All Posts in Category: Medical Billing

The Benefits of Medical Billing Outsourcing

The Benefits of Medical Billing Outsourcing

Medical billing outsourcing offers a supervised and practical technique for managing the revenue cycle. A successful medical billing practice is essential for the long-term success of any medical firm. A very effective strategy to guarantee this is to outsource the medical billing. By outsourcing, the vendors can handle the entire medical billing process, freeing up the providers to focus on what they do best: caring for patients. 

The number of patients receiving services, personnel changes, and other dynamics is continuously improving going forward. In these situations, the medical providers maintain a consistent level of revenue. Additionally, by outsourcing medical billing, they can make the best use of their resources and time.

Why would one outsource medical billing?

Medical billing has a number of other benefits outside only saving time and money. Before making a choice, one should carefully weigh all the advantages of medical billing outsourcing. We’ve outlined the many benefits of why choosing to outsource medical billing services is a preferable choice.

Minimizes Billing Errors

Medical billing service providers with experience and training are familiar with all the intricate steps of submitting claims. They ensure that their team has thorough process training and domain-driven knowledge. Furthermore, they guarantee accuracy and prompt submissions. You may even witness a reduction in the number of claim rejections. Additionally, they also check and correct claims before sending them.

Cash Flow and Revenue Both Increase

You can actually save a lot of money by outsourcing your medical billing because you won’t need to spend money on office supplies, medical billing software, or hiring more staff in-house to do the job. Occasionally, while in the shuffle of running a medical practice, it is common to overlook medical billing tasks. Outsourcing medical billing tasks to a professional service provider can prevent all of these hurdles. Billing companies have a productive method of getting insurance companies to approve claims. Overall, timely bill payment boosts your income.

Enhanced Level of Safety

Your billing operations are absolutely safe when they are outsourced to a third-party service provider. A fairly transparent invoicing method is offered by reputable outsourcing firms. The majority of service providers have medical billing procedures that are 100% secure and compliant to guard against any hacking attempts. Reputable outsourcing companies delivering medical billing services have the necessary infrastructure and security to create a secure environment for medical billing operations. Thus, they provide businesses the peace of mind that their data is safe and private at all times.

Greater Consistency

The danger of handling medical billing in your clinics is substantial. The revenue cycle could be disrupted by an unexpected absence or staff turnover, which delays the submission of claims and increases the possibility of human error during the claims processing process.

When you outsource your medical billing and coding, you can be sure that all of your claims are processed accurately and without delay since this is their sole job and they are experts in it.

Ensure Better Patient Satisfaction

It can be difficult and inconvenient for certain patients to visit the clinic. They not only need to accept any disappointing news about their health, but they also need to be aware of the fees associated with visiting a doctor. While the medical billing specialist takes care of all the financial details, a skilled and welcoming team can ensure that your patients are delighted and happy throughout their treatment plans. This increases everyone’s effectiveness and productivity.

The Ability to Stay Current with Industry Changes

To comprehend the numerous patient billing requirements, one must maintain ongoing industry awareness. Because of its network connections and resourcefulness, medical billing service providers are able to keep a pulse on the market at all times. Even a capable internal team is unable to consistently keep up with the numerous and intricate changes that billing codes undergo, which might include being established, updated, or even eliminated.

Speed

Regular patient billing errors can put a doctor’s practice out of business, but so can poor claim processing times or delayed payments. Utilizing cutting-edge technology, medical billing service companies guarantee quicker claims collection and money recovery. They streamline billing and revenue cycles for greater profitability, efficiency, and time.

Access to skilled professionals

The majority of offshore service providers provide access to highly proficient experts. Additionally, they have the necessary training in all business aspects of medical billing services. In order to ensure that all carriers are paying the correct amount, they examine and monitor all payments. To cut down on overhead, they keep track of every unprocessed claim until the full amount is paid.

Takeaway

Benefit from a higher degree of profitability with our comprehensive medical billing services. Additionally, maintain your position as a leader and raise the quality of your patient experience with us.

