All posts by medicalhealthcaresolutions

Massachusetts Urgent Care Billing

Massachusetts Urgent Care Billing

Do you want to increase your clinic’s collections by streamlining your urgent care billing process? Are you looking for highly qualified and experienced Massachusetts urgent care billing professionals who can handle all of your medical needs? Then outsourcing urgent care billing needs to an expert urgent care billing service provider can prove to be the best alternative for you.

Before we get started, let’s know more about Massachusetts Urgent Care Billing.

How does the urgent care billing process work?

Urgent Care Clinics are becoming increasingly popular as a way to bridge the gap between general care and the emergency department. To get the most out of this increasing phenomenon, businesses must pay close attention to their billing procedures.

Massachusetts Urgent Care billing services assist through the typical service bureau approach as well as an online connection from the client site to their office by utilizing full, complete healthcare information software systems. Further, the provider will tailor their services to the client’s exact requirements.

Massachusetts Urgent Care Billing Services Offerings:

Some of the key Massachusetts Urgent Care Billing Services include –

Urgent Care Billing Data Entry

Providers of Massachusetts Urgent Care Billing have the necessary experience to give clients error-free and highly accurate urgent care billing data input. Thus, these services ensure that all data is entered correctly and that no errors are made while filing claims.

Fee Schedule Updation

They have some of the best and brightest urgent care billing professionals who can handle all of your fee schedule updates. Furthermore, their company assists you in negotiating timetables, setting them up, and ensuring that all is updated on a regular basis to meet the demands of the customer.

Urgent Care Billing Audit

In addition, the team evaluates each entry in the claim for accuracy and validates it after they get the money and proper reasoning from the clients. Such services assist clients in submitting error-free claims and minimizing rejections.

Urgent Care Claims Filing

Furthermore, Massachusetts Urgent Care Billing service providers employ the most up-to-date urgent care billing software and resources to assist customers in filing urgent care claims. Before the claims are uploaded to the site, they are double-checked for correctness. As a result, you may be confident in its correctness and get reimbursements within the stipulated period.

Appeal Management

The providers also help with high-quality and speedy appeal management services during insurance company denials for erroneous claims. This allows clients to file an appeal before the deadline. Furthermore, it guarantees that clients overcome denials and receive timely payments. 

Why choose Medical Healthcare Solutions as your Massachusetts Urgent Care Billing partner?

Massachusetts Urgent Care Billing

Medical Healthcare Solutions, Inc. (MHS) assists you in increasing revenue by optimizing your urgent care billing procedures. We have a team of billing professionals that are highly qualified and knowledgeable and can meet all of your demands.

We understand each client’s individual objectives and give them solutions that will meet their business demands, having been one of the best quality urgent care facility billing services since 1991.

MHS focuses on the Allscripts product line. Also, we have experience with IDX, GE Centricity, EPIC, eClinical, Cerner, and Athenahealth, among other software systems. Moreover, MHS can also connect to all of the most popular EMR systems on the market.

We have the expertise with a variety of products and interfaces that let us satisfy the specific demands of our diverse customer base.

Benefits of choosing MHS as your Massachusetts Urgent Care Billing provider

Some of the best advantages you will receive with us include:

  • Flexible pricing approach according to the clients’ demands and expectations while keeping their financial capacity in mind.
  • Complete data protection for both clients’ and patients’ information.
  • Our clients benefit from world-class infrastructure and a devoted workforce that works around the clock to provide the finest service possible.
  • Billing managers with years of experience assure the most accurate and cost-effective billing procedures.
  • In comparison to our competitors, we have a faster turnaround time.
  • Highly scalable approach that may scale in response to the client’s needs and requests.
  • Insurance verification over the internet (iVerify)
  • Calling to remind you of an appointment (iRemind)
  • Others.

Contact Medical Healthcare Solutions now to learn more about our Massachusetts Urgent Care Billing services and solutions!

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Four Ways a Medical Billing Company Can Save You Money

Four Ways a Medical Billing Company Can Save You Money

Medical billing is truly a fuss! Moreover, it isn’t necessary to carry out your billing services in-house. Fortunately, billing is mostly a clerical chore that involves skill sets and experience and can be performed outside the healthcare organization.

To put it another way, outsourcing this task is a great idea. Outsourcing medical billing is incredibly useful to medical practices. However, this may not suit everybody, and there are likely drawbacks.

On the other hand, finding qualified medical billers can be difficult and costly. Recruiting, interviewing, and training good medical billers requires time and money. You’ll have more costs in the shape of pay, bonuses, office area, technology, and taxes whenever you recruit people.   

