If [...]]]> You are losing up to ten percent of your collections if payer underpayments are not being aggressively pursued by your outsourced medical billing company. It is simply a minimum requirement of being in business that medical billing services compare your payments to the amounts your payers have agreed to pay you.

If you make the decision to outsource medical billing or are currently outsourcing, then there are a number of critical tasks and process steps that your medical billing service should provide. These include scrubbing claims before they are submitted, systematic follow-up on submitted claims, posting denials, pursuing underpayments, using patient expected payment scores just to name a few.

This article focuses on just one of the key elements you need from your medical billing service: pursuit of underpayments. Pursuit of underpayments starts with a critical step: comparison of EOBs to your contractual allowables (the payment your payers have agreed to make for each CPT code). You cannot count on payment posters to catch underpayments with their naked eye; the comparison must be automated and systematic. It goes without saying that if you do billing in-house the comparison still should be done.

Payers have adopted underpayment techniques that are too difficult for a payment poster to spot on their own. Medical billing companies can design their process to battle payers underpayment techniques because they have an advantage over individual practices – they see EOBs for a given payer across multiple practices and multiple states. The enhanced scope allows medical billing services that pay attention to identify patterns that might be overlooked by individual medical practices.

A disturbing pattern that can regularly be seen by a medical billing company that is paying attention is one where a payer will select a set of procedures and underpay this set of procedures across a large number of providers (often by the same amount). This will continue for about 30 days and then the payer will resume paying the procedures at the correct amount and begin underpaying a whole new selection of procedures.

These underpayments are not huge (5 to 10 percent) but they add up quickly to big dollars for a medical practice. The combination of switching the codes being underpaid from month-to-month and keeping the underpayment amount “under the radar” can make the underpayments difficult for an individual practice to spot.

As you can imagine, these small underpayments switching from CPT to CPT would be difficult for a busy payment poster to notice. They will often spot the large underpayments (which occur with a much lower frequency than the small underpayments), but without automated comparisons the smaller underpayments are typically missed.

What does all of this mean to your top line? A medical insurance billing service that properly implements the pursuit of underpayments can increase your revenue by between 5 and 10 percent – and this is pure profit.

Spotting the underpayment is only part of the battle, of course, the billing service also needs to have a systemic process in place for pursuing the underpayments. It is critical to pursue event the small underpayment amounts. Once a payer sees that their resources are being tied up readjudicating claims because of a $5.00 underpayment, the underpayments will often cease to happen.

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economy is to cut costs and the best way to do it is by outsourcing services.

In the health care industry, medical billing is a cumbersome process. To manage an [...]]]> The health care industry is booming and the competition is increasing everyday. The best possible way for a company to survive in this competitive

economy is to cut costs and the best way to do it is by outsourcing services.

In the health care industry, medical billing is a cumbersome process. To manage an in-house medical billing unit is not only costly but also is time consuming. This is the reason why most health care industries in first world nations have started to outsource their medical billing operations to off-shore destinations like India, China, Mexico and Philippines. Medical billing outsource allows a company in reducing bill processing times and at the same time cut operational costs. Apart from the health care industry most of the utility, insurance, and distribution industries can particularly