Most medical billing companies in the US have a specially-recruited team of professionals to handle claim denials. The reason is that they anticipate claim denials from insurance payers, which has become more frequent these days. When a claim gets denied, the specialized team takes several steps to analyze the cause for denial. Once the problems are sorted out, the claim is resubmitted to the Payer. Continue reading “Prudent use of Appeals”
Payment Posting of ERAs
The modernization of the healthcare medical claims processing has brought in so many changes to the existing workflow and medical billing and coding patterns. Payment postings no exception in that list. Traditionally, payment explanations were sent out in the form of paper EOBs (Explanation of Benefits) by the Payers. However, the advent of Electronic Remittance Technology has moved medical claims processing a step forward. With what is called EFTs, Payers can now easily deliver their payments to Healthcare Providers and Facilities in the electronic form. In the same manner, they use ERAs (Electronic Remittance Advice) to deliver payment explanations, thus replacing the traditional EOBs. To learn more about ERAs , see below: Continue reading “Payment Posting of ERAs”
Offshore Medical Billing – Pricing
One of the major factors that are a puzzle to US healthcare billing companies in offshore medical billing is the pricing. The oft asked questions are “How do you price your service?”; “What is the pricing?”; “Is it really economical?” The main objective of this piece is to solve some part of that puzzle for them. Continue reading “Offshore Medical Billing – Pricing”
HHS Sequestration – How does it Impact your Billing?
Recently, medical billing companies have been facing a tough time due to the payment reductions caused by the Patient Protection and Affordable Care Act. In addition, a new challenge – the HHS Sequestration has worsened the payment scenario. The Center for Medicare and Medicaid Services has brought into effect the sequester provision of the budget control law on April 1, 2013. According to this law, a 2% cut will be implemented on all Medicare provider payments. The impact is more since we are beginning to see that HMOs and some of the Commercial payers following suit. Let’s see how the HHS Sequestration Plan impacts the revenue cycle management of medical billing companies, Continue reading “HHS Sequestration – How does it Impact your Billing?”
Denial Management – Check on the Web or Call?
Denials are a big problem faced by both healthcare facilities and individual physicians. Even though they take concerted efforts on medical claims processing, claims do get denied by the payer for several reasons. Claims can be re-sent to the insurance company but only on learning the status of the denied medical claims. Continue reading “Denial Management – Check on the Web or Call?”
Anesthesia Billing – Unique Requirements
A common myth about Anesthesia Providers is that their work simply involves giving anesthesia to the patient undergoing surgery. In reality, they have more responsibilities like creating a customized anesthesia plan for a patient, monitoring the health status prior to and after giving anesthesia, and more. Continue reading “Anesthesia Billing – Unique Requirements”
Importance of Modifiers
The importance of modifiers in Coding is that they play a vital role in medical claims processing. Therefore, Healthcare Facilities and Providers must show extra care while using modifiers in the medical billing and coding process. If they fail, then there could be serious repercussions concerning reimbursement. Continue reading “Importance of Modifiers”
Outsourcing – Do You Have a Vendor or Partner?
Many medical billing companies recently have realized that their growth purely depends on outsourcing a part of medical billing services to offshore companies. If you are one among them, then you have to be choosy in selecting the offshore medical billing company. Continue reading “Outsourcing – Do You Have a Vendor or Partner?”
How promptly are your denials handled?
The prime hassle that most medical billing companies face from their clients is undoubtedly prompt handling and managing denials. “How promptly do you handle your client’s denials?” – When this question is asked, most of the billing companies indicate that this is their biggest pain-point. Continue reading “How promptly are your denials handled?”
Medical Billing – Expand your Clientele!
In recent times, the US has witnessed a substantial increase in the growth of medical billing companies. Not only that! These companies fiercely compete with one another to earn a reputation in the healthcare reimbursement domain, which is definitely an arduous task. Continue reading “Medical Billing – Expand your Clientele!”