Medical Insurance Billing
A billing service that does not bill the sessions accurately, missestimelines, or does not do enough follow-up can have a disastrous effect on yourbusiness; however, a well-run billing service can ease your life and greatlyimprove both your cash inflow and total income.
A competent billing service drives positivity in your practice and in yourlife. This positivity enhances your patient seeing hours or some bettercreativity hours that are lost behind submitting bills and waiting for refunds.A billing company doesn’t leave a single penny uncollected to provideunprecedented boost and control in your cash flow.
MDofficeManagerprovides the best combination of services to make physician work flawless. Ourhighly experienced and professional staff handles end-to-end billing needs. Forbilling to be handled professionally, accurately, and thoroughly, MDofficeManagerwill be your right choice.
A physician providing care for the patient and managing revenuesimultaneously is not an easy proposition. Certain aspects become hard tomanage like scheduling appointments, following unpaid claims, etc. At MDofficeManager,we also vacate you from keeping up with all the regulations and procedures inever-changing industry standards.
How can one find the difference between a fly-by-night medical billing companyand a billing company to which they can hand over their patient’s medicalinformation with confidence? If they know the criteria by which to judgea medical billing service, they’ll be able to select a company that willsignificantly decrease their time spent on billing issues and increase theirtime spent on patient care.
To correctly choose a billing company, aprovider will need to evaluate these criteria:
Criteria: 1 : Level of Service
§ Pursuing denied claims.
§ Billing follow-up.
§ Complying with regulations.
§ Reporting and analysis. What reports wouldbe provided? Frequency of reports? Reports on demand?
Criteria: 2 : Industry Experience
§ ICD-9, CPT-4 & HCPCS Coding.
§ Medical Terminology.
§ HIPAA and Office of Inspector General (OIG)Compliance.
§ Insurance claims and billing, appeals anddenials, fraud and abuse.
§ Information and web technology.
§ Reimbursement.
Criteria3 : Use of Technology
Here are some potential technological issues in those realms that will needto be addressed, and which MDofficeManager effectivelyaddresses:
§ How will super-bills and claims be shared?
§ How does billing service fit with the provider’sEHR strategy?
§ Does the service have an integrated EHR?
§ What about data security?
§ What are the procedures for disaster recovery?
§ Where and how is the storage of backup data?
§ Will a provider need to install and maintainsoftware or would they be accessed online?
§ What about compliance of HIPAA?
§ By choosing a medical billing service thatintegrates with a provider’s EHR (or provides their own EHR) this gap can beclosed even more.
Criteria 4: Pricing Options
Huge volume of dollars are moved from one account to another and pricing iscritical, as well as a social responsibility.
- Percentage-based: The service will charge a percentage of collections or they will charge a percentage of gross claims submitted or total collections.
- Fee-based: With this model, the billing services charges a fixed dollar rate per claim submitted.
- Hybrid: With this model, the billing service charges on a percentage basis for certain carriers or balances and charges a flat fee for others.
FUNCTIONSOF A BILLING SERVICE
The Entire Revenue Cycle –Automated & Interoperable
Θ Contract Management.
Θ Fee Schedule.
Θ Pre-Visit/Scheduling.
Θ Check In & CheckOut.
Θ Charge Entry.
Θ Track Claims.
Θ Reject Management.
Θ Pre-Remittance ClaimStatus.
Θ Post & ApplyPayments.
Θ Electronic EOB/ERA.
Θ Account Follow-Up.
Θ Patient Billing.
Θ Denial Management.
Θ Reporting &Benchmarking
HOW MDofficeManager CAN HELP?
Our billing services have the capability to submit claimselectronically, which has become the norm for claims submission. Online claimmanagement means on demand access to your detail just a click away that isquick, easily manageable, secure compared to paper.
However, keep in mind, that some of the smaller insurances and HMOsdo not accept electronic submissions at this time, so some claims will still besubmitted on paper.
MDofficeManager offers several different options foryou to submit demographic and claims information to us. Most of our customersprefer to enter their data directly into our web-based MDofficeManagerPM system. Providers will dictate or use our EHR system to complete patient note. Our AAPCcertified coders will review the documentation and complete coding. If it isrequired, they will educate providers for better documentation to comply withregulations. We then extract the information needed to submit the claim withoutyou having to do anything further. We also offer other option for customers whodo not want to do any data entry themselves.
We follow up on all claims to be sure that they are received in atimely manner and paid. Since the vast majority of claims are submittedelectronically, we have immediate confirmation of claims receipt, and if thereare any issues with a claim, we know about it quickly. We follow up immediatelyon any claims that are rejected, denied, or underpaid, or on any claims wherethere has been no response from the insurance company. You don’t have to worryabout claims follow up, tracking specific claims, etc.
