Tips and Solutions for Improving Your Revenue Cycle

When it comes to reviewing your revenue cycle, the devil is in the details. Rejected insurance claims that remain unreimbursed for years, coding errors, irregular or zero follow ups with the insurance carriers, lack of verification and credentialing, and incomplete medical records can all cause you to lose serious amounts of money. These mistakes make it easy for money to slip from your fingers—and in many cases, they can cost you millions over time. The good news is that they are resolvable.

Many healthcare institutions and hospitals have said goodbye to their old ways of billing and have opted to hired offshore medical billing companies that offer end-to-end medical billing services. This is an essential solution in improving and shortening your revenue cycle. Doing so will free your hands to focus more on your patients instead of worrying about unreimbursed and denied insurance claims.

Outsourcing your medical billing to another company whose expertise is medical billing saves you money. Instead of building and maintaining an in-house team, you could simply hire a company that does all of your billing management functions for a lower cost.

You can hand over any project any time because they have expertise in over twenty medical specialties such as radiology, neurology, cardiovascular, anesthesia, chiropractice, dental, OB/GYN, pediatrics, psychiatry, and more. They can also handle dozens of medical billing software, such as Medisoft, Intellisoft, Lytec, Denticon, Greenway, GE Healthcare, Cure MD, Ingenic, Ultra etc. There is no need to spend time training them or developing a system that works, because the best medical billing software company in India has already done that. Their program allows them to focus on speeding up the cash flow by ensuring a faster turnaround for submitted claims and identifying unreimbursed claims. They have helped many healthcare institutions with their revenue cycle—and the next one could be you.

Outsourced Medical Billing: Maximizing Revenue and Efficiency

Medical billing is one of the biggest expenses hospitals and private practices have to deal with. The process is long and complicated—and it takes a lot of time and resources that could be better used elsewhere. In many cases, outsourcing your billing functions is more practical and prudent in the long run. By hiring an overseas medical billing company, you can improve your clinic or your hospital’s efficiency and ultimately increase is revenue and profitability.

Some of the most seasoned, trusted, and reliable offshore medical billing companies call India their home, but they have customer support offices in the US so you always get real-time support. You might be discouraged by the obvious time difference between the US and India, but when it comes to processing medical billing statements, the 12-hour difference works in your favor. While you sleep at night, they are already processing the billing and claims that will be approved as soon as the offices in United States open the following day. This means you have a day’s worth of head start, which results in shorter revenue cycles and increases your cash reserves.

Switching from in-house billing to outsourcing is easier than you might think. There is virtually no adjustment period because the best outsourced medical billing providers can operate dozens of medical billing software. They can readily adapt to your system whether you are using Medtron, Medisoft, Lytec, GE Healthcare, Intellisoft, Ingenix, CureMD, Greenway, Raintree, Ultra, or some other platform. They also have experts in over 25 medical specialties. When you hire any outsource medical billing company with over fifteen years of experience, you can rest assured that your claims and invoices are managed properly. You can finally focus on your patients and taking care of them because you never have to worry about medical billing calculations and denial management. Be sure to choose a company that is ISO certified and HIPAA compliant. The best providers of outsourced medical billing are also members of the HBMA or the Healthcare Business Management Association.

Know the Best Time to Purchase Medical Billing Software

Ask practitioners who jumped too late into the electronic medical billing bandwagon, and they will tell you the same thing—the best time to purchase medical billing software was yesterday. Medical billing software systems offer a long list of benefits that significantly impact the way payments and insurance claims are handled in medical offices. If you are considering investing on your own medical billing system, here are some critical features you should know about to help you make an informed decision:

• The ability to process claims efficiently and in a timely manner is a fundamental feature that you should look for in a medical billing software. When claims are not being paid or collected promptly, your financial health as a practice might be put in jeopardy. Streamlining processes by employing electronic means make certain aspects of the billing process more efficient, such as dealing with claims and verifying insurance statuses.

• Choose a billing system that includes good claim validation functions so that it will be easy to spot and avoid possible rejections before a claim is even submitted. Among the main glitches that put a clog in a medical office’s cash flow and revenue cycle are resubmissions. A good medical billing software remedies this by making sure that claims get paid the first time.

• When choosing between medical billing systems, make sure that you find a provider that offers good support. Every vendor will claim that they offer the best customer service, but don’t take their word for it. Ask for references and do a quick review of their services and user experiences through feedback from other practices.

• While billing systems are fairly intuitive, some users, especially those who are inexperienced in the billing process may have trouble getting into the groove of using the program. It is best to find a vendor that offers ample training in the use of their system.

How to Choose Medical Billing Software for Your Practice

Now that you have invested in keeping your patient’s health records electronically accessible, it is high time that you upgrade your medical payment process and consider acquiring supplementary software system—one that will streamline billing and ultimately increase reimbursement rates, while keeping your revenue cycle continuous. When trying to decide on a medical billing solution to implement, here are some considerations you must take into account to ensure a good investment:

• While most payment management and electronic health record programs are designed so they can be interfaced, it is easiest to purchase both technologies from a single provider so integration can be more effective. While most systems have the ability to interact and talk with each other, limitations exist when they are designed and programmed separately. By purchasing both products from a single vendor, it is much easier to pull transactions and processes from your electronic health record (EHR) into your PM system. In fact, programs designed to work together can do this automatically and as seamlessly as possible.

• Choose a provider that offers ample technological support not only during system set-up, but after its implementation. While companies may charge high fees for important system upgrades, consider scheduled updates on the system so your processes will remain up-to-date. Consider your options when it comes to hosting and other technical aspects like program upgrades.

• Most importantly, choose new technology that supplements your practice’s goals and objectives, especially in relation to internal growth and healthcare reform. Choose a program that is well equipped to meet your requirements as an organization as well as the requirements of individual users. More than being an efficient billing tool, your payment management system should also ideally include practice management features, which can help you better keep an eye on your practice as well as the changes and trends in the industry.

Know Basic Information Regarding Account Receivable Management

Account receivable management is critical to any practice’s revenue cycle. With insurance companies increasingly inventing and implementing new and more complex sets of rules for medical procedures, practices are experiencing more underpayments and denials than ever. As a result, doctors, pharmacists, and other practitioners are finding it particularly difficult to manage under ever-changing standards and regulations for practices and drugs. This is also causing many doctors to shift their focus away from private practices, especially with increasing challenges in sustainability. More and more doctors and practitioners are therefore looking for a better and more innovative ways to approach account receivable management and amplify their bottom line.

Claim submission management is one of the best ways to avoid and bypass high levels of rejections. Generally, a submitted claim that hasn’t been paid during the first cycle of submission is likely to cause payment delays or never get paid at all. Identifying claims that have high chances of being rejected with the help of a well designed and intelligent engine that adapts to constant changes and updates on payer rules and regulations can help you prioritize account receivables.

Another major challenge when it comes to account receivable management is underpayment. Every doctor, for instance has a unique contract with each unique payer. This means insurers may pay a different amount depending on the type of medical insurance each patient has, even when they went in for or has received the same treatment for the same medical condition. Proper payment tracking is therefore critical to ensure that contracts are fully paid all the time as well as to predict future collections.

Documentation and workflow management are also critical parts of account receivable management. Having the proper tools to ensure proper documentation and efficient workflow enhances management of accounts receivables and makes way for proper reporting and analysis, which further translates to practice efficiency and success.

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Minimize Your Delays and Improve Your Collections with Insurance Eligibility Verifications

The number of patients paying through their insurance plans in the US is ever increasing. For this reason, healthcare providers need to strengthen their insurance eligibility verification process all the more. Failure to do this often leads to undesirable situations—more particularly unpaid or delayed claims that ultimately impact revenues. While it is possible to hire an in-house team, it’s often more practical to just outsource this task to a third-party company. If you have tried insurance eligibility verification yourself, then you know how detailed and tedious it is and how much it ties up your resources. Instead of providing excellent health care to your patients, you or your staff are caught up with telephone calls and paperwork that need to be accomplished.

To make the verification process less stressful and minimize delays, healthcare providers seek professional help from medical billing companies overseas. Outsourcing this process results in increased collection and reimbursements from insurance companies.

How exactly do medical billing companies help you? By keeping abreast with the changes of insurance policies, their expert teams of medical billing specialists can check whether a patient is still covered by their primary and secondary insurance plans or not. These agents also contact the patients to ask for more information when necessary. And in case the procedure is not covered, they inform the patient before treatment is given.

A reputable and reliable medical billing company is fast and accurate. They can do insurance eligibility verification ahead of time, offering outstanding services to both the provider and the patient. They also update the medical billing system with important information such as coverage period, co-pays, co-insurances, and deductibles for each patient. If next time the same patient needs treatment, the verification process gets faster.

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Know About 3 Anesthesia Coding Rules Which Will Get You the Reimbursement

Anesthesiologists, Anesthesiologist Assistants, and Certified Registered Nurse Anesthetists have huge responsibilities, and the lives of their patients rest on their hands. That's why it is only right that they get paid according to the service and care they provide. Coders or billers have a responsibility to ensure accurate anesthesia coding and timely reimbursements and following three rules help ensure the best results. 

1. Use the right modifiers.

To ensure proper payment from the insurance company to the anesthesia service provider, the coder must be aware of the different types of modifiers and know how to use them correctly.  

2. Include qualifying circumstances.

The anesthesiologist can receive higher reimbursement when the biller reports all the qualifying circumstances of the patient. Doing this also helps in providing accurate treatment to the patient in the future because every important detail is documented in the health chart.

3. Use the right conversion factor.

While computing the total amount of reimbursement, the coder must make sure that he or she is using the current conversion factor. This part can be tricky, as conversion factors for each state are different and ever-changing.

Each level of anesthesiologist has specific codes. They are billed according to base units, time units, and modifying units. Aside from these, many other factors should be considered when identifying anesthesia coding, make coding and billing for this medical service is complicated and daunting. For this reason, healthcare providers choose to outsource this process and let anesthesia billing companies do all the hard work. These third-party companies focus on documenting records and calculating the total amount of anesthesia reimbursement so that healthcare providers can collect payment faster. If you are considering this option, you might want to sit down with offshore anesthesia billing companies to explore your options. The best companies can offer affordable and reliable services.

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