All Posts in Category: Medical Credentialing

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.

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Get Paid For What You Deserve With A Medical Billing Company

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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The Importance of Revalidation & Credentialing for Groups & Providers

Medical providers must undergo revalidation and credentialing updates on a regular basis with their insurance carriers to stay current with the latest requirements regarding state and federal guidelines. This process also provides the insurance carriers with the latest information pertaining to their organization so that an active and accurate database of information can be kept on file. The insurance carriers require that all Medical groups and providers go through this process every few years in order to ensure that the correct information on file is maintained.

It is imperative that you do not ignore these requests because a lack of compliance will result in the deactivation of your billing numbers; and, without active provider numbers, a practice will not receive payment. Please note too, that if your number becomes deactivated it may take up to 90 days for reinstatement, impacting your bottom line even further.

Medical Healthcare Solutions, Inc. (MHS) offers complete provider insurance revalidation services as well as comprehensive provider enrollment and credentialing services for initial enrollment. It is crucial to work with a team backed by many years of experience in working with the major commercial carriers such as multi-state Medicare, Medicaid, and Blue Shield, among others. For instance, per Mass.gov, Medicare requires that all providers must revalidate every five years;  and submission of that application must occur within 45 days from the date on the revalidation notice.

Consistent Database

The main advantage of revalidation is to maintain an accurate and timely record of all provider and group information to speed up the process of claims and other medical billing tasks. Credentialing involves the review and validation of the professional qualifications of physicians who apply for participation in select insurance networks. This process is designed to ensure all participating providers meet their strict professional standards, thereby ensuring patients get the highest quality medical attention possible by qualified doctors and other providers.

Many medical billing companies provide complete credentialing services, which include assessment of the requirements by carrier, completion of the application(s), submittal to the carrier(s), and follow-up for processing by carrier(s). A database is then maintained by the billing company to keep track of those records across the board.

Switching hospitals or affiliations? Simply contact your medical billing company to prepare the right letters and forms for you to fill out. In addition, providers must submit credentialing change forms if there are any other changes to their enrollment information such as:

  • Legal business name
  • Practice location (change or addition)
  • Ownership
  • Authorized or delegated official
  • Changes in payment information
  • Legal actions

This is a crucial step in maintaining an accurate profile with your insurance carriers.

Insurance revalidation services work in much the same way. Your medical billing company will help you fill out the paperwork, submit the application and provide all necessary forms. MHS, your trusted provider of cooperative billing, has extensive experience working with a variety of software platforms with the ability to interface with all electronic medical records.

Contact Us

If you are sent a revalidation letter or credentialing request, contact Medical Healthcare Solutions, Inc. (MHS) right away to get going on your application. It’s important to get this information submitted as soon as possible to avoid payment interruptions.

Please contact us today to learn more information on how we can help with your revalidation and credentialing needs. We are proud to have decades of medical billing experience and service to the healthcare community under our belts and look forward to assisting you today!

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Medical Credentialing

Medical Credentialing is Important for Building a Successful Practice

Medical credentialing is the process of ensuring that healthcare organizations are in compliance with certain regulations. In most cases, this means communicating with insurance providers so that medical providers are able to accept third-party reimbursement for their services. Credential services specialists work closely with hospitals, physician offices and ambulatory care facilities in addition to insurance companies and credential verification organizations.

Some healthcare professionals see credentialing services as unnecessary or even a hindrance to their day-to-day operations, but the truth is that they are more important to the healthcare industry than ever before.

The Importance of Insurance

There was a time not too long ago when credentialing service specialists were considered optional to medical practices. Some patients would use their health insurance to cover treatments and procedures, but there were also plenty of people who were willing to pay out of pocket. That time is long gone. Presently, the vast majority of Americans have health insurance, and they are far more likely to use it than in the past. This is also due to the broader scope of many of today’s health insurance plans, which cover a wider range of treatments and procedures than before. Insurance plans cover more mental health and behavioral health treatments, there are fewer restrictions when it comes to pre-existing conditions, and even supplemental services such as physical therapy and holistic healing services are now covered.

Unfortunately, the changes that have been made to health insurance coverage over the last few years has also made credentialing services more complicated. While many healthcare facilities could perform these duties themselves before, hiring a credentialing specialist or doing business with a credentialing service is essential today. The right credentialing service can ensure that your medical practice is always in compliance with billing regulations and they can act as mediators between yourself and insurance companies. This can save you a lot of time and energy that would be better spent providing services to patients.

Making Your Job Easier

More than anything else, a medical credentialing specialist will give you peace of mind. Insurance is an increasingly large aspect of operating healthcare services, but it is far from the most important. Your staff needs to be able to provide services to your patients, and they shouldn’t have to feel like they’re spread too thin if they have to solve an insurance issue. Hiring the services of a credentialing specialist helps make your job easier, even as medical insurance becomes more complicated.

Sources:
http://medicalcredentialing.org/medical-credentialing/
http://www.usnews.com/news/blogs/data-mine/2014/07/10/percentage-of-uninsured-americans-now-lowest-on-record

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