Get Paid For What You Deserve With A Medical Billing Company

As a healthcare provider, you know you need solid medical billing practices in order to keep things organized and get paid for the services you render, but have you ever stopped to think why it’s so important to your bottom line and indeed survival in this industry? You know full well most people don’t pay for their services with a wad of cash. That means they need to be billed. Yes, many people are responsible for co-pays but that money is a mere fraction of the full amount owed to your practice. The balance must be billed to the insurance company for reimbursement.

As a healthcare provider, you may depend heavily on revenue cycle management, submission of claims on a timely basis, payment from insurance companies, and balances paid by patients for their portion of the bill. While this is how things work in an ideal world, you’re often left waiting weeks, months and even longer to get what you deserve.

Why Are You Struggling With Billing?

You may ask yourself this question every once in awhile. Why can’t you just get paid for the services you have rendered? The main reason why so many practices, especially small ones, struggle with this task is because they are trying to save money by handling it in-house. You may have a receptionist who handles medical billing in her spare time, in between checking in patients, taking down contact and insurance information, and handling any number of administrative tasks.

So what ends up happening? Billing mistakes happen. Oversights are made. Timely follow-up on critical issues falls by the wayside. As a result, you don’t get paid — or at least you don’t get paid when you should.

Why Efficient Medical Billing is Essential

Bottom line is, you need to bill out as quickly and efficiently as you possibly can. In order to stay in practice, you need constant streams of revenue coming in to meet payroll and other expenses. Just like a lawyer, contractor or consultant, you depend on timely payment in order to make a living. You’re not being greedy or unreasonable. You provided the service; you earned the money. But too many physicians are waiting far too long to receive payment.

An efficient, outsourced medical billing service is imperative if you’re going to get claims submitted in a timely manner and make sure that the billing contains all the information needed for processing, such as correct codes for services, treatment, procedures, and surgeries.

Enjoying a healthy revenue cycle management process means you need to hire the right people with the right skills. Often times, that means hiring an outsourced medical biller who has the experience, qualifications, and skills to tackle coding and billing head on, every single day — not just on a lunch break, after-hours or in between checking patients in.

Streamlining your medical billing starts with an efficient billing service. Everything will fall into place from there. It’s time you got your house in order. Call Medical Healthcare Solutions today!

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Top Challenges Physicians Are Facing Today

Top Challenges Physicians Are Facing

In 2017, physicians are facing certain challenges this year more so than others. From MACRA to prior authorization requirements, physicians now have more to deal with on their plate in addition to staying at the height of their industry career-wise. Here are some of those biggest challenges.


A transformative healthcare event, unrivaled in probably about a decade, took effect January 1 but many physicians are unsure what the compliance requirements are. To review, MACRA stands for Medicare Access and CHIP Reauthorization Act. It was passed in 2015 as a sweeping way to fundamentally change the way our country evaluates and pays for healthcare. Essentially, it establishes a whole new method to pay physicians for caring for Medicare beneficiaries, including funding for technical assistance to providers, new development and testing measurements, new requirements for data sharing, and new federal advisory groups, according to the Network for Regional Healthcare Improvement. With the goal of restructuring U.S. healthcare, MACRA is based on two new reimbursement structures: the Merit Based Incentive Payments Systems (MIPS) and Alternative Payment Models (APMs).

Many physicians haven’t gotten on board yet. With a migration from volume to value, it’s necessary for physicians to get educated about the process now before they get buried by it.

Prior Authorizations

These requirements have increased quickly recently, with no signs of stopping. Prior authorizations can be the bane of many a physician’s existence, but the good news is there are many products and services available that can speed up the whole process. In addition, value-based payment models can cut down on how many drugs and procedures require approval before coverage kicks in from payers. Prior authorizations are necessary due to the higher costs and complications of medication. Technology like e-prescribing software can help through integration with electronic health record systems.


Negotiating with payers is necessary as more and more payers consolidate. As a result, physicians must face narrow provider networks and declining reimbursements. It can be frustrating to agree to one-sided contracts in order to keep up with their patient head count, but the prospect isn’t all grim. Physicians are advised to concentrate on the value and success they provide to their patients, outlining why the payer needs them to be on board. Come up with a pitch whereby you outline all the value your practice provides and how you’ve maintained quality consistently. It’s also not a bad idea to come up with a spreadsheet, updated weekly, that you can use to keep track of payer contracts, termination clauses, rate of payment speed and common codes for reimbursement rates. Now you have something concrete to reference when you feel the squeeze from payers.

Patient Frustration

Patients are understandably upset about rising healthcare costs. As a physician, you are often on the front line of these complaints, even though your hands are tied. You don’t set the prices yet you hear first-hand how frustrated your patients are with the system. With deductibles rising 40 percent last year alone and co-pays rising nearly 70 percent, patients are opting not to come into the office unless they have no other choice. They’re choosing not to fill prescriptions or they’re skipping important procedures due to the potential price tag involved. Educate your patients on cost and do some research on where they can get the same services or medications at a lower cost. Cross-analyze labs, pharmacies and even hospitals for the lowest prices on common services.

Maintaining Motivation

With all these compliance rules and regulations, it can be disheartening to keep up the good fight. You got into this career because of the joy you received from helping people. Dissatisfaction with strict compliance rules, as well as increased workloads and less time interacting with patients, can put a big damper on your job satisfaction. There are things you can do, though, to combat burnout, such as making changes in your work environment and engaging in stress reduction techniques in order to restore the work-life balance. One of the contributing factors to physician burnout has to do with dealing with the minutiae of administrative work. One solution is to outsource your medical billing services to a company like Medical Healthcare Solutions contact. We provide comprehensive medical billing, electronic health records and practice management services for physicians just like you. Call us today at 800-762-9800.

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student health billing

Increase Focus on Student Care with Third Party Billing

As a student care provider, you no doubt want to center your efforts on the quality of care that your students are receiving. Whether you manage a boarding high school, a small college or a university, you are likely experiencing some difficulties in terms of billing, particularly if you’re trying to handle it all in-house. This taxes your existing staff, increases chances for costly mistakes, and can be detrimental to your bottom line as accounts receivables are not enforced like they should be.

Your students need quality care, that’s a given. It’s also a fact that they have to be billed for those services. Generally, health care services are not covered under tuition costs. This is a precarious situation because many students are still included on their parents’ health plan. But what works in terms of billing for the parents may not necessarily work well on the student end. Students, especially young ones who may only be 14 starting out their first year at a boarding school, need extra TLC. They are in a new environment, they have questions that Mom or Dad can’t answer and they need help. That’s where you come in.

As such, it’s important that you streamline your medical billing efforts to bring an increased focus to student care.

According to the National Center for Education Statistics, more than 20 million students were enrolled at American colleges and universities in 2015, an increase of nearly five million since 2000. All of those students require quality care.

How Third Party Billing Helps

When it comes to student health billing, consider a third party provider to handle all this. You may currently divide billing among your staff, or perhaps you have an in-house employee that takes care of this. Either way, you could be losing money. Not only that, you could be devoting so much time on billing tasks and chasing down payments that you are failing in your most integral role: caregiver.

So, why should you outsource to a billing service? The main reason is to establish a new revenue stream through the reduction of self-pay billable line items. Those streams that you may have believed uncollectible now have the ability to be recouped, presenting a whole new possibility for revenue and growth potential. This is a good thing, especially in an economic climate where the recovery rate for non-hospitals is 21 percent for healthcare debt and collections, says ACA International.

Medical billing is demanding, draining, time-consuming and challenging. Taxing your staff with these challenges absolutely takes away time and resources better spent with your young patients. In addition to increased focus on student care, you can experience these benefits from hiring a third party biller:

  • Reduce billing errors
  • Save thousands of dollars annually on salaries and benefits, office supplies, furniture, billing software maintenance and computer equipment
  • Reduce billing interruptions due to employee absence
  • Improve patient satisfaction
  • Ensure billing compliance
  • Increase revenue

Sound like an asset to your school? Contact Medical Healthcare Solutions to learn how to make this a reality.

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HIPAA: Why You Need It

As an urgent care provider, you need to be quick in everything you do. From service to patient care and yes, even to billing — how you handle your processes can make or break your business. And with competition so high these days within your industry, you can’t afford to fall behind. One of the most important factors with your business, as you know, is customer satisfaction. Another factor is your own bottom line. With urgent care medical billing, you can achieve both goals: satisfying your customers and improving on how you collect payment.

However, it’s not enough to just have a good urgent care medical billing service in your corner. They must also know the ins and outs of HIPAA and how to apply them to their daily operations. HIPAA (Health Insurance Portability and Accountability Act) made history in 1996 when it provided the first nationally-recognizable set of regulations for the use and disclosure of patient health information. Since then, those regulations have formed the basis of healthcare, from doctor’s offices and ERs to ambulatory services and hospitals. Privacy is at HIPAA’s heart, and nowhere is privacy more important than in urgent care settings.

Emergency room medical billing is complex, with services being rendered at any one time by radiologists, cardiologists, respiratory therapists and all staff members. That’s a lot of patient information to keep straight, let alone safe and secure. That’s why you need an experienced HIPAA-compliant medical billing company to offer value-added support AND put confidentiality at the forefront. With so many ER and ambulatory services happening at one time, it’s impossible to stick to just one area of coding. Knowing all the coding specialties is a must, which is why any medical billing service worth its salt will have certified coders on staff who are experienced in a range of specialties.

Some sample services may include:

  • Hospital/inpatient coding
  • Payer-specific coding
  • Emergency room services
  • Hospital coding protocols
  • Audits
  • Temporary emergency medicine coding services to cover staff on vacation or sick leave
  • Physician documentation training
  • Compliance reviews

From patient enrollment and insurance verification to audit and claim submission, there are many balls to keep in the air, especially in an urgent care setting. Payment posting, accounts receivable collection and analysis, insurance authorization: all of these areas require dedicated professionals to ensure that no step is missed. Breaches in patient confidentiality can be a direct violation of HIPAA rules and regulations. Your organization can be hit with heavy fines and disciplinary measures, cutting into your bottom line. As an urgent care provider who can’t afford a hit like that, it’s in your best interests to ensure you have a dedicated team of professionals handling your medical billing. Leaving this up to your already-overworked staff means that mistakes can be easily made.

Many safeguards must be in place to ensure correct HIPAA compliance every time.

Some of those safeguards include:

  • Thorough checks on every employee who enters and leaves the premises
  • Password-protected computers
  • Firewalls and antivirus software installed on all computers
  • Regular backups of computer systems

Medical Healthcare Solutions Inc. is comprised of HIPAA-compliant coders and can help you more efficiently and safely run your urgent care operation.

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How to Wow Your Patients During Their Next Visit

Patient engagement is key in attracting and retaining people to your practice. Without it, and you’re just another faceless business that doesn’t do enough for your customers. Standing out in your industry takes more than friendly service and accommodating hours. It takes full engagement of patients in your care, providing them with the tools they need to more readily connect with every facet of their experience.

Staying connected is important. But, sadly, it isn’t readily achieved across all healthcare platforms. However, this should take support found outside your team to connect all available resources. You need products that integrate with solutions across your healthcare enterprise no matter what type of individual software you may use. The result? Improved patient care, satisfaction, loyalty, outcomes and the impact to your bottom line.

Streamlined Processes

User-friendly…easy navigation…secure…these are all words to describe the ideal patient portal system. When it comes to medical billing, people expect those processes to be as streamlined as possible. In a world of one-click ordering on consumer marketplaces like Amazon, people are used to instant gratification. They want to pay and manage their medical bills quickly and easily. This trend is moving toward patient financial responsibility, empowering a sense of “consumerism” to healthcare, points out The Beryl Institute. Bottom line is, people want simple, easy-to-read bills that they can pay out just as readily as they can their mortgage. Make it hard for them, and you may not see a payment at all.

Studies show that a patient’s payment experience influences their overall feelings about their doctor’s visit or hospital stay. That’s why a streamlined medical billing strategy is imperative.

A Patient Portal That Works

As a healthcare provider, you want a patient portal that’s easy — for your patients to navigate, sure, but also for you to navigate as well. Open-platform solutions like Allscripts FollowMyHealth® tailors options to your specific practice’s needs, blended with superior connectivity and robust population health capabilities. Never before has access to information, health plans, care teams, and patient history been so readily available. It’s also the most secure it’s ever been, as well.

You can use this user-friendly platform to encourage patient participation by adopting an active role in their healthcare experience. You can access it on the web or via an app, allowing patients to send their physicians messages in confidence, gain access to lab results, view updates on their account and renew prescriptions.

When it comes to monitoring and compliance, providers should be able to communicate with patients regarding their care management so they can better comply with their insurance companies. From simple assistance to navigating around the portal to patient engagement consulting services (PECS), smooth transitions should be part of your day to day routine.


Making a difference for your patients starts with the right medical billing provider and the right platform for delivering seamless integration. Make them stand back and say “wow”! Then you know you’ve done your job.

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