From streamlining the complex collections process to overcoming continual declines in reimbursements and satisfying HIPAA requirements, there are a number of tasks that constitute the medical billing process and lead to the successful close of a revenue management cycle.
Outsourcing to Billing Blues, a top Medical Billing Outsourcing Services company, will enable your healthcare business to grow your revenue generation, reduce operational cost and increase in the efficiency of your delivery.
Our services aim to simplify the billing process for medical practices of any size. Getting paid should not hold your practice back from serving your patients. Let our medical billing specialists take the lead while you focus on what is important: your practice.
We offer a long list of medical billing services that are conducted through our management system for our clients’ convenience.
1. Insurance verification
Our team of medical billing specialists compile the patient list, copies of insurance cards, and demographic details via email, fax, or secure FTP. This ensures all necessary information is always in the right place at the right time, making it easy to verify insurance information. This provides an ease for medical practices, as insurance payment will be quick and secure. We also offer pre-certification for specific lab tests for patients, along with diagnostic tests and surgeries. This takes the burden off the medical practice and gives peace of mind to the patients before costs begin to add up. All details are sent to the necessary hospitals and clinics in the prescribed and necessary formats.
2. Patient demographic entry
Our system keeps track of demographic information in an easy format that is consistently updated and verified as needed. These details include, but are not limited to, names, dates of birth, addresses, insurance details, medical histories, guarantors, and other important information. This information is provided by the patient at the time of their medical visit. For established and regular patients, the files are validated and changed by our medical billing specialists as needed in the practice management system.
3. CPT & ICD-9 coding
The team works in full accordance with CPT codes and the ID-9 and ICD-10 Coding compliance. Our team consists of AAPC certified coders. Each of our members has over two years of coding experience from multiple specialities. Our clients are free to send over superbills with diagnostic notes either with or without ICD and CPT codes, and we take care of the rest. When codes are already on the superbill, our team of specialists does the work to ensure they are validated. This prevents any up-coding or down-coding, leading to few or no denials.
4. Charge entry
Fees for schedules are put into our practice management system ahead of time for easy use. The CPT and ICD-9 codes are entered into the system reliably and without extra stress on the client. Our billing specialists ensure that all necessary details are in the system and accurately provided in the claim to ensure every claim is ready to be filed.
5. Claims submission
Submitting claims is an easy process for our clients. Each claim is electronically submitted through the practice management system simply and quickly. For any practice that works in paper, we can process those claims as well. Once claims are submitted through one form or another, our specialists go to work and provide a thorough quality check. This is done by one of the senior members of our team before being submitted. If there are any rejections in the report from the clearing house, our team analyzes the results and implements the necessary changes for approval. After being thoroughly checked once again, they are resubmitted for review. Denials and rejections are few and far between due to the thorough process for each and every claim.
6. Payment posting
Checks that have been scanned, along with EOBs that have been scanned, are sent to our team to be entered into the system. Once received, our specialists do the work to ensure each payment is properly entered into the management system. Every amount from an EOB or check that has been posted into the system is reconciled and checked each day. There is a daily log that tracks and reports this information for our clients.
7. A/R follow-up
Each and every claim that is put into the system is examined. After that, priorities are set on the claims to ensure the most important claims are looked at first. Claims that are closest to their filing limits are looked at first, with the rest of the list worked on based on the age of the claim. This ensures claims that need to be reconciled and worked on first do not go to the wayside as new claims are processed. Our team conducts follow-ups by phone, email, and online to check on the status of every claim that is being submitted to the insurance company.
8. Denial management
Whenever there is a denial, our team works to analyze why the claim was denied. There is an analysis of denials and partial payments each time it occurs by our senior billing specialists to resolve issues as they arise. Our follow-up process for denials is extensive and includes calling payors, patients, providers, facilities, and any other participants whenever a claim is denied, underpaid, pending, or otherwise incomplete. We record the progress and results in the management system as we work to resolve the issues. When the issues come down to ID#s that are missing, we take the extra step to talk to the patient to get things filed as quickly as possible. We take the information they provide and update the Coordination of benefits with their insurance companies. At times, secondary paper claims may be necessary. When that arises, we process and send the claims to the client’s office for submission.
Our services include a long list of reporting options that help keep track of every claim both on a daily and weekly basis. Our daily reports include:
* Scan control log for charges
* Scan control log for payments
* Pending log for charges
* Pending log for payments
Each week there is also an A/R report. Between the five reports, our clients will know exactly where in the process every claim is at and what is pending for approval. Additionally, these reports can be customized to fit different preferences.
Our medical billing specialists work to ensure every regulation has been met throughout our medical billing services. Additionally, we provide coding support and help against declined reimbursements.
Our clients experience an increase in their operation costs while still having full control over the billing system. With these benefits in mind, our specialists can help any practice, regardless of their size and operations.
Contact us today to find out how we can help your medical practice succeed.
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