Medical Billing Outsourcing – Key Considerations beyond Claim Submission

by Outsource Strategies International Medical Billing Company

In a scenario of new coding regulations and increasing regulatory requirements, many physician practices are resorting to medical billing outsourcing to stay compliant. Billing services allow physicians to focus on their patients and free up their staff for other important tasks. However, to get the most out of their billing company, physicians need to look beyond the conventional services of patient enrollment, claim submission and mailing patient statements. Here are some key features they need to consider when choosing a medical billing service:

Expertise in handling all types of advanced practice software: Billing specialists in a reliable outsourcing company would be experienced in working with all types of advanced software. It would be ideal if the company has the same practice management software as the physician’s office, though these experts will be able manage the billing process efficiently using the physician’s software or that of their company. Physicians should ensure that they will have secure access to their accounts so that they can check balances, examine patient accounts and get reports.

HIPAA compliance: It is crucial to partner with a HIPAA compliant medical billing company. In such companies, the entire workforce is trained and monitored on HIPAA privacy, security, and confidentiality. They will also have stringent measures such as encrypted email and breach procedures to safeguard Protected Health Information (PHI). Physicians need to check whether their Business Associate (BA) has these security administration activities and also ask about how sensitive documents are destroyed. The signed BA agreement should clearly state all of this.

Medical billing reports: A reliable billing company will provide its clients with daily, weekly and monthly reports to help them track the health of their establishment. This helps physicians understand how their practice is performing on important revenue cycle metrics and how their reimbursement cycle is progressing. Key reports to look for include review aged A/R by payer identifying insurance and patient balances and the patient collections report.

Update team’s coding and billing skills: Professional medical billing and coding companies will invest in updating their team’s skills on a continual basis. This includes sending their staff to attend annual coding training and specialty specific coding courses, besides free payer and Medicare webinars.

Advanced tools for fast billing and collection process: Speed is a key factor in medical billing. Physicians should partner with a company that uses time-saving electronic methods to manage unpaid accounts, funds transfer, payment posting, and appeals and denial management.

Effective A/R management: The right service provider will actively and accurately pursue unpaid and underpaid claims. The company will track and manage denials and provide A/R management guidance such as recommending accounts for collection and cancellation of debt.

A medical billing and coding company that employs these proactive strategies can help physician practices improve compliance, avoid denials, identify missed revenue opportunities and improve collections.