Medical Coding Services: Avail Faster Claims with Accurate Processing

The medical coding process is no doubt complicated and time-consuming, and the ever-changing legislations and requirements make it even more compound. If you are still doing it in-house, you are probably losing precious time and money. Some of the most successful Medical Billing Companies today choose to outsource this function to expert third-party company that offer medical coding service because they realize the positive impact of accurate processing on their bottom line.

Outsourcing your medical coding functions does not mean that you are no longer ‘in control.’ In fact, it puts you in a better position than ever because it ensures that this administrative aspect is never overlooked. Outsourcing ultimately enhances the experience you provide to your end clients. And if there are no errors, payment of claims is faster.

Outsourced medical coding service can lead to accurate processes and faster claims. To ensure that you can truly enjoy these benefits, make sure that you are partnering with an o offshore Medical Billing service that has the following credentials:

1. Expert coders

The best outsourcing companies invest in training their employees on the latest codes and guidelines in the industry. Their level of speed and accuracy is better, and their processes are designed to minimize coding errors. When you work with them, you work with people who devote 100% of their time to medical coding—they are not distracted by other client relations activities.

2. Various coding services

The best outsourcing company is not only knowledgeable in one type of medical coding service, but in all of them. They are indeed capable of providing the best solutions catered to your organization's needs. These companies also have disaster recovery strategies to guarantee uninterrupted operations.

3. Accreditation

Most importantly, the best medical coding companies have accreditations and certifications. Choose one that is ISO certified and HIPAA compliant. Also, find out whether their coders are certified by American Association of Professional Coders (AAPC).

Common Reasons That Causes Claim Denials

It can get frustrating when claims are denied, but if the incident keeps occurring in your healthcare facility or organization, you may want to take a look at your processes and the way they are handled in your office. Timing issues, errors, and input oversights are among the reasons why some claims are denied. By being mindful of these incidents and following HCC medical coding standards, you could minimize denials and improve your approach to billing.

Hierarchical condition category (HCC) and risk adjustment coding is the payment model that identifies patients with chronic or serious illnesses, then designates a risk factor score to them according to factors like demographic details and health conditions. HCC medical coding was implemented in 2003 and mandated by the Centers for Medicare and Medicaid Services (CMS) in 1997. A patient’s health condition is identified using ICD-10 (International Classification of Diseases-10) diagnoses, which you submit to insurance companies when filing a claim. There are over 9,000 ICD-10 codes being mapped to 79 HCC codes.

HCC medical coding errors are among the reasons why claims are denied. By working with a seasoned team of AAPC-certified medical coders, you could minimize those mistakes and increase the accuracy of your claims. All coding must be audited before the charts are finalized. Claim denials may also occur when the claim is not up to the insurance company’s standards.  So, you need to make sure that the claims are made according to their regulations and that they are legible, specific, and complete with all the information required.

Missing information is another reason why a claim can be denied. Even a small detail left out can cause problems later on, especially when you are dealing with a detail-oriented insurance company. Keep in mind that some payers will look for minor specifics, such as the date of the medical emergency, onset, and the accident. A claim can be denied if it is not filed on time. Some providers of HCC medical coding services have a team of specialists who will make sure that the claims are submitted on time.

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Accounts Receivable Management: Top Tips to Get You Paid

As much as you want to get paid immediately, there are unavoidable circumstances that might prevent Insurance Company from paying you on time. In some cases, you might encounter an insurance company denying a claim. While there is no way to ensure that all claim can turn into money, you can minimize denials and inefficiency by considering account receivable management. It may sound complex, but it is actually simple when you work with the right billing partner, which you can outsource to save money and effort. Here are some tips to make accounts receivable management work for you:

• Outsource the service – An established and reputable medical billing company will provide you with an effective and highly trained AR team that can address the challenges in your cash flow. Their goal is to help you recover the funds owed to you as quickly as possible by accelerating cash flow and minimizing accounts receivable days by providing clean and error-free claims. They can analyze denied claims and regularly follow-up with patients and insurance companies on your behalf in case of any outstanding dues and claims.
  
  
• Do not wait – Go after late payments as soon as you notice them. The longer you ignore them, the more difficult it will be to collect. Accounts receivable management can help by following up, so you can focus more on your business.

• Follow-up insurance – Medical billing companies and healthcare providers lose money due to their inability to follow-up on any outstanding claims. When you lack manpower and the time to process insurance claims, you could risk losing a lot. So, consider working with a good Account receivable management team for assistance. Medical billing partner can aggressively follow-up all accounts with insurance companies to ensure the quick settlement of claims. They have the ability to monitor accounts receivables, too.
  
  
• Clean-up old accounts – Unresolved accounts receivables occur due to insufficient follow-up as a result of low manpower and backlogs. Account receivable management still analyzes previous reports and come up with ways to reduce debts and maximize collections.

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Medical Billing Codes: A Key to Fraud Case

Mistakes in medical coding and billing can negatively affect practice revenue in various ways. They can disrupt your cash flow and take your attention away from your core function of providing high quality care to patients. They can even possibly lead to fraud charges, which will harm your reputation and practice. Making a mistake and actually engaging in fraud are two entirely different things, of course. However, if the mistakes seem habitual and claims are always getting rejected, suspicions may arise.

Health insurance frauds happen when a practice intentionally submits incorrect claims with the intention of getting paid for services that weren’t actually performed. Physicians who bill excessive charges, submit a huge number of claims, and perform unnecessary services may be charged with fraud.

