Medical billing service providers come in many different shapes and sizes. On the one hand is a large practice management company with a wide support network, but sometimes it is both rigid and expensive. At the other end is a small family business. As more and more courses are offered through local universities, mail order and internet, home-based businesses are everywhere. Somewhere in between these two extremes, we call it a professional medical billing service. When considering your choices, it's important to understand what each type of Mediation Service Provider must provide and which is best for you. This article discusses these common types of medical billing service providers and some of the services they offer.
Home-based medical billing business from
There are differences in experience, capabilities and services. Many are small startups with only one or two employees. Some people have extensive experience working in a doctor's office, others may have only one or two customers. While these service providers can offer the highest level of customized service, a small, home-based business can sometimes lack management knowledge and business acumen to survive long term. What happens when a solo journalist decides to take a vacation? Most core services that provide medical billing [discussed later], and many have other personal experiences of providing ancillary services.
Practice management company from
It is usually a larger company and may have 100 or more employees. Most real practice management companies take a holistic approach to supporting your practice as they seek to address all aspects of business management - including medical billing, marketing, staffing, and even patient scheduling. While some providers may be excited about letting the practice management company seize all the "trouble" opportunities, others feel that it is suffocating to let others run their business. While their services can be comprehensive, providers interested in working with a practice management company should carefully read the service agreements and contracts to ensure they know exactly how their practices will be "managed".
Professional medical billing service from
It falls between the extremes of the family medical billing business and the business management company, taking advantage of both and eliminating weaknesses. With dozens of employees, professional medical billing services can provide greater flexibility than practice management companies, but with more structure than family services. Customers often find that medical billing services have an ongoing support network that eliminates cash flow disruptions during vacation or unplanned vacations while providing tailored services to meet their needs.
When considering each type of medical billing company, it's important to consider what services you need, what services you can handle internally, and the expectations of your health care professionals. Each of these types should be able to provide the following standard services; although service delivery, flexibility and customization can vary widely.
Standard medical billing service
The standard services provided by medical billing companies are generally similar within the company discussed above. The level of provision of these services will vary. Similarly, experience and scale play a key role in defining where the change is possible. In any case, the following list lists the most basic services offered by any well-organized medical billing company.
Claim generation and submission from
Claim generation involves entering patient demographics, insurance and encounter information into medical billing software. Claim submission is the process of electronically transmitting data to the carrier through the clearing house or through paper in the mail. For electronic medical bills, the service should apply one or more "scrubers" to the claim [and manual quality checks for paper claims]. The scrubber is a diagnostic quality assurance check and an error or mismatched program code that is typically integrated into the advanced medical billing software program.
Operator follow up from
Operator follow-up is an integral part of the medical billing industry - arguably the most important aspect. The quality of medical settlement services usually depends on how well they apply to claims and will have a terrible impact on reimbursement. By following up, the medical billing company is able to isolate claims that may be unpaid or partially paid and work with providers and operators to ensure that editing and resubmission [if necessary] is clean.
Secondary school, junior college and workers' compensation claims from
These special requirements usually require special consideration and processing as they usually require additional documentation. Without experience and preparation, service providers can sometimes fall into the details required for these unique claims.
Practice report and analysis from
Reports can be generated by almost any medical billing software, but what is the frequency and depth of your reports provided by your medical billing service? The report provides key information about ways to improve the practice, such as growth direction, cost savings, and ways to improve profitability. The importance of reporting cannot overemphasize the health of monitoring practices. Reports should be available at least once a month, and experienced medical billing service providers should be able to advise on how this approach can improve profitability.
Patient invoice and support from
Patient invoices are a very detail-oriented process, but if done well, it can significantly increase practice income. Still, balancing accounts, printing reports, filling envelopes, and applying postage can be time consuming. Once a patient statement is sent, someone will inevitably have questions about their bill. An excellent medical billing company has the infrastructure to support patient queries in a customer-oriented manner, indicating that they understand their behavior is a reflection of your practice.
other service
Since most medical billing services have extensive experience in the interoperability of medical offices, other services are available. Some horizontal practice services may include the following.
certification from
Credentials may be especially important for new practices. This process of "signing" with the operator for the first time can be tedious and overwhelming, especially at the beginning. Credential services are also assets of established practice and another way of developing new businesses. Many medical billing companies bring experience working with operators to help you easily get credentials.
Medical code from
The natural extension of medical billing services is medical coding. Encoding is actually the first step in the billing process, preparing diagnostics and program information for entering the medical billing software.
Transcription from
With extensive experience in medical practice support, many established medical billing companies naturally expand their product range to include transcription services. Familiarity with HIPAA requirements and an in-depth understanding of the insurance industry supports the natural increase in this practice support service.
HIPAA compliance from
The detailed requirements of HIPAA are not limited to health care practices, but extend to anyone who processes patient information. Medical billing services that are well versed in the HIPAA outlined responsibilities typically plan to help customers maintain compliance.
Summary
Working with the right medical billing service is critical to the success of your practice. Just as you find a good accountant or lawyer to support your practical needs, you must be satisfied with your medical billing service provider - they are the key to your income stream. There are many different types of medical billing service providers to choose from, each with its own advantages and disadvantages. The key is to decide which type of medical billing service provider you are most familiar with and establish an open working relationship to help you achieve prosperity.
Orignal From: Medical billing service: choose the type that suits your practice
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