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Top 5 Tips for Improving Your Revenue Cycle Management

Top 5 Tips for Improving Your Revenue Cycle Management

With proper care and management, your hospital’s revenue cycle can be one of your business’s most essential and lucrative areas. Hospital revenue cycle management is not always easy, particularly when considering the number of stakeholders involved in the process. From insurance companies to patients to physicians and more, each party has its expectations, which may often be at odds with one another’s.

You can streamline your operations with a revenue cycle management service. This includes all the steps required to get reimbursed by insurers for claims processed by your hospital and its medical staff. Here are five tips to improve your hospital’s revenue cycle management.

#1 Hire a designated care coordinator

A designated care coordinator is a person who cares for a patient from admission to discharge. They will be responsible for ensuring that all necessary procedures are completed on time and that everyone involved with the patient understands their role in the process. To keep up to date with value-based reimbursement, a care coordinator should always stay current with new legislation and policy and measure the organization’s efficiency.

Hiring a care coordinator for your healthcare organization can help streamline your revenue cycle management. So whoever you hire must have experience in several areas, including communication, being responsible for monitoring, and project management. It is better if they have experience as an administrator or manager.

#2 Use Software Solutions

To improve your revenue cycle management, you should consider using software solutions to automate your manual processes. This will help prevent errors and ensure your data’s accuracy, enabling you to identify areas of improvement in real-time quickly.

  • Software solutions can also help streamline your billing process by offering online payments and scheduling appointments, making it easier for patients to get the care they need on time.
  • Create a waiting room that is designed for efficiency and does not waste time by having people stand in line for hours. This can be done with a simple computerized check-in system.
  • Utilize an online registration process, which allows patients the freedom of filling out the form from home and scheduling an appointment from the comfort of their own homes.

#3 Audit your denials

A great way to improve revenue cycle management is by conducting a denial audit. This process entails reviewing your denials for possible overpayments, underpayments, and other errors, to better understand how often these mistakes happen and how much you might be owed.

You can do a denial audit internally or with the help of an outside consultant. Either way, it will help you understand where any weaknesses in your system may exist, and then you can improve them so that fewer mistakes are made.

#4 Track performance

In the healthcare industry, revenue cycle management is a crucial part of the business. It’s essential to keep track of your organization’s performance to improve and stay competitive.

Find out where you are doing well and where you need improvement. With this, you can focus your resources on the right areas.

Another helpful way to improve your hospital’s revenue cycle management is by benchmarking yourself against similar hospitals.

Don’t be afraid to consult with outside sources for help, either. It can be hard to know what needs improvement if you’re not an expert in every area of hospital operations.

#5 Automate patient financial experience

One way that hospitals can improve their revenue cycle management is by automating the patient’s financial experience. This will include updating the registration process, new patient forms, and statements. In addition, automation tools for discharge processes may be beneficial in reducing errors and streamlining post-care instructions.

Also, review your current contracts with payers, so they don’t have restrictive terms like requiring a provider to use a specific billing service.

Conclusion

The more efficient your hospital is, the higher your revenue will be. Following these five tips can improve your revenue cycle management and help you achieve your business goals. You need to manage all aspects of your revenue cycle with a holistic approach. You can streamline operations by integrating various departments and optimizing workflow. Implement the latest technology to increase productivity. You must ensure you collect payments from uninsured patients, so they don’t go into collections. Also, ensure you train the staff in customer service and keep up-to-date on changes in healthcare laws.

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Barriers to Care: How This Urology Medical Billing Company Is Committed to Improving Patient Access

Barriers to Care: How This Urology Medical Billing Company Is Committed to Improving Patient Access

Two components determine the success and longevity of urology practice: timely billing and rapid reimbursement. Urology medical billing is exceptionally complicated, with modifications and other complexities having a significant impact.

Numerous urologist offices recognize the necessity for a competent medical billing service to manage their billing issues and increase their practice’s earnings. They conclude that outsourcing is the most efficient way to handle their urology medical bills. Moreover, in 2016, fraudulent provider billing, duplicated billing, and charging for treatments that were not medically necessary contributed to 46% of provider fraud incidents. Hence, the need for a urology medical billing company is essential.

Medical Healthcare Solutions, the leading medical billing company, helps practitioners with urology medical billing. Here is how outsourcing urology medical billing to us can help you. 

How Is Medical Healthcare Solution Helping Urologists?

Inaccurate medical billing is frequently why urology clinics do not get timely medical reimbursements. Urology practices might depend on a urology medical billing company to fulfill reimbursement requirements. Hence the urologist medical billing business with whom you work must know to manage the complexity of urology billing codes and modifiers. 

At Medical Healthcare Solutions, we are committed to delivering services with additional value that ensure greater reimbursement and minimal rejections. Our medical billing and coding services suit hospitals, physician offices, clinics, health professionals, multi-specialty health centers, and other practitioners.

Additionally, the urology service codes vary depending on the patient’s operation. Our medical coders are familiar with the most recent diagnostic and procedural urological codes and modifiers. Further, they undergo continuous training to remain updated with the current updates of urology billing.

Several medical offices are uncertain about whether they should do billing in-house or outsource it. By outsourcing medical billing responsibilities to Medical Healthcare Services, you have much more time to allocate to patient care-related duties without worrying about your collections since we are working continuously on it.

We provide efficient and trustworthy medical billing solutions to reduce your burden and enhance your earnings. We adhere to the most recent medical billing and coding regulations. So save time and money by outsourcing medical billing services instead of carrying these activities in-house and saving resources and investment on costly software and employee training and retention. 

Still not convinced why to outsource your urology medical billing to us? Here are the top reasons to do so.

Reasons To Outsource Medical Billing To An Urology Medical Billing Company

Better revenue via increased collection

We will prioritize increasing your income with consistent collection efforts if you outsource your urological medical billing. Your payments will also accelerate, saving your unnecessary worry. Further, we provide you with the advantage of professional and highly-skilled billing and coding employees who remain up-to-date with changes in urological coding and other regulations.

This assures that your claims are filed accurately and without mistake, preventing payment delays. Further, we are well aware of what factors cause urology medical billing denials and the procedures for avoiding denials through appealing them effectively to the insurer to get prompt payment. We are competent in handling rejections and have extensive skills and experience.

Better control

It is a prevalent misperception that outsourcing Urology Medical Billing would result in losing control over your organization’s processes. However, many think having a skilled and dedicated urology medical billing company offers them greater control of their medical billing processes. This enhanced control ties itself closely to the significant monetary and operational benefits that outsourcing offers.

Better Security

Outsourcing Urology Medical Billing to a urology medical billing company is completely risk-free. Moreover, we employ HIPAA-compliant and completely secure medical billing methods to avoid hacker attempts. So medical professionals must understand that their data is always secure. In addition, we have the necessary security measures and infrastructure to ensure a safe environment for your urology medical billing outsourcing activities.

No costly upfront investment

When a medical company outsources medical billing, it avoids the need to purchase software packages or other cutting-edge technologies. Following outsourcing, the company no longer requires updating expensive software. Since they don’t own a  comprehensive billing system, the expenses have been drastically reduced. Instead, you may allocate those funds to other areas of your practice to improve practice.

Conclusion

By outsourcing medical billing operations to a reliable urology medical billing company like us, your clinic commits more time and resources to increase patient retention and satisfaction. We strive to deliver exceptional customer service. Contact us to see how our medical billing outsourcing services may increase your profitability.

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The Complete Guide To Urology Medical Billing

The Complete Guide To Urology Medical Billing

Urology billing is the process through which practitioners submit claims to insurance companies for services rendered to patients. The medical billing and coding professionals predefined codes for various treatments. To achieve this formality, the whole procedure of Urology Billing individual treatments has to undergo restructuring.

Account reimbursement, rapid follow-up, and timely invoicing affect the income earned through your Urology services. One of the most important decisions a medical service provider can make is to hire a good medical billing company to comprehend the commercial element of Urology Billing services.

Let us deep dive into this guide to urology medical billing.

Types of Surgeries in Medical Billing Urology 

A few of the most renowned types of surgeries under medical billing urology include:

  • Endoscopy (Urethroscopy, Cystourethroscopy, Cystoscopy, etc.)
  • Laparoscopy
  • Transplantation
  • Catheter introduction
  • Incisional/Biopsy
  • Excision
  • Repairs

The Changes in Urology Medical Billing Procedures?

Urology billing and coding is pretty comparable to other medical billing and coding. The urinary-related treatments billing codes begin with ‘0T’ and continue depending on the type of procedure conducted, according to the Medical and Surgery category.

For example, if the treatment involves inserting an artificial sphincter into the patient’s urethra to aid with incontinence, 0THD0LZ will be the ideal billing code.

The ‘0T’ indicates that this is a urinary system surgical operation. The ‘H’ indicates that the primary procedure is a Urology medical billing insertion. The letter ‘D’ represents the portion of the body where the ultimate procedure will take place; in this example, the urethra. The ‘0’ indicates that the method is approached in an open manner.

When a patient is open to undertaking specific treatments, it is called an open approach. The ‘L’ indicates that the equipment being injected is an artificial sphincter, whereas the ‘Z’ indicates that the treatment has no extra qualifiers.

Understanding the Urology Medical Billing and Coding Structure

Keep in mind that urology billing codes vary depending on the operation performed on the patient.

The code for treating the patient’s right kidney repair, for example, would be 0TQ00ZZ.

‘0T’ again places the code in the category of urinary system surgical procedures. The ‘Q’ denotes a repair for the root operation.

The ‘0’ indicates that the right kidney is undergoing therapy or repair. The next ‘0’ indicates that the operation is open-ended. The ‘Z’ indicates that the healing technique is open and that there are no further criteria for this therapy.

Following the entry of the procedure codes, the information is transferred to a billing form and delivered to the insurance company. The insurance payer then transforms the code to determine how much of the procedure is covered by the patient’s specific insurance plan.

The insurance company will then repay the urology practitioner or facility for its allocated amount, and the patient will be billed for any leftover balance. Also, patients seldom, if ever, see the particular billing code allocated to them for any operations. Overall, this is for internal usage and documentation only.

For individuals who are unfamiliar with the various codes for certain procedures, urology billing and coding might be difficult. Moreover, you can identify the performed procedure if you know the pattern and the codes, which makes billing even easier. Finally, keep in mind that the correctness of your codes and paperwork is critical to receive full reimbursement.

Urology Medical Billing: Key Steps

Prior Authorization:

Because urology treatments are costly, the doctor must first obtain prior approval from the insurance provider. Prior Authorizations help the organization comprehend the filing procedures, submit claims on time, and receive reimbursements instead of denials.

Medical Necessity: 

To charge appropriately for the high-cost services as per the physicians, medical billing for Urology must show the medical importance of the course of therapy.

Denials due to eligibility and benefits: 

Verifying a patient’s eligibility and coverage for a specific service at least 48 hours before the appointment will decrease denials.

Invalid or missing CLIA number: 

While invoicing for the Lab test, the practitioner must update the CLIA number. CLIA stands for Clinical Laboratory Improvement Amendments (Clinical Laboratory improvement Amendment)

Not Covered

Medicare will not pay for A Codes such as A5114, A4357, A4340, A4334, A4331, and others, and they will be denied as Non-Covered Services. Some supplemental insurance policies, on the other hand, will cover Medicare’s non-covered treatments.

CPT codes for certain CPTs should be encoded with the right units as approved by the payer. Payors will deny CPT codes 77263, 52310, 52300, and 51700 if we bill for more than one unit.

CPT 51701-51703 Medical Record Documentation in Billing:

Providers should not report 51701-51703 in conjunction with any other operation that requires catheter insertion.

Modifier 59: 

When invoicing for two Urology services at the same time, the providers must use the 59 modifier.

LCD (Local Coverage Determination) Recommendations:

Providers should follow LCD rules before charging for Urology services.

Best coding and billing practices for urology

Urology coders are difficult to find and expensive to hire, and their continued training might be pricey. Our urology coders have received the necessary training and have CPC certification, and they can handle several operation reports each day. We cover the most difficult component of the CPT codes in our Urology specialty coding service, and our coders can handle all diagnostic, modifier, and procedural coding issues. 

At every level of the billing and coding process, we assure HIPAA compliance. To avoid rejections, our team undertakes prior authorization of the patient’s eligibility and benefits. Contact Medical Healthcare Solutions for more information.

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Benefits of Urology Medical Billing

Benefits of Urology Medical Billing

Urology billing and coding services include coding and billing for all diagnosis and treatments for the urinary system and male reproductive system dysfunctions. Because of the nature of its codes and terminology, urology billing might be more complicated than other specialties.

Importance of Urology Medical Billing

Urology medical billing is an important part of any hospital or medical office’s ongoing operations. 

Receiving Proper Reimbursement

This urology medical billing includes drafting and submitting urology billing claims to insurance companies. This guarantees that the medical office or hospital receives proper reimbursement for the services provided to patients.

Gathering Funding from Commercial Insurance Companies

Medical offices receive funding from commercial insurance companies as well as government-funded healthcare programs like Medicare and Medicaid. If the medical practice obtains sufficient financing, it will be able to continue operating. Because they are underpaid, it is difficult for them to provide quality service to patients.

Saving Money for Greater Benefit

Insurance companies make money by collecting premiums or monthly payments from their insured consumers. Depending on the arrangement of the policy, insurance companies may be able to cover most of the policyholders’ medical expenses owing to buy-ins from pool members. With that in mind, reimbursements represent a significant amount of money that is not coming from customers’ pockets.

Paying Only For The Services Claimed

Not only that but precise medical billing and coding is necessary to ensure that patients do not overpay for procedures and that they and their insurance have to pay only for their services claimed.

That is why proper medical billing and coding is crucial. Data must be documented for every patient who visits any medical facility such as an urgent care center or a hospital.

The Need to Outsource Urology Medical Billing

Urology billing and coding need particular experience and understanding, which can only be handled by a urology billing professional. So, taking the benefits of urology medical billing can be critical. Urology is different and difficult to comprehend since it overlaps with other specialties such as gynecology, endocrinology, pediatrics, andrology, gastroenterology, and oncology.

Urologists frequently lose sight of their revenue cycle as they focus on providing outstanding medical treatment. Because urological treatments are often expensive, underpayment or non-payment for urology services delivered can have a significant impact on the business. Although having an in-house billing staff might be beneficial, the lack of knowledge may result in many denials. Outsourcing to a specialized urology billing service provider who is experienced with urology codes and terminologies may provide healthcare institutions more control over collections and rejections.

Urology practices and medical institutions cannot afford to leave income uncollected by billing agencies or freelancers who are unfamiliar with urology billing while the cost of delivering urology-related healthcare services continues to climb. Not only is insurance billing more complex in urology, but patient billing is also more challenging. 

Patients frequently have large balances, confusing explanations from their payers, and do not comprehend all of their urologist’s charges. A billing organization with extensive urology billing experience has already discussed such statements with the patient. A less skilled patient gathering attempt might result in less money for the urologist and dissatisfied patients.

Urology Medical Billing from Medical Healthcare Solutions

It is critical to recognize that understanding all of your practice’s income streams is essential to effective Revenue Cycle Management. As a result, our team will monitor, measure, and manage all parts of your revenue cycle to assist you in increasing profitability.

The Medical Healthcare Solutions team does indeed have outstanding tools and experience. As a result, we’ve put in place Revenue Cycle Management tools to gather revenue from claims payments, patients, and evidence-based data. Collecting from all of these sources can help your practice obtain its healthcare payments and become more lucrative.

The team at Medical Healthcare Solutions has a solid reputation as a medical coding specialist for urology medical billing. Our team can assist you in understanding all the benefits of urology medical billing. 

Medical billing, for the most part, starts with accurate and full data in the medical record. As a result, coding is the process of converting your intellectual effort and services into a code that can be used to charge insurance and demonstrate the worth of your service.

For the insurance claim, the core objective of medical coding is to convert a provider’s narrative or description of a condition, accident, or surgery into universal medical code numbers. As a result, by accurately matching services with a medical diagnosis, our team of expert, qualified medical coders provides better compensation.

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