Investigations on fraud charges can take years. They can also cost a lot and result in the revocation of a physician’s license. Hence, it’s prudent for doctors and other healthcare professionals to always be careful when submitting claims. All activities must be well-documented and all rules and regulations should be strictly followed.

The truth is that committing errors and being fraudulent are no different from each other; you may still face charges whether your mistakes were honest or you actually engaged in fraud. Medical coding and billing should be taken seriously, and any errors should be quickly acted upon. At the same time, it is also important to evaluate and correct the factors that are causing these mistakes to happen.

To make sure such errors are minimized and fraud charges are avoided, it will be best if you just outsource medical billing and coding duties. That way, you will have access to trained and experienced professionals as well as a comprehensive range of services. Outsourcing healthcare services is more efficient and will help you save money. When you outsource to a reliable company, you and your staff will be able to focus more on providing quality health care to you patients.

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How Outsourcing Medical Billing Overcomes Medical Billing Pitfalls

Medical billing is a complicated and extremely demanding process and it can be difficult for a practice to deal with all of the tasks involved. The billing function possibly takes up a huge chunk of your support staff’s time—time that could be better spent caring for patients. The good news is that you can choose to outsource this process. By outsourcing medical billing, your team will have more time to deal with other important responsibilities as a healthcare provider while reducing billing mistakes.

Rules and procedures in medical billing are constantly changing. This means that if you won’t outsource medical billing, you will have to consistently spend time and money in acquiring new software and training your staff on the Industry changes. For a practice that needs to take care of a lot of other responsibilities, constantly keeping up with these rules and regulations can be too taxing.

It’s more practical to simply outsource medical billing to a reliable company so you can leave the task to professionals. Medical billers are always on top of things; it is their job to comprehend and implement new rules thoroughly. As long you are confident that you have chosen the right company and professionals, you can trust that these billing rules will be followed.

Because of ICD-10, everyone is worried about getting coding errors and are thus taking much longer to double check their coding. This puts a lot of pressure on a practice’s support team and takes time away from other functions that need attention. More time taken up by coding also means less time for billing. This results to rushing—and that’s when mistakes happen.

Outsourcing medical coding and billing prevents errors from happening. Medical billing companies are focused on getting everything right, and they’re less likely to commit mistakes because this is the core of what they do. They also have ample knowledge and the right equipment to see to it that bills and claims are processed quickly.

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Rectify Your Patients’ Health Information with Document Management System

Administrative costs account for over 25% of the total expenditures of healthcare clinics and hospitals. A large portion of this goes to paperwork involved with billing, coding, records, and insurance. Each patient visit adds to the already voluminous paperwork healthcare providers have to deal with on a daily basis. What’s more is these medical facilities are obligated to maintain all these records for at least 10 years after any patient’s final visit. With the amount of information that practitioners have to manage, how do you ensure your own practice’s reliability, accuracy, and efficiency in keeping patient records?

Many healthcare providers are discovering the benefits of digitizing their patient records and other related paperwork and adopting the appropriate document management system, which, in a lot of ways help reduce the cost of paperwork management and at the same time ensure document processing speed and accuracy.

Cost efficiency is one of the most obvious benefits of document management systems. Facilities that have already switched to digital record keeping systems cut spending substantially in terms of reduced material and equipment costs, reduced storage needs, reduced retrieval fees, and smaller staffing costs. Well-designed document management systems also ensure information security and regulatory compliance. Paper documents are prone to damage due to natural disasters and accidents, ranging from mold to fires, flooding, and other incidents. Physical damage to paper-based documents are usually irreversible rendering patient information non-recoverable. Electronic document and file systems have redundant storage features and highly efficient disaster recovery solutions, making sure that all information stored can be recovered one way or another. Even when a particular server fails, there are digital backups that practitioners can turn to so important information can be recovered when needed.

Document management systems also provide a level of protection no paper-based file system can offer, that is a detailed chain of file custody, wherein timestamps and employee names are recorded on each stage of the document processing. This means extensive protection of patient information confidentiality.

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An Essential Tool for Efficient Practice Management – Medical Billing Software

Practice management will be less stressful and tedious with the help of the right tools. No matter the size of your operation, any medical practice entails a lot of complex processes to keep up with. Streamlining different aspects of your operations should help simplify your practice and allow you to focus on what you do best—which is providing your patients the care they deserve. Discover the many great advantages of practice management solutions by letting electronic medical software and medical billing programs do the work for you:

• With a medical billing software, you can automate many time-consuming aspects of the billing process, ranging from invoicing to claims processing. Electronic medical billing is the future of any medical practice and it is exactly what sets today’s clinics apart from traditional doctor’s offices.

• Transactions are made easier and faster as medical billing services help reduce excessive paperwork traditional medical billing processes require. With your own customizable program, you reduce tedious paperwork without compromising patient records, claims, and billing records.

• Medical billing software programs do require a substantial investment, but the upfront cost is a small price to pay compared with the efficiency that they bring to practices. Overhead expenses are also reduced as they eliminate the need to hire additional employees to take care of the different steps of the billing process that medical billing software can all do with little human intervention. 

• Thanks to advanced technological integration, medical billing programs also allow fast and easy access to all data and patient information a medical practitioner needs. With all essential data kept in a central location, you have access to the information you need anywhere and anytime you need them.

• Finally, medical billing software programs help reduce error margin as there is less manual work involved. The best programs can even be customized to fit your office’s workflow, helping you reduce errors while ensuring all your billing needs are met.

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