Know How Accounts Receivable Solutions Can Help Business Owners

It is the lifeblood of your organization’s cash flow, yet it can be difficult to manage and monitor when you lack the expertise and manpower for it. Known as ‘accounts receivables,’ it pertains to the money that your business must receive from the customers for the services or the goods you provide. It is a critical aspect of determining your business’ profitability, too, as it is a clear indicator of income, making it an asset that can help you tell if your company is earning sufficient money or not. Accounts receivable solutions can be outsourced to reputable service providers who specialize in your particular type of business.

Medical billing is one of the areas that can benefit from accounts receivable solutions. When you work with the right service provider, you can be sure that the AR management team can address the challenges that occur in your cash flow, and they will operate as an aspect of your own medical billing team. That way, you can recover the funds that are owed to you as quickly as possible. Seasoned AR solutions providers aim to accelerate cash flow and minimize accounts receivable delays. Those are achieved by ensuring error-free claims, regular follow-ups with patients and insurance companies, and proper analysis of any denied claims.

There are many other benefits that accounts receivable solutions can do for your business. Once implemented, the AR plan should save you a lot of time and money. You can minimize overhead costs when you outsource the service instead of building your own department and employ staff for it. You do not have to take time and spend more to buy extra equipment, too. Solutions may improve your overall accounts receivable process, too. You can count on the solutions provider to help collect payments and follow-up on patients and insurance companies in a more timely and quicker way, while you focus on your business.

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Difference Between Medical Billing Outsourcing & In House Medical Billing

Medical billing can be complex and extremely time-consuming, and for this reason, it makes sense to outsource it to a dependable company. The medical billing outsourcing company can make your revenue cycle management and processes smoother and deliver accurate results, which ultimately improves the financial viability of your healthcare organization.

You might be thinking that in-house medical billing is better and cost-effective—but this often isn’t true. With an in-house staff, you would have to take care of the hiring and employment process, create your own billing department, and provide the salaries and benefits for every employee in that area. This could mean extra hard work for you, as well as additional overhead costs for your company.

Working with a medical billing outsourcing company will dramatically lower your overhead costs. It is less expensive, especially if your business is fairly new or is on its way to transition due to some employees leaving. Outsourcing your medical billing will make it easier to obtain complete performance reports when needed. This way, the service provides more transparency into the billing operations, even without micro-management and overseeing the staff. The company you are working with will enhance the consistency of the deliverables, too.

There might be some concerns when choosing a medical billing outsourcing company, such as hidden fees, variable cost, and the absence of more control over the process. The good news is that you can avoid potential problems by carefully choosing your service provider. Take time to get to know the company and the software and technologies that they use, so you can be sure that you will be hiring a team that is favorable to your business and the way you run your company, and that you can rely on them to deliver results on time. Moreover, consider a HIPAA-compliant company that offers dependable round-the-clock support, in case you encounter some problems or have any questions. Ultimately, your choice between an in-house and outsourced medical billing team will depend on your own staffing, volume metrics, and expenses, so you may want to reflect on those, too.

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Several Benefits of a Credentialing Verification Provider

Physician credentialing is the process of determining that the physician is authorized to provide services and medical care to the patients who are part of a payer (i.e. medical insurance company). Likewise, it ensures that the physician is a member of the payer’s network. Provider credentialing verifies the physician’s ability to meet the standards of the payer, and it is done by reviewing his or her license, certifications, experience, training, adverse clinical occurrences, malpractice, clinical judgment, affiliations, and education. While you have the option to verify the credentials of doctor or healthcare specialist, you could save time and effort by having it outsourced to a qualified credentialing verification provider.

Why leave it to a specialist?

An effective provider credentialing expert will improve your practice and the way you run your medical facility. The absence of proper enrollment could cause the delay or refusal of payments by your patients’ insurance carriers, even if you have doctors who are able to provide medically necessary and competent treatment and services. A credentialing verification provider has the right manpower, tools, and connections to help you enhance revenues through a tailor-made service, which can facilitate a payer enrollment process when a physician wants to become part of a new payer network or when you are adding a new physician to your existing group.

Provider credentialing can help a physician start with their practice straight out of medical school, or switch from one practice to another, as the service can serve as a guarantee of their capabilities and expertise. It is important to note that different payers maintain their own sets of forms, which means a lot of paperwork online or offline. Once submitted, you need to follow-up regularly to make sure your revenues will not be affected. A credentialing verification provider can help speed up the process by providing services such as new provider affiliation and group credentialing, handling the provider letter of interest and the application requisition from payers, and facility credentialing, which can include the addition of the provider to your facility’s identity.

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Important Steps of Professional Medical Claims Processing

Medical claims processing can be straightforward to complex process, depending on the circumstances. Typically, a medical billing insurance claim process would start when a healthcare provider or practice provides treatment to a patient and then sends the bill of services to the designated payer. This designated payer is usually the patient’s health insurance company. The payer will then evaluate the claim based on their set standards along with different determining factors in order to verify services that it will reimburse.

Medical claims processing only becomes complex when there are complications in the claim, such as insufficient coverage or the failure of a patient to stay current with dues. In a perfect world, the steps to a medical billing procedure are quite simple:

• The patient receives a medical service from a licensed provider

• The services are recorded and assigned the appropriate codes by a medical coder

• ICD codes are to diagnoses as CPT codes are to treatments.

• A summary of services rendered is generated through the entered code sets, which in turn makes up the bill.

• The patient demographic data along with his or her insurance information are then added to the bill; and

• The claim is now ready for processing.

Medical claims processing can be done either electronically or manually. Various technical protocols as well as industry standards must then be followed so that insurance claims can be delivered accurately and expediently between the payer or the insurance provider and the medical practice. Different medical billing services use various approaches to medical claims processing. Others may use the manual or paper route, while more modern service providers do everything electronically with the help of increasingly reliable software programs and applications. Today’s healthcare providers as well as insurance companies subscribe to electronic claim systems as they offer faster and more accurate, (sometimes even cheaper) processing than traditional manual methods.  

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