Medical Billing Companies Near Me – Are They A Value – Added Service?

Posted by Jalal Official on January 22nd, 2022

Outsourcing medical billing services may enable effective and efficient claim filing, but is there any benefit in doing so?

Full-service medical billing businesses provide a wide range of services to help doctors optimize insurance and patient collections, enabling them to concentrate on patient care and practice expansion.

Many medical billing organizations in my area provide web-based solutions that cover the whole revenue cycle from beginning to end.

Claims Processing — Entering patient details, insurance information, confirming a prior authorization was acquired and on file, submitting claims electronically, filing secondary follow-up claims, and organizing automated crossovers are all part of this procedure.

Patient billing includes mailing patient statements, responding to account queries, addressing patient questions, and sending client-approved collection letters.

Payment Posting - Inputting payments and changes from insurance companies\' explanations of benefits (EOBs), as well as posting patient copays.

Financial Information - Making financial reports about the practice\'s financial health available. Insurance aging, patient aging, monthly, weekly, and daily summaries, and payer reimbursement analysis are all included in the reports.

Calling insurers to check on the status of underpaid claims, refiling rectified claims, and filing appeals are all examples of follow-up and appeals.

Online Data Access - 24 hours a day, 7 days a week, practitioners may check on the status of outstanding claims, evaluate balances, and run financial reports.

Verification of Benefits - Contact insurance companies to confirm health benefits and eligibility before seeing a patient. The service will validate copay amounts, deductibles, the maximum number of visits permitted, authorization requirements, and the claims mailing address during the conversation.

Clarify the Collections Process Up Front — It is critical to have open and transparent communication with patients. Patients must be made aware of their financial commitments. In the reception rooms of many offices, a notice describing copay collection and unpaid bill rules may be seen.

Practice Management Solutions — Some companies include time and money-saving features like online appointment calendars, credit card processing, online payment portals, appointment reminder calls, and text messages, among other things.

Even with all of these services, some may wonder whether working with a medical billing business adds value.

Yes, to put it simply. Medical billing services might be outsourced for a profit. However, how can we be so certain? Why should you take our word for it?

The value-added is seen in the case studies below.

The First Case Study

A client wants to outsource charge entry and patient demographic duties for one of its patients.

The billing services\' objectives were to: provide a seamless transition with little practice interruption; reduce claim error rates from 4% to 2%; maintain productivity levels after outsourcing, and train their personnel on the customers\' current software and processes.

Collaboration with the in-house billing staff is essential.

The happy customer elected to outsource their complete medical billing process, including insurance calling, charge entry, patient demographics, patient contacting, and payment posting, after the second month of operation.

Case Study #2 

A prospective customer-managed their revenue cycle management process in-house, but after a few months in business, they noticed that collections were falling short of expectations.

In reality, they fell short of their target of 0,000 in the first six months, generating just approximately ,000.

Major claim rejection difficulties highlighted by the medical billing service included:

• Credentialing issues - Credentialing for certain payers was incomplete. They thought their in-house employees had finished credentialing.

• Inadequate Eligibility and Benefit Checks – Either the patient\'s demographics and insurance information were input improperly, or the personnel never double-checked coverage or benefits with payers.

• Coding Issues - Several claims were mistakenly submitted based on outdated and inaccurate billing and coding requirements. For example, inexperienced employees utilized CPT codes, which have since been phased out and replaced.

• Filing difficulties — Due to a backlog of billing function issues and patient inquiries, the in-house employees fell behind and failed to bill out claims on time.

The practice struggled to overcome the problem of catching up while still treating patients. They chose to contact a medical billing organization in my area.

Within the first six months, the medical billing business reached its revenue objective of 0,000 and continued to grow to 0,000 for many months.

They also assisted in the reduction of Accounts Receivable (AR)days from 90 to 120 to less than 30 days.

These are just two of many case studies that show how working with a medical billing business eliminates mistakes, boosts revenue, and improves cash flow by reducing AR days.

This, we feel, illustrates without a shadow of a doubt that hiring a medical billing services firm near me adds value.