Importance Of Adequate Medical Billing

Posted by basshopper on June 15th, 2019

Medical billing, billing of medical plans or electronic billing, as it is also known, is one of the most important components in the success of any individual or group medical practice. From the administrative point of view, it is definitely the most important. The continuity of said operation depends on it.

Despite its importance, in many cases, the care, attention and supervision necessary to ensure that the efficiency of the medical office's operation is not affected. The relationship between an efficient medical billing and a profitability that goes according to the volume of patients being treated is a directly proportional relationship, without considering the control of expenses, which is also an integral part of the equation.

The profitability of the practice is affected when you receive denials and recoveries from insurance companies or medical plans, as they are also known. In the vast majority of cases, these denials and recoveries are the result of errors in medical billing.

The most common errors in medical billing are the duplicity of bills, errors in the eligibility of patients, procedures that do not correspond to the codes submitted, codes not covered, invalid codes, incorrect or non-applicable modifiers, rates not updated or incorrect, lack of relevant clinical documentation, lack of referrals and authorizations, among others. All these errors lead to the refusal of recoveries from insurance companies, which negatively impacts, and in some cases dramatically, the cash flow of medical practice. In these cases, a medical audit could be very beneficial to identify the cause and magnitude of such errors.

Medical billing and coding services

To the extent that these errors are controlled and minimized, the accuracy of the medical office's revenue projections will be more reliable. Having accurate financial information will increase the value of medical practice and maximize the use of resources, which will definitely impact significantly and positively the profitability of medical practice.

Summary
The specialist in medical billing is the individual who assists the health professional in decorating, organizing and auditing administrative activities. Without a doubt it is one of the most important components in the administrative point of view. On many occasions the necessary care and supervision is not provided. Medical billing and a profitability is a directly proportional relationship according to the level of patients attended without considering the level of expenses.

Profitability is affected when refusals or recoveries are received from insurance companies or medical plans. These denials in most cases are the result of errors in medical billing. There are different errors in medical billing such as duplicity of invoices, errors in eligibility, procedures that do not correspond to codes, codes not covered, invalid codes, incorrect or non-applicable modifiers, rates that are not updated or incorrect, lack of relevant clinical documentation, lack of referrals or authorizations, among others. All these errors cause refusal recoveries from insurance companies. This impacts negatively, and in some cases dramatically. As these errors are minimized, the revenue projections in the offices will be more reliable.