Important Steps When Processing Medical Billing Claims

Here’s a fact: hundreds of millions of claims are denied by insurance companies in the US every year, amounting to billions of dollars. If you don’t have an efficient medical billing claims system, just imagine how much money your medical institution or healthcare organization is losing. Perhaps it’s time to review those rejected claims, get paid for them, and ensure that rejections are avoided in the future.

Steps in Proper Medical Billings and Claims

As much as healthcare should be a right, hospitals and healthcare practitioners still need money in order to do provide services. How do you ensure that your practice or billing company stays alive? Take note of the important steps when processing medical billing claims.

After servicing the patient, your hospital or clinic submits the claims to the insurance company. There are hundreds of insurance providers in the United States alone and the medical codes can be confusing, but you have to be meticulous because a single typo or wrong letter can cause a claim to be denied. After you submit the insurance claim, the insurance providers will process it according to the plan of the patient. Then they will reject or accept it.

In the event that the claim is denied, the first step would be to identify the reason for the denial. Common reasons for denied claims include incomplete information, coding errors and omissions, lack of prior approval, co-pay etc. By following up on patients and correcting claims, resubmitted claims can be approved to prevent aging claims.

Many of the most successful healthcare institutions and practitioners in the world have hired offshore medical billing companies to handle the insurance claims. By outsourcing your medical billing, you can save time, money, and energy. It will also ensure fast cash flow and shorter claim submission turnaround. One of the finest medical billing companies in India has over 16 years of experience, and they provide end to end medical billing services such as denial management, patient registration, AR follow up, and physician credentialing, among other services.

Blog Source URL: https://www.ecareindia.com/blog/important-steps-processing-medical-billing-claims/

Details to Check during Insurance Eligibility Verification Process

The process of insurance eligibility verification is not as simple as cross-checking data. There are hundreds of insurance providers in United States alone—and they all update their plans frequently. Unchecked details lead to insurance claim denials. Unfortunately, many details fall into the cracks because hospitals, clinics, and other healthcare organizations often lack the manpower to focus on this task.

The best solution is to partner with an offshore medical billing company to prevent rejected claims. By partnering with an offshore medical billing company, your billing company or physician group saves time, energy, and money. Offshore medical billing companies in India are affordable, and since they are doing all of the medical billing, you gain more time to focus on your Client Service or patients based on your business. However, choosing the right business partner is essential in the offshore space!E-care has over 16 years of experience. We offer end to end medical billing services, from insurance eligibility and benefit verification, Demo Entry, Coding, Charge Entry, Transmission, Payment Posting, Accounts Receivable and denial management, patient registration, indexing medical records, and much more. We are ISO-certified, a member of the HBMA or the Healthcare Business Management Association, and comply with the regulations and the latest HIPAA rules.

When we go through the process of insurance eligibility verification, we receive the schedules of the patients via email, fax, or EDI. We make sure to verify the Insurance for patients two days or more prior to the encounter depending on the requirement from our client. We have highly skilled and experienced team who is capable of maintaining the TAT and accuracy over 98%!

Our team may also regularly check the schedule through the appointment and scheduling software. The next step is to verify the patient’s insurance coverage with the insurance company. This involves making calls to the insurance providers, speaking with the insurance representatives or requesting fax through IVR and checking information through their authorized insurance portals online. If need be, we contact the patients for more information. Post which, the team updates the billing system with the details of eligibility and benefits verified, such as the co-pay, coverage period and identification (member ID, group ID, etc.) The team also input other information such as deductibles and other benefits information including maximum limitations. In the event that there are issues arising from a patient’s insurance eligibility, the client is informed as soon as possible. This streamlined process will considerably reduce rejected and delayed claims and increase practice collections. It also shortens your revenue cycle.

Blog Source URL: https://www.ecareindia.com/blog/details-check-insurance-eligibility-verification-process/