8 medical billing tips

Collect More from Patients: 8 Medical Billing Tips

Unsurprisingly, medical billing is among the most challenging tasks that healthcare organizations come across. Though physicians are well-trained in handling their patients’ health, there are a number of things to consider to keep up with the revenue cycle

While medical billing is complicated, here are the eight medical billing tips which can help you to sustain the costly work of offering healthcare services.

Tip #1: Develop a clear collection procedure

This is the first and most significant medical billing tip. 

  • Notify patients about the requirements of debt repayment. Provide information concerning their payment responsibilities in their new-patient papers, and nudge them off their duties frequently, particularly when things alter. 
  • Collect complete details of the patient. Such details comprise their address, contact number, email-id, etc.
  • Help the patients recall their co-pay and its importance. Make sure your team knows how to respond to any inquiries a patient may have.
  • To avert claim rejections, bring the proof of insurance with you to each appointment and double-check the person’s eligibility. Much better, to save money on staffing, employ an electronic verification method.
  • Determine what funding methods are accessible to the patient at the moment. Clarify what comes under their payments. For instance, help them to know if credit cards, cheques, or money are accepted and whether installment plans are possible.

Tip #2: Engage in staff training

After establishing a structured and verifiable billing procedure, you must put effort into proper staff training. It’s never a good idea to skip this medical billing tip or think that only the person who files the claims requires training. In addition, ensure that every team member has exact knowledge of their responsibilities and expectations.

Tip #3: Handle claims correctly

8 medical billing tips

  • Never procrastinate in filing claims. Yet, exercise extreme caution to confirm that the claims are accurate and comprehensive. Make it a practice to file all the claims at the end of the day. 
  • Submission of the claim does not refer to the end of the process. Make very sure that all claims are updated until the patients fully settle them. It’s all too easy to get caught up in the daily grind and overlook minor claims.
  • It’s essential to deliver the claim to the correct payer — the one who is accountable for that specific payment. Claims addressed to the wrong recipient will cause delays. They will reject the claim, and then you have to resend it to the correct recipient. Delayed payments have almost the same impact on the revenue cycle as rejected refunds.

Tip #4: Verify Patient’s Insurance

You can check the patient’s insurance upon every visit. In addition, double checking that it is up to date from when they were last seen would help to avoid any further renewal issues. Also, it is important to check eligibility to be sure the patient’s visit is covered by their insurance. This will not only increase cash collection but will also eliminate any bad debt. 

Tip #5: Stay informed

Medical billing standards are continually updating, and catching up with them can necessitate ongoing staff training and technology updates. Keep up with any changes that may affect medical billing processes, and obtain required training. It’ll save you money in the long run if you don’t have to redo claims as often.

Tip #6: Determine problem accounts

By setting clear protocols for dealing with patient finances, you can have the data for identifying possible problems. Adopt methods for identifying problematic behaviors such as delayed payment, consistently denied payments, or variations in contact details. 

Tip #7: Manage denied and rejected claims on time

Screening a claim for mistakes can help to reduce the number of rejections and cancellations. However, if they do happen, make sure to deal with them as soon as possible. 

Maintain contact with a payer agent. They can assist in resolving issues with the initial claim and supply updates on subsequent claims. This can all assist in speeding up the claim modification cycle and reduce the time it takes to reject and resubmit claims.

Tip #8: Hire a trustworthy billing company

8 medical billing tips

This is the must-follow medical billing tip if you are unable to follow the above ones. If you’re having trouble keeping up with current invoicing laws, getting rejections in payments,  have problems delegating responsibilities, etc., then a medical billing company can help you.

Takeaway

All these tips can help you collect more from your patients and on time. For your best medical billing system and to have some more information, Medical Healthcare Solutions Inc. can help you.

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Physician Credentialing Services

The Advantages of Using Physician Credentialing Services

When it comes to the medical world, medical credentialing has opened doors that were earlier not so helpful for medical providers. More and more patients opt for insurance and try to benefit themselves with reimbursement from the insurance companies. Thus, the medical practitioners can deliver their services to a number larger than ever.

Let us look at how physician credentialing can benefit the physicians searching for credentialing services and offer them privileges through an insurance company.

Assuring quality

Medical credentialing offers quality assurance in the healthcare industry. It’s a means of review for the medical field. In other words, it makes sure that the medical sector regularly provides quality standards to the patients.

To keep the prices down, insurance companies are attracted only towards well-off medical physicians. Also, they look at those who have shown the ability to showcase their specialties.

Physician Credentialing Services

Keep up patient’s safety

Credentialing helps to keep patients safe as it ensures continuous practices. It makes sure the physician has the skill, capability, and experience needed to perform procedures on their patients. This process helps reduce the chances of medical errors, usually caused due to incompetent providers.

When all this background is available, physician credentialing helps rebuild the lost trust between medical practices and the patients. Patients who are aware of their physicians’ merit and qualifications to be the chosen providers place their faith in their capabilities. 

Save losing revenues

Proper credentialing helps medical practitioners save thousands of dollars in revenue in the form of reimbursement. This is either denied or delayed. If there are errors in the process or receive improper attention to receive proper credentialing, it may lead to insurance companies failing to reimburse the medical bills for the treatment.

In scenarios where medical practice lets a physician give services before or between the credentialing process, the insurance company can advise the patient for the complete reimbursement to cover the expenses of the treatment.

Enhances your patient base

Physician credentialing gives medical practices access to those patient bases that were not earlier available to them. With this, they can accept patients covered under health insurance. Most Americans use health insurance plans.

As per 2019 data, 90.8% of people were covered under health insurance. This helps medical practices to raise their clients and significantly boosts their revenue.

Increase practice reputation

The number of patients researching healthcare practices and the physicians before choosing them has seen unprecedented growth. These include knowing their background or going through a patient’s review online.

One of the best ways to improve your online reputation is to undergo medical credentialing. While potential patients research your medical practice, looking at your credentials conveys that your practice is reputable, merited, and trusted.

Improves the hiring process

Physician Credentialing Services

If a physician is credentialing, they need to go through a full examination process that studies their educational background, residential history, work experience, and any other merit.

If your medical practice wants to hire a medical practitioner, who should be credentialed, this process helps verify whether they are capable enough to perform the given job tasks.

Conclusion

Though it is important to access the new patients, the medical credentialing process can be time-consuming and lengthy. To speed it up, learning how medical credentialing works will help you simplify all credentialing requirements. For more information, you can visit Medical Healthcare Solutions Inc.

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Get Claims Paid Faster

How To Reduce Your Insurance Accounts Receivable And Get Claims Paid Faster 

How To Reduce Your Insurance Accounts Receivable And Get Claims Paid Faster 

Life insurance, health insurance, motor vehicle insurance and (strictly if applicable) malpractice insurance – all intend to help the end consumer work seamlessly, live comfortably and breathe easily.

However, repeated corrections in accounts receivable lead to much mental stress for all those associated with this process. Further, it troubles those who have to generate them. This includes the healthcare practitioner’s office, and ultimately, the patient.

Since everything boils down to the patient as the customer, we should receive the funds of the claims faster. Let us see how we can do it.

Revenue Cycle Management Chain: Right from Generation of Patient Bill to Actual Payment

The need of the hour then is to reduce the time taken for “claims processing” and ensure accounts receivable are kept at a minimum. This can be done by implementation of the following:

Get Claims Paid Faster

Greater efficiency and Lesser Wastage of Resources

The ancillary medical staff should come qualified in the processes involved. It comprises medical coding, billing and also communicating to the insurance carriers. This applies to the insurance companies too. The generation of medical bills starts right after the initial examination of the patient. And, it sums up until the actual monetary amount is credited to the healthcare provider. You can reduce this entire process of the “accounts receivables” that forms part of the complex and extremely time-sensitive key function known as Revenue Cycle Management.

Any clog in this wheel and the disadvantages, not merely monetary, can increase the magnitude.

Innovation in Available Processes

The revenue cycle for ‘Insurance Accounts Receivables’ begins with a patient walking into a caregiver’s office, clinic or hospital and ends with that caregiver receiving due compensation for his services, time and sometimes, empathy over and above the two formers. Not only the patient, but even the physician also undergoes a lot of stress.

Being up-to-date with the latest in medical billing and newer technology are the crux for ensuring faster claims and reducing Insurance Accounts Receivables.

Get Claims Paid Faster

Accepting the limitations of the Healthcare Insurance System/Healthcare Practitioner Business Model:

There is no such thing as an optimal RCM (Reverse Charge Mechanism). It needs to improve constantly upon itself.

It is not for nothing that most hospitals are ‘Not for Profit.’ That means an increase in revenue gets pooled back into the system. This should be essentially in place to help patients heal.

So, to conclude, from identification and rectification of process lacunae to creating new processes themselves, the “Kaizen” philosophy of management should work for faster claims processing.

Implementing the Principles

It is best to adapt these principles at the core.

Personal Discipline and Improved Morale

Any and every healthcare worker who puts the patient before himself leads the way for optimal processing of claims and insurance reimbursement.

Teamwork

Positive outlook in recruiting and training personnel, keeping in mind their necessities, builds teamwork with a uniquely positive cumulative effect on institutional efficiency.

Quality circles

A relatively new term, quality circles means an “optimal” chain of the management processes. Here, each resource can help in a multipronged manner to the best of its capacity. This avoids duplication altogether. For instance, the process can use the same mobile phone of a healer for anything and everything between securing patient appointments to confirming billing numbers.

Ultimately, Suggestions for More Improvement:

Optimization of resources and enhancing personnel efficiencies along with their morale can refer to as the holy grail of faster claims payment. Moreover, the revenue cycle management should be open yet transparent for everyone to understand easily.

Takeaway

The process is a financial burden on all involved. And, more so, it affects the patient who is also the health insurance consumer. You can call them the fulcrum of the healthcare business model and the start and endpoints of the monetary aspect of the insurance industry. Lastly, so also is the healthcare business owner.

If you want a faster and top-notch process following company, Medical Healthcare Solutions Inc. is the one to look for. With decades of experience in medical billing, you can have a seamless journey of medical billing.

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Medical Claim Denials

How to Deal With Medical Claim Denials and Rejections

We know you hate medical claim denials and rejections. It can be difficult for practitioners to deal with such denials. The job can be complicated, frustrating, and often very time-consuming.

Knowing how to deal with medical claim denials can save you time and improve your cash flow. Here are some basic pointers to remember:

Review all Information That You Have

Rejections are more common than you’d like to think. About 17 percent of all in-network claims were rejected in 2019 and the number was 14 percent in 2018.

To reduce your risk of medical claim denials, review all the information you have including remittance advice and explanation of benefits.

The notification sent by the insurance provider indicates whether the claim was denied, partially paid, delayed, or paid in full. 

Follow the instructions if the claim stands “contested or unclean”. Correct the issues, if any, and resubmit the claim with any missing information. 

Look for reasons why the payment was declined and make sure to follow the steps provided by the insurance company.

Get in touch with the carrier if the notification isn’t clear. Having a conversation with the carrier can help solve small issues such as an administrative error or poor submission procedures.

Waste No Time

Waste no time and submit and resubmit claims as soon as you can. Most companies and statutes put a limit on when claims can be submitted. Being too late can cause you to lose money. 

Apply Again and Again

If your resubmitted claim gets denied and the denial seems improper to you then go ahead and appeal the decision. Make sure to follow all guidelines and submit the required documents to ensure your appeal gets accepted.

Remember that the process varies from provider to provider, hence check with the carrier. Moreover, state laws also come into play. In most cases, you will have to submit an explanation of why you wish to appeal the decision and provide documents to support your claim. 

You may have to submit documents to demonstrate necessity if your claim got rejected due to a lack of “medical necessity”. Be careful about the information you provide.

All practitioners are required to meet the set obligations under the HIPAA and to only provide what’s ‘necessary’. Working with a HIPAA-compliant company like Medical Healthcare Solutions can help reduce the risk.

Filing another appeal or resubmitting your claim may do the trick. Do not give up just because you are asked to submit the claim again and again. Being persistent shows you’re serious about getting paid.

Understand How to Appeal

Since the appeals process changes from company to company, it is important that you ask questions and ensure you’re fully familiar with it. 

Being aware of the policies will put you in a favorable position to respond to medical claim denials.

Keep a Record

Keep a record of everything related to a claim including the name of the person you’ve been corresponding with. A few more things to take note of include: 

  • Why the company chose to deny, partially pay, or delay the claim
  • How your office followed up
  • The outcome of the follow up

You might need this information in the future when you choose to appeal or file a complaint regarding medical claim denials. Moreover, these records can help face similar situations in the future.

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What is AllScripts

What is Allscripts?

Allscripts or Allscripts Healthcare Solutions, Inc. is considered a global leader in the domain of healthcare IT. A US company, it offers health care providers, hospitals, and doctors’ access to electronic health record technology and practice management systems.

The company offers different products intended for patient engagement, care coordination, analytic technology, and financial software.

As of date, its network has more than 180,000 users – primarily physicians and its solutions and services are being used in 2,700 hospitals. The flagship of Allscripts is also visible in almost 13,000 extended care groups and organizations and 40,000 in-home clinicians.

Allscripts’ Brief History

Allscripts is a household name when it comes to health care solutions. The company was founded in 1981, with its main headquarters based in Chicago, Illinois. Later on, an additional operations office was established in Raleigh, North Carolina.

Allscripts merged its healthcare systems operation with its competitor, Misys Healthcare Systems LLC of London, in 2008. Two years later, Allscripts-Misys also connected with another healthcare IT competitor – Eclipsys became part of the business organization in a whopping $1.3 billion deal. This merging of powerful and innovative companies and patient records resulted in an extensive database of clients in the industry.

Last year, Allscripts made two huge divestment decisions. At the beginning of the fourth quarter of 2020, AllScipts sold the brand’s EPSi business. This was the unit responsible for providing financial decision support and planning tools with health systems and hospitals as its primary clients.

For $365 million, Strata Decision Technology became the new owner of EPSi. And by the last month of the year, Allscripts also let go and closed the deal of CarePort Health, its care coordination business. Wellsky was the winning bidder for $1.35 billion.

Allscripts’ Competitors

The company’s top two competitors are Cerner Corporation and Epic Systems Corporation.

Ranked third among the best hospital-oriented EHR vendors based on revenue, Allscripts has the full potential of moving ahead of both Cerner and Epic Systems.

In the ambulatory market, AllScript competes with eClinicalWorks, eMDs, AthenaHealth, Greenway, and NextGen.

Allscripts Solutions and Services

Allscripts’ very first software is an e-prescribing system, well-known for its innovative and reliable features. Here are some of the brand’s services and software.

Electronic Health Record (EHR) Systems

Gone are the days of messy and indecipherable patient charts. An EHR system is the electronic and more organized version of a patient’s medical records. Allscripts maintain this crucial electronic documentation, and it includes all the essential clinical data relevant to the patient.

Among the information collated are the patient’s demographics, medical history, medications, previous lab test results, and progress notes.

Allscripts’ EHR system is not limited to the information of the patient. It also includes modules for ambulatory clinics, emergency rooms, lab systems, surgery, and wound care. It also makes coordination with other health departments easier and seamless too.

You also have the following options with Allscripts’ EHR systems –

o   Appointment monitoring

o   Care coordination and guides

o   Clinical decision support

o   Date source consolidation

o   E-prescribing

o   EHR Mobile

o   Maternity care management

o   Mobile access

o   Quality management

o   Patient Flows

o   Streamlined administrative tasks

 

Managed Services

Working in any healthcare organization, regardless of size, entails you to be on top of all things and not just your patients’ progress and diagnosis.

One of the services that Allscripts provides is managed services. While all organizations need to be on the top of their game with strategic initiatives in place, it can be difficult given that skilled resources are limited and oftentimes shared.

Contractors are an option, but they take a significant chunk of the budget. If you require a healthcare IT partner to support applications, planning, and project delivery, AllScript can provide the solution to these. In fact, Allscripts is the solution.

Upskilling, Training, and Education

Health organizations need to have employees that are knowledgeable about their jobs. Health care workers should always be equipped and upskilled so they can be better with their responsibilities.

One of the services offered by Allscripts is training and education –  a  solution that can provide health organizations with better leverage for unit and system functionality.

This system allows for streamlined employee training and improving user satisfaction while at the same time fostering customer loyalty through enhanced support.

Benefits of Using Allscripts

All working industries have zero tolerance for mistakes. But when it comes to the medical sector there is even more pressure for perfection in hospitals, clinics, and medical organizations, understandable because actual lives are at stake.

By incorporating and availing of Allscripts services like EHR, your organization stands to enjoy the following benefits.

A Comprehensive Patient Information System

Any bit of information can be life-changing in the medical field. When it comes to making a diagnosis or writing down a prescription, a doctor needs to know all information about a patient, and these details are made available by Allscripts.

With a comprehensive information system, the risk of errors is set to minimal and even zero. Everything a doctor needs is digitally documented. This allows the health care team to be more efficient in their work.

More time can be allocated to treatment and patient care instead of collating information.

Access to Information Remotely

Allscripts provides mobility and versatility when it comes to working. You can access relevant information, anywhere, anytime from prescriptions to history or lab results.

There is no need to be tied to a desk

The Allscripts software is web-based, but at the same time, it also supports Android and iOS making it easy to access information on your smartphone and tablets.

Streamlined Routine Work

With its incorporated tools and features like mobile access, e-prescribing, and clinical assistance, health organizations will be able to manage routine but important tasks more efficiently.

No more rework. There’s no need to revalidate. Repeat lab tests are no longer necessary. With almost 800,000 care guides within the Allscripts software, you can promote accurate and better clinical results, which facilitates better diagnosis and treatment.

Patient expenditure can be lowered because unnecessary tests can be avoided. Treatment and care can be given in real-time with inter-department coordination.

Schedule An AllScripts Demo

If you’re interested in learning more about AllScripts and how Medical Healthcare Solutions can implement the software into your practice, please schedule a demo. One of our EHR AllScripts specialists will be happy to show you the features of AllScripts. Click here to schedule your demo today.

Final Thoughts

With innovative products and services that are geared towards creating a positive impact and boosting efficiency and productivity, it is time for you to experience yourself the difference that Allscripts can make for you and your organization.

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