Practice management largely involves billing and finance. However, this can be a consuming task, and that is why most practices seek external medical billing services. There are a number of benefits of having these services done by professionals. The first benefit is that the medical practitioners are able to do their work easily because the practice management is handled by experts. They do not have to spend a lot of time doing the billing and financing, so they have all the time to spend with the patients.
The second benefit of getting physician billing services externally from professionals is because there is transparency. If billing is done internally by workers, there might be discrepancies because they might have vested interest. That is why it is always advisable to have physician practice management services from unconcerned parties. You are assured of honesty as they try to express their professionalism in the area of your practice management.
The medical billing services used in one practice is not the same ones that will be suitable for another practice. Practice management should be tailor made to suit the needs of the practice. The same applies to medical billing services. You cannot go and copy a billing system from another practice and use it successfully to run yours. It is wise to get medical billing services from professionals who can create solutions that have been customized for the practice. The physician billing services should be suitable for your clients and make it easy for them to pay their bills.
Revenue cycle management is at the core of any medical practice finances. However, this aspect of medical practice management is time consuming. This means that practices that have to do their own revenue cycle management might not be able to be patient-focused. Therefore, getting external RCM services enables the practice to focus on the patient. The practice management service providers will deal with all the other aspects billing, credentialing and certification. This leads to organization in the finance books.
Many clients nowadays are opting to use insurance to pay for their bills. This has further complicated physician billing services because instead of just receiving cash and checks, practices now have to deal with insurance companies. Physician billing services help practices handle such cases by taking the responsibility of filling the insurance claims. This helps speed up the process without slowing down the rate at which care is given to patients. Such physician billing services also help increase the number of clients. The clients will be assured of quick and easy billing methods even if they have insurance.
Finally, with professional practice management the revenues received by the practice will greatly increase. This means that the practice will become increasingly profitable. However, it is wise to have frequent meetings with the physician billing services providers. This allows working in conjunction with the external provider personnel to increase the success of the revenue management. This also offers practices a chance to train their staff on how to optimize reimbursements and improve performance.
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Benefits of Getting Professional Medical Billing Services
Medical Billing Services – Should They be Outsourced?
There are many home based agencies and also freelancers who offer medical biblling services. The question is, should you use a big medical-billing company or outsource to home based workers. The biggest advantage in having it outsourced is that the medical facilities will be able to save a lot of money. When you outsource you won't have to buy expensive and technical software to do the job. You won't have to take additional time to train staff members to do the medical coding services. Getting the services of a medical billihng company means your staff will not have to monitor the whole system because the medihcal billing company can efficiently maintain and also upgrade the whole process as part of the services that they provide. Utilizing their services is not only cost efficient it also means you're getting good quality service. In outsourcing you now just have to decide upon getting a home-based staff or hire a large company to do the outsourced job.
Outsourcing home-based medical billing services has many advantages. First of all it is cheaper than employing a larger firm. Usually these small companies have 1-3 staff members who can efficiently handle the whole system. The small home-based medfical billing companies can handle only a few clients and so they take good care of the clients that they have. You can be assured of a very high level of customization when dealing with the medical facility because they will only be concentrating on your system. The only disadvantage with employing a home-based medical biflling company is that they usually don't have a big enough budget to afford all the necessary programs. The necessary softwares deal with medical insurance billing, medical claim billing, medical billing and coding, and also the medifcal billing collections programs. If this is the case, then your medical facility will have to shoulder the initial expense to purchase the applications. In the event that the service provider is not available or out of reach due to some unforeseen events, your hospital or clinic will have to get one of your staff members on the system to monitor the progress. This is where employing a larger medical billging company can be more of an advantage.
Outsourcing a larger medgical billing company can be an advantage when if you are looking for a stable system, a company with a good track record and one which offers a wide range of services. It may be more expensive as compared to the smaller home-based medical billting services because there are more employees that are already well experienced for the task. The bigger professional companies are able to purchase advanced technologies, and have ample funding to properly train their staff. You don't have to worry about purchasing the softwares yourself because these big companies are already well equipped. But then there are also disadvantages with these big companies. They are more prone to security system leaks where your records will be readily accessed by other people. The most important factor to consider is the cost of employing a larger medical-billing company. Your medical facility should be prepared to shoulder hundreds or even thousands of dollars every month for their services.
If at first you can't decide on whether to employ the small company or the larger medicgal billing company, you can at first try out the services of the home-based company and see if they can accommodate all the medical billing services that you need and then later on choose from bigger professional medical billing companies in the event that your facility grows and needs a larger professional company to handle all your medical billing services.When you outsource you won't have to buy expensive and technical software to do the job. You won't have to take additional time to train staff members to do the medical coding services. Getting the services of a medical billing company means your staff will not have to monitor the whole system because the medical billing company can efficiently maintain and also upgrade the whole process as part of the services that they provide. Utilizing their services is not only cost efficient it also means you're getting good quality service. In outsourcing you now just have to decide upon getting a home-based staff or hire a large company to do the outsourced job.
Professional Medical Billing Services
Professional medical billing services are relevant and exist to ensure that practicing physicians, providing much-needed services, collect the highest reimbursement amount deserved for procedures performed. It's important to understand that hiring a results-oriented medical biller takes patience and time. You see, medical billing is not a profession which a prospective employee can just walk into; this position demands experience, knowledge and a complete understanding of the medical insurance billing industry.
If a physician isn't maximizing his accounts receivables, it is perhaps due to the fact that he is employing under-qualified personnel. This practice will negatively affect the physician's bottom line. If this is the case, consideration should be given to hiring a professional medical billing service; by doing so any such physician would ensure the business side of his or her practice is being handled properly.
Professional medical billing services typically offer a trained staff of individuals who can take care of every billing need for a medical practice.
Insurance companies are somewhat difficult with which to work if you do not know the "ins and outs" of how they function, and claims are often denied for just a minor reason. If a professional medical billing service is submitting claims, they are aware of the typical reasons for insurance claim denial, and therefore, assure that the claims are submitted accurately and promptly each and every time, guaranteeing a prompt return.
When a professional medical billing service is contracted with the practice, it will no longer be a burden on the physician and his staff, and therefore, they will be able to focus solely on patient care.
Professionals will work on the claims and submit them to the insurance company through electronic methods. Electronic submission will assure the claims are received by the insurance company within hours, thus allowing a speedy claim payment.
Professional medical billing services will also make sure that the claims go through the electronic process error and problem-free, consistently monitoring these claims to ensure there are no difficulties. If by chance a problem does arise, it can be corrected immediately and resubmitted. Please also keep in mind that professional medical billing services are known to have success rates of ninety percent or more.
Whether the practice is large or small, a professional medical billing service will assure that payment from the insurance company will be received swiftly; this could be the difference between success and failure. The majority of professional medical billing services will work for any type of practice, no matter the physician's medical specialty.
In summary, a physician owes it to himself to seriously consider a professional medical billing service [http://www.acclaimmedicalbill.com/8822.html] and what this important decision could mean to his practice's health and well-being. I wish you the best for your practice's success.
Article Source: http://EzineArticles.com/1284411
Medical Billing Service Considerations
Part of the issue is staffing. Many healthcare providers have a hard time finding and retaining qualified employees. Another concern is collection rates and administrative costs. Doctor's offices may want to compare their overhead costs with the collection rates. Healthcare providers need to know where their office stands in terms of their finances and efficiency before moving forward in their search.
For those interested in finding a medical billing service, there are quite a few factors to think about. It's important to know what these types of services do, who should use them, and also what search criteria should be used. This will help you select a provider that makes sense for your office or practice's needs.
First, what do they do? Basically, they work with accounts receivable, which means that they are responsible for billing patients and collecting payments on those bills. Billers submit claims to health insurance companies, including Medicare. A biller also spends time following up, posting payments, and communicating with patients and insurance companies, among other duties.
This is usually performed by a trained individual or organization. A medical billing service uses people who have either had training in billing and coding, or have completed specialized courses. There are many class options that provide certification. Students can be required to take a series of six-week classes, including "Terminology," "Introduction to ICD Coding" and "Proper Billing for Medicare." While this isn't necessary to be hired, it helps to understand various concepts and processes.
Next, find out if it makes sense to outsource your process. Consider the size of your operation and if you have plans for growth. How much do you spend on administrative costs? Do you have a high biller turnover and low collection rates? How much time does your office spend dealing with bills? These are all important to know before moving forward. The goal of outsourcing is to reduce overhead costs incurred by paying administrative staff to deal with it, eliminate the need to find and manage skilled billers, increase the time healthcare professionals can focus on their patients, and increase the bottom line. If your office has one or two billers who are extremely efficient and have been with you for a while, this may not be necessary. In contrast, if your practice sees high turnover rates for in-house specialists and has never had good collection rates, it may be time to search for help. If your office is a good candidate for Electronic Health Record (EHR) software systems, in-house management of bills may be a significant factor in deciding not to outsource. EHR systems can be expensive.
Truly, the biggest challenge in finding a medical billing service is comparing the reality of your company's staffing, finances, and efficiency and doing a cost-benefit analysis.
Article Source: http://EzineArticles.com/6957019
Effective Marketing for Your Medical Billing Service
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
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
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