All posts by Stephen Brighton

why you should be using a medical billing company

Why You Should Be Using A Medical Billing Company

A medical billing company is a valuable resource for physicians, medical practices, and other similar healthcare providers. There are many things medical billing professionals do other than post bills to patients. A good medical billing company will handle entering data about your patients into a patient management software such as patient information, physician information, medical codes, insurance information, as well as payment information. Additionally, medical billing professionals will help keep the payment process moving by re-submitting claims, interacting with all necessary parties to complete the billing process, as well as collecting payments from patients and insurers.

While some medical practices opt to do these services in house, there are many reasons why these services should be outsourced to a qualified medical billing company.

Finances

You will save money outsourcing medical billing to a third-party provider. The costs related to purchasing software and hiring and training staffers to do the work typically exceeds the amount you would pay to a medical billing service. In addition, medical billing companies will likely keep a closer eye on denied claims, forms, bills, and other issues that come up with medical billing while one or two staffers in your office may overlook these important issues causing severely delayed or lost payments.

Compliance

Medical billing companies are invested in staying up to date with the latest laws and regulations related to medical billing and patient management. Being compliant ensures that their clients are receiving the high quality service they can rely on. A medical billing company will award peace of mind that your practice’s medical billing practices comply with new laws, regulations, and industry standards.

Time

Another reason why you should hire a medical billing company is to better serve your patients by dedicating your time and resources to treating your patients instead of having to deal with billing. Running a practice brings a lot of responsibility, however outsourcing the revenue cycle to a third party provider frees up your time to focus on patient care.

Efficiency

Most medical billing companies will be able to provide comprehensive reporting on each aspect of the revenue cycle to show you where improvements can be made whether it’s during patient intake or after. This reporting provides an in depth look into the inner workings of your process and point out how to make it more efficient which could resolve cash flow issues, improve payment collection, and shorten the time between the patient’s visit and receiving the final payment. Without medical billing experts to help identify some of these opportunities, you could be leaving money on the table.

A medical billing company can provide a streamlined process starting with patient intake all the way through to final collections relating to the patient’s visit. Making sure this process is working at optimum levels is vital to the financial health of your practice. This process is called revenue cycle management and it’s all about processing information in a timely and strategic manner that will result in collecting payments as quickly and as efficiently as possible. In addition, a medical billing company will be able to communicate the status of your revenue cycle management and make recommendations for improvement. Overall, the business side of your practice must be working efficiently in order to keep it running. A medical billing company can help any practice do just that.  Contact MHS today to set up a demo and we can show you how we can help improve your bottom line.

Read More
2018 HEALTHCARE REVENUE CYCLE CONFERENCE

2018 Healthcare Revenue Cycle Conference: Sessions We’re Stoked About

The 2018 Healthcare Revenue Cycle Conference held in Charlotte, North Carolina this year will be jam-packed with industry leaders, workshops, and valuable insights into the latest developments regarding the revenue cycle management industry. As medical billing and coding professionals, it is our duty to keep a pulse on the latest hot-button issues, industry trends, and new technology to continue bringing cutting-edge value to our clients.

Revenue Cycle Management is very important to the financial stability of healthcare practices. It bridges the gap between providing valuable healthcare services and handling the business side of providing that service. Revenue Cycle Management utilizes a complex network of Health IT systems, communication with patients and payers, and internet-based billing procedures to manage the cycle of healthcare from the initial patient visit to getting paid. Over the years, there have been many new developments in Revenue Cycle Management such as the way we access information, how data is stored, how bills are paid, communicating with patients, handling insurance claims, and many other facets involved in running a healthcare practice. One of the best ways to keep up with these important trends is to attend conferences such as this year’s Healthcare Revenue Cycle Conference taking place in mid-September. We’re excited to take part in this important event and here are some of the great sessions we’re looking forward to.

Hitting the ground running on the very first day, Dan Mingle, MD, Founder and CEO, Mingle Analytics and Kelly Whittle, Founder and CEO, Whittle Advisors will share the newest trends regarding the MACRA regulation including techniques on how to succeed with MIPS and the Quality Payment Program introduced under MACRA. Mingle’s overview of MIPS will include new 2018 requirements, measure selection, data requirements, and the importance of measure performance monitoring. Additionally, he’ll highlight ways to handle reporting with the MIPS program and how RCM companies like us can help our customers unlock data to analyze practice performance and improve MIPS scores. Ultimately, this session will give us a strong foundation to help our customers transition from claims-based reporting to a more value-based framework and to clearly communicate the new payment reform strategy laid out in the MACRA regulation.

Following up this powerful session, Ted Stack, Managing Director, Falcon Capital Partners LLC, will deliver a helpful lecture on creating value in our RCM service that will transfer on to our clients. In this session Stack will discuss how creating value in our business is critical for our customers given the fact that the healthcare market continues to evolve each year with constantly changing consequences on the billing service providers. As we continue to follow these trends, we will be able to identify areas for improvement and ways we can further maximize the bottom line for our clients.

One of the key developments in the Revenue Cycle Management Industry is Robotic Process Automation (RPA).In recent years, new technology has developed that can further streamline the process of collecting money in less time and at less cost. John Fundingsland, VP and GM Healthcare Operations, Hexaware Healthcare Technologies, and Dan Hillman, VP Revenue Cycle Strategy, Hexaware Healthcare Technologies will discuss in detail how RPA has impacted Revenue Cycle Management processes and how we can incorporate some of these practices into our programs so we can pass along those savings to our clients.

Another session we’re looking forward to is Five Strategies Critical to Achieve Payment Assurance Through Patient Engagement, provided on the Operations Track. This session will help us identify ways we can engage with the patient before, during, and after the visit to assure payments are being made at a fast pace. What’s interesting about this session is that these strategies were put in place to combat the recent explosion of patients visiting doctors’ offices, yet still owing a balance for previous visits long after the service was completed. This can cause significant damage on cash flow and overall daily office management. This session will help uncover opportunities for improvement in billing services while also reducing overhead costs and ensuring providers get paid. This is a big goal we strive to meet for our clients on a daily basis.

These are just a few of the sessions we’re looking forward to attending, but there are many more! Not to mention that this year, the conference is held in Charlotte, North Carolina, home of the Hornets! We’re excited to explore the Queen City as we dive deeper into one of the most important facets of our industry. There are so many new facets and areas to learn about when it comes to Revenue Cycle Management and a great place to dive in head first will be the 2018 Healthcare Revenue Cycle Conference.

Read More
Get reimbursed for medical services

Get Reimbursed for Medical Services You Already Are Performing

You are already performing a wide range of medical billing services within your office. You should be getting reimbursed for all of them. In a nutshell, medical billing reimbursement medical healthcare solutions involves payments received for procedures and services performed, from commercial payers such as insurance companies, that act on behalf of healthcare programs. This reimbursement is determined by the claims submitted and documentation provided and filed by providers like you through the proper use of medical diagnosis and procedure codes.

Commercial payers must follow standards set by the U.S. Department of Health and Human Services (HHS), with many of these regulated by each state. With the exception of specific national mandates, like reimbursement for childbirth, commercial payers determine what their rules will be in regards to medical necessity or payment/reimbursement fee schedules. Federal intermediaries like Medicare will reimburse physicians and other providers for services provided to beneficiaries on a fee-for-service, or FFS, basis. Fee schedules are set for physicians, ambulance services and clinical laboratory services, as well as medical equipment, prosthetics, orthotics and supplies.

The Changing Role of Healthcare

Reimbursement in the realm of healthcare is changing. Even prior to parts of the Affordable Care Act began to take effect, a burgeoning focus on value-based care vs. volume has prompted many health-care organizations and providers to look at accountable and patient-centered care models whereby they take on a greater amount of risk. That’s why revenue must be managed in a different way to make sure that the value delivered to patients is paid for — both accurately and in a timely manner.

In order for hospitals and physicians to ensure their claims are paid out, they first have to understand the differences in various components of claims management and how they can affect reimbursement. This knowledge is time-consuming to attain but can pay off in the end.

You are likely handling several aspects of your company’s billing services. With overworked staff taxing that system, you could be overlooking many reimbursements for work you’re already doing. There are many components of the patient-provider interaction that fit within the revenue cycle and that could lead to loss or risk due to gaps in service:

  • Pre-service (including pre-registration and pre-auth)
  • Process of care
  • Process-integrity practices (including code compliance)
  • Billing services (customer support)
  • Administrative services (debt collections, contract management, etc.)

Professional, Outsourced Assurances

The business of healthcare requires certified medical billers who possess the skills necessary to expertly tackle all aspects of the revenue cycle. Without this expertise in medical billing and the nuances of payer requirements, reimbursement is often compromised. Seeking out a professional medical billing and reimbursement specialist means you can submit claims in accordance with government regulations and private payer policies, follow up on the status of a claim, resolve denials, submit appeals, manage collections, and post payments and adjustments.

If you would like to know more about medical billing reimbursement and how it can help you, contact Medical Healthcare Solutions, Inc. in Andover at 800-762-9800.

Read More
Drug & Addiction Center Billing

Drug & Addiction Center Billing

Just as hospitals, medical centers and doctors’ offices need help with their billing processes, so too do drug and addiction centers. These centers are designed to treat people of all ages who suffer from all manner of drugs and addictions, from prescription drug abuse and hard drug abuse to alcohol and drug addiction treatments. As the owner or office manager of a drug and addiction center, you know all too well how tricky this area can be to monitor and enforce.

Substance abuse billing is different in many ways from medical billing and coding, and comes with its own set of challenges and parameters. This is why billing has to be handled in a specialized way. This is also why there is such a high value placed on partnering with a specialized substance abuse billing company rather than a standard medical billing company. Ideally, you should hire a medical billing company that handles both aspects because you know they offer a well-rounded suite of services.

Why You Need Specialized Services

Procedure codes form the foundation of the billing process, which help insurance companies identify what is being prescribed by the doctor, clinician or therapist to prevent potential insurance fraud. Each industry has different sets of codes and protocols for filing claims. Lacking an understanding of the specific substance abuse billing procedure codes means a medical billing coder is essentially ineffective. Costly mistakes can happen, all at your expense.

The substance abuse billing company and the treatment center both know and understand the patient’s struggles inside and out, allowing for a stronger, combined effort that results in better communication between all parties involved: the treatment center, billing company, and insurance carrier. This is achieved through customized paperwork solutions, such as verification of benefits forms for each center’s use.

Billing companies accustomed to working with treatment centers know the details of how the every-day business is run. With such a specialized knowledge of the substance abuse industry, billing providers can offer rehab facilities the best possible care for patients.

Resources

There are many resources for drug and addiction centers and the billing providers that help them. The codes alone can be staggering. From Medically Supervised Outpatient Withdrawal to Chemical Dependency for Youth Outpatient Clinic, the list can go on and on. Proper knowledge of these codes inside and out is mandatory for any billing provider. Some helpful resources for codes include:

Center on Addiction

American Society of Addiction Medicine

Substance Abuse and Mental Health Services Administration

HCPCS

Department of Health and Human Services

Here at Medical Healthcare Solutions, we understand the intricacies of substance abuse center billing codes, with a highly experienced team that works hand in hand with the treatment team and the insurance company. Offering both a customer service and clinical perspective, we can ensure you receive compensation for all services rendered. Count on us to understand all the intricate methods needed to correctly bill for substance abuse, behavioral health and eating disorders, among others, founded on a deep knowledge of chemical dependency, detox, dual diagnoses and behavioral health disorders. We also know it’s critical to bill the insurance companies right the first time.

Our clients can rest assured they will receive reimbursement for every level of care they offer, from verification of benefits to electronic billing and collections. Plus, we stay apprised of all the latest insurance and coding procedures so you can enjoy high returns.

To learn more about our drug and addiction center billing, contact Medical Healthcare Solutions today online or call us at 800-762-9800, or fill out our online form for a speedy reply to your query.

Read More
Medical Billing mistakes

The Cost Of Medical Billing Mistakes

The Cost of Medical Billing Mistakes

Medical billing errors are costing you money. Period. As a healthcare provider, you know the high cost of care and the competitive nature of the market. You can’t afford to lose an extra penny — especially due to a billing mistake that could easily be corrected. Sad thing is, you may not even realize how much your current medical billing system could be costing you. Some studies put the error rate for medical bills at a conservative 30 to 40 percent, with others put it closer to 80 or 90 percent, says The Huffington Post. Another study shows that medical billing errors cost about $20 billion, a number that has increased right alongside the increase in U.S. population.

A Look at the Numbers

Most of the costs associated with such billing errors involve expenses due to unnecessary inpatient and outpatient care, ancillary services and prescription drug services. But a surprisingly large portion of the mistakes is linked to the mortality rate and missed days from work. If you widen the lens and look at the costs as they pertain to quality of life and fatalities due to medical errors, the total costs jump to between $187 billion and $250 billion. Widen that lens even further to account for loss of productivity in patients who have experienced a decrease in quality of life and you’re looking at costs even into the trillions. Human error is one of the most common causes of medical billing mistakes, such as when a wrong billing code is entered.

Bottom line: medical billing errors are expensive. While you may be able to afford malpractice insurance (and let’s face it, this cost alone is probably eating into a lot of your profits), you certainly can’t take the blow to your reputation in event a major medical billing error costs someone their health or their life. So, ask yourself: do you have the in-house manpower necessary to make sure you are responsible for as few billing errors as possible? If the answer is no, you should probably think about outsourcing your medical billing.

Protecting Your Business and Your Patients

To protect your business and bottom line, it’s wise to examine your records for the past couple of years. What’s the total cost of your errors? How could they have been avoided? Remember, you’re in the healthcare business, caring for your patients from the time they step in your door until they walk out. You have a certain duty of care to uphold for them. It’s critical to ensure your patients don’t fall victim to easily-avoided medical billing errors. In the process, you’ll save your business’ budget and reputation.

Contact Medical Healthcare Solutions

If you are ready to improve your office processes, cut administrative overhead and boost patient satisfaction within your practice, rely on the seamless medical billing provided by Medical Healthcare Solutions. We can help you put an end to those costly mistakes that are leeching your profits and taxing your resources. Call us today to learn more at 800-762-9800.

Read More