You might think about outsourcing your medical billing to a medical billing company.

Four Ways You Can Save Money with Medical Billing Company

#1 Check for Patient Insurance Coverage Automatically

It’s a waste of time and resources if your organization relies on temporary staff or needs to hire part-timers to execute the fundamental task of validating a patient’s health insurance.

Allowing a medical billing company to handle this on your account is simpler and more convenient. Moreover, checking on this information automatically is simple. Also, knowing a patient’s policy means you’ll know significant facts faster, like whether they have reached a threshold or what may be covered versus what required pre-authorization.   

Moreover, if you don’t know your patient’s insurance policy, there may be chances that you would deduct a significant amount. So, you may incur a heavy loss. However, if you don’t address their insurance policy, patients will likely choose your medical services the next time.

#2 Spending minimal time and money on recruiting and retaining top performers.

Medical billers are in high demand, yet supply is limited with the number of physicians. On the contrary, hospitals often have far higher finances than private firms.

However, hospitals are in a stronger position to support and maintain the leading medical billing professionals now that they have more financial capital. As a result, you may need to devote a significant amount of time and money to finding qualified medical billers for your firm.

Also, you’ll need to set aside cash to keep a qualified medical biller once you’ve hired them. Due to the great demand for medical consultants, they may seek employment elsewhere if they are dissatisfied with your clinic’s salary or working environment.

Moreover, a medical billing company is a vendor; thus, the partnership is at the authority of your practice. The medical billing business is responsible for continually providing value and retaining you as a client. It’s in their best interests to keep your business so they can maximize revenue and maintain client acquisition expenses down.

Four Ways a Medical Billing Company Can Save You Money

#3 Secure Patient Data

Furthermore, one of the strongest reasons for outsourcing medical billing services is its increased protection.

In 2018, 222 cases of hacked medical records were reported, and around 11 million patient information was affected.

Cybersecurity is a top priority for medical billing organizations. After all, healthcare providers’ confidence in them makes or breaks their organization, and even a single data breach might jeopardize their professional reputation.

They have the provision of storing electronic health data in the most secure environment.

Do your research before selecting a medical billing company. Make sure they have a good track record when it comes to security.

A competent medical billing service will take care of cybersecurity and ensure that your patients’ information is kept safe in all situations.

#4 Reducing Coding and Billing Errors

Even the most competent and professional setting can lead to human errors and blunders. There might be chances your team might not suggest that there might be a better way to deal with an increase in billing errors or incorrect diagnosis and treatment codes.   

You may bet on fewer billing errors if you outsource billing.

The reason for this is simple: a medical billing company spends all of its work, especially with codes, and its employees have a lot more familiarity with them. They will make significantly fewer mistakes and will be able to detect and correct them far quicker than your team employees.

Bottom Line

Many practices benefit from outsourcing medical billing to a medical billing company; nevertheless, your revenue and expenses will ultimately drive your decision. We recommend thoroughly evaluating the medical billing company to ensure they have professional experience, in addition to the cost-benefit analysis.

With Medical Healthcare Solutions, the most reputable medical billing company in Boston, be assured you will get top-notch medical billing services.

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Physician Credentialing Services

How Much Time Are You Wasting On Physician Credentialing?

You have toiled for years to gain the right skills, knowledge, and training to become a doctor who selflessly serves their patients. Finally, you are looking forward to joining a clinic or practice. You are certain this is the start of a golden career ahead. But before you can actually start practicing medicine, you need to become a credentialed physician

Credentialing is the process of verifying your education, training, experience, and license to practice. It basically means the medical authorities authenticate you as a physician with an original and genuine educational and professional background. Though you can undertake this exercise yourself, physician credentialing services take away all the hassle from you and do the verification in an organized, professional manner. Their services are trustworthy, and important medical institutions and offices vouch for them.

The Significance of Physician Credentialing Services

Physician credentialing is important for doctors, nurses, and all healthcare providers. This physician credentialing process acknowledges and places on record the training and certification of these professionals in medicine. It also implies that your license to practice is valid, recognized, and authenticated. 

A physician credentialing service undertakes a high level of scrutiny so that no one and nothing can compromise the integrity of the medical profession. The ethical standards of people working in medicine should always match standards set by various medical authorities and institutions.

Why Outsource Physician Credentialing Services

If you undertake physician credentialing by yourself, there will be a lengthy procedure to follow. There will also be considerable paperwork to submit and numerous phone calls to make. You also need to be familiar with various rules and regulations, which vary from state to state in the USA. 

So, do you have the time and resources to undertake this by yourself? You need a minimum of 3 months to complete the credentialing. However, it might take longer than that, and there will be a lot of communication and coordination you will have to do in the interim. As a doctor who is first and foremost a caregiver, your priority would be diagnosing and treating people. This indicates that you may have to leave this task to the professional physician credentialing services. After all, just a month of time and expense diverted to activities not related to providing patient care is a considerable dent in your income. Multiply this by (at least) 3, and you know how much you are losing when you undertake physician credentialing on your own.

Relying on a Physician Credentialing Service Provider

Now, let’s consider a scenario where you have roped in a professional physician credentialing service to do this for you. You just provide them with the necessary documents and sit back and relax. Such a service usually has experts who undertake complete physician enrolment and credentialing services for you. 

How do they do that? They have worked with and are familiar with the functioning of all major commercial insurance carriers. So, no matter which insurance carrier covers your practice, the credentialing service will take care of everything for you. They are there for you right from filling the application. These services then submit the same and also continue following up with these carriers until such time that your application is approved.

Your credentials are very significant for your professional identity and future medical practice. When selecting the physician a patient would like to visit, the first thing they check is the education and years of experience a doctor has. It goes without saying that you don’t want to make any errors while undergoing credentialing – all the more reason to select an expert, trustworthy physician credentialing service that does full justice to your profile.

Why Medical Healthcare Solutions?

At Medical Healthcare Solutions, we provide a doctor credentialing service that is efficient, timely, and comprehensive. We don’t mind going the extra mile to ensure nothing is left to chance when it comes to your physician enrolment and credentialing. We hand-hold you throughout the process, leaving your time and resources for other, more important tasks. With us as your credentialing service partner, all your information and documents are in safe, expert hands.

How exactly do we undertake such an accurate physician credentialing service on a large scale? It’s simple. We have a team of experts who are well versed with the functioning of major insurance carriers and their framework of rules and regulations with respect to physician enrolment and establishing credentials. 

We are there with you from start to finish. Not only do we help you actually fill in the application, but we don’t rest until the final credentialing is done. It does not matter how often we need to initiate and follow up; what matters is the seamless process completion.

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Physician Credentialing Services

Physician Credentialing Services Can Save You a Lot of Time

The internet today is a major part of the healthcare system. A majority of patient appointments nowadays have found a place online. This also has extended to updates regarding treatment and other health-related activities. 

Before any physician can have an online profile as part of their practice, the hosting portal or platform needs to verify the genuineness of the physician. In addition, they should garner basic information like their registration number, board certifications, admission privileges, work history, etc. 

You also perform background checks to rule out any prior medical malpractice or otherwise untoward event in the doctor’s earlier period of caregiving. You can call this process of authenticating a physician’s record and ascertaining whether the practice falls under illegal or illegitimate as credentialing.

Process of Physician Credentialing Services

Physician Credentialing Services

Under this process of physician credentialing services, the entire professional life of a doctor is vouched for and ascertained to be true. For instance, it includes their degrees and board certifications, years of practice, hospitals where they help and provide care. Further, it also looks after their clinic and registration numbers, and anything else related to their work histories.

Most health maintenance organizations and online healthcare portals have a physician credentialing service in place. This process begins with the physician (or healthcare platform/portal) completing an application for charges against care provided. Later, they submit it to the insurance carriers. 

Once the carriers accept such an application, the process of credentialing is complete. Besides this, healthcare provider enrollment, or the procedure of including a doctor as a caregiver with a particular healthcare portal, also falls under physician credentialing service. 

Undertaking a physician credentialing service ensures that the doctor’s information and records are up-to-date in the insurance carrier’s accounts. Also, the insurance carriers receive intimations about the changes in hospital affiliations and practice locations as part of credentialing follow-up.

This process of physician credentialing service is really beneficial to both doctors and health maintenance organizations. Let us look at how and why.

Less Time Wasted in Undertaking Self-Credentialing by the Physician:

According to a study, physicians spend a significant amount of time in activities not related to direct caregiving and examining patients. Paperwork and other administrative tasks like scheduling eat up this time. 

When a doctor undertakes the process of credentialing themself, they lose valuable time. This time, they could otherwise spend productively examining patients and generating revenue. In such a scenario, outsourcing the physician credentialing service makes a lot of financial sense.

Professional Handling of Claims and Payments by Experts:

Physician Credentialing Services

As a medical professional, suppose you have hired a third-party entity to undertake your credentialing. In that case, you can rest assured that all the paperwork related to claims processing and ensuring that payments are secured will be undertaken by them knowledgeably and professionally, devoid of errors. 

Getting claims approved by insurance carriers can be tedious and a little complicated. Leaving this job in the hands of experts and experienced to do so will turn out as a strategic move. Moreover, it will prove quite beneficial to your practice.

Physician credentialing services ensure that the entire process of submission of forms and claims and any follow-up required in this regard is carried out meticulously by personnel trained for the same.

Updating Changes to Your Professional Profile:

Your physician credentialing service does not merely undertake a background check on you and verify your details. It also follows through and keeps track of any changes in areas of your functioning. For instance, it updates for any change in location practice, hospital affiliations, etc. 

Imagine informing every known as well as a prospective patient that you are now practicing in a different area. You may have a lot of work to do. Thus, the credentialing service follows such details, and updates your information regularly. So once you have a credentialing service on board, you can forget any headache about intimating new information to those concerned. It will all be taken care of.

Physician Credentialing Services Also Provide Additional Services

Nowadays, you have physician credentialing services that are also into revenue cycle management, maintenance of finance and accounting services, and marketing. They basically offer you a bouquet of services in the realm of administration which takes away a massive chunk of the paperwork that otherwise you would have ended up doing. 

Overall and in the long run, this system simplifies the entire caregiving process for you, so you have all the technicalities of administrative work sorted out under one roof. What’s not to like?

Come, partner with us today, and get more productive in your medical career!

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Nursing Home Billing Guide

Nursing Home Billing Guidelines

Nursing homes are as important as hospitals and other centers of medical care nowadays. They are an equally important factor for ensuring the good health and wellness of citizens of modern American society. This applies more to the infirm and the elderly.

There are different types of nursing homes like skilled nursing facilities (SNFs), Independent Living Facilities, Assisted Living Centers, to name a few. These institutions bill their patient or the patient’s legal appointee for their services. The State has put some guidelines in place for such billing.

Let’s see what these nursing home billing guidelines are and which factors affect the billing process.

Period of Coverage of Bill

The nursing home usually issues a monthly bill for its residents for services it has rendered and medical care it has provided. The resident (or their legal appointee) enters into a contract with the nursing home. This contract offers details about billing frequency.

Mainly, this bill includes the charge of all essential services provided. However, sometimes, it also includes the charge of other associated services.

The billing cycle is the time period (calculated as the number of days – a month, for example) for which each billing takes place. Then, the nursing home may also charge a prorated amount for the month of admission. This means that in case the resident did not start his stay on the first day of the billing cycle, the billing amount equates to the per-day charge of room and board multiplied by the number of days. Sometimes, the care facilities also issue a pre-bill for the cost of the upcoming month.

Level of Care Provided

Assisted Living Centers like nursing homes and SNFs provide different, multiple levels of care based on the requirement of their inpatients. This level of care affects the amount they bill their patients to a significant extent. Further, these levels can broadly be classified into primary, secondary, tertiary, and quaternary levels of care.

A primary level of care provides the very essentials or the basic level of medical care. So, routine testing of a patient’s vitals falls under primary care. Additionally, if you require other specialized doctors to treat you, the primary level of care undertakes this required coordination.

Then there is the secondary level of care. Medical specialists usually provide this level of service. As an example, the primary care physician might treat a resident for common indigestion. But when the physician refers them to a gastroenterologist for further gastro investigation, it becomes the secondary level of care.

Tertiary care is very high, requiring complex equipment and a high degree of medical expertise. Some examples are complex microsurgeries and neurosurgeries. Tertiary care, being complex in nature, is not provided at small, regular hospitals or nursing homes. The nursing home usually refers its patients to specialized tertiary care centers.

Lastly, there is quaternary care which is nothing but an extension of tertiary care. It is a highly specialized level. Experimental cancer trials are an example of this.

Nursing Home Billing Guidelines

Type of Insurance Coverage

There are some Medicare Part A criteria for SNFs. If the medical needs of the patient in question meet these criteria, Medicare as an insurance carrier will pay for up to 20 days of stay in the nursing facility. Some insurance policies cover long-term care in nursing facilities.

Leaves of Absence

This is a factor that also affects the nursing home bill. A resident might need to leave the nursing home for a while. Mostly, they or their proxy will sign the bed hold waiver to reserve their room for them in their absence.

But this implies that the care facility will continue to bill the patient in his absence too. Alternatively, the inpatient could forfeit the bed hold, meaning fewer charges but nonavailability of room as a possibility when the resident returns.

The US Government has also specifically created and issued nursing home billing guidelines for nursing home billing. There are also CPT codes for nursing homes that simplify the billing process. For more information, you can visit Medical Healthcare Solutions, Inc.

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