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What to Expect From a Medical Billing Service

Medical billing services offer a tantalizing proposition: healthcare providers leave the billing legwork to the experts, and watch their collection ratio increase as a result. Besides benefiting financially, the provider gets to focus on what matters most--patient care. Its no wonder third-party medical billing services are quickly becoming the industry standard. Heres what to expect when signing on with a medical billing service.

A Closer Look at Medical Billing Services
Medical billing services range from simple claim submission to comprehensive practice management. Home-based and smaller professional organizations may limit their service to billing-specific tasks. Practice management companies take a more holistic approach, offering everything from marketing to scheduling assistance.

Standard billing services include:

  • Insurance claim submission. Typically, the provider will use electronic billing software to transmit patient demographic, insurance, and encounter data to the insurance carrier.
  • Insurance follow-up. This is where most clinics realize the value of a third-party billing service. A good service is experienced and tenacious in following up on the claim with the carrier, which has, as one expert puts it, an enormous effect on reimbursements.
  • Reporting and analysis. Billing services typically prepare a monthly report and can make recommendations on how to increase profitability. These reports offer a deeper and more customized look at key metrics, helping businesses identify strategies for growth and cost savings as well as greater billing returns.
  • Patient invoicing and support. Billing services take care of the logistics of sending bills and fielding patient inquiries.
  • Extended Billing Services include:

  • Medical coding. Some billing services will take over this initial step, coding the diagnosis in preparation for entry into the medical billing software program.
  • Transcription. Transcription of medical records precedes the coding stage. Though transcription is not a billing process, many billing services offer this related administrative service as well.
  • Credentialing. A real asset to new clinics, credentialing services take care of the paperwork needed to initiate a relationship with an insurance carrier.
  • Practice Management Services include:

  • Financial services. Insurance claims collection is just the beginning of a practice managements financial services. Accounts payable, bookkeeping, tax planning, and budgeting are available extensions of the standard billing service.
  • Contract negotiation. Negotiating with managed care representatives and hospitals can strain a private practices resources. Practice management companies have the expertise to negotiate effectively on their clients behalf.
  • Human resource services. Payroll, benefits program design, staffing, and employment contracts can be outsourced to a full-service medical management service.
  • Medical billing services offer small private practices, clinics, and hospitals a cost-effective way to handle the increasingly complicated administrative tasks associated with insurance and patient collections. No healthcare provider is sorry to see these onerous tasks go. Especially given that in this case, the reward for passing the buck is a boost in revenue.

    American Medical Billing Association
    Medical Transcription Daily
    Preferred Health Resources
    Using Medical Billing Companies

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