourcing medical billing full attention is given to financial interests; so that you can focus on what you do best, namely the provision of quality health care.
We at Medical Billing Outsource offer a complete medical billing solution to your medical billing and practice management needs. Our experienced medical billing specialists will work remotely within your current billing platform.
So, get more information at http://www.medicalbillingoutsource.com/ and email at info@medicalbillingoutsource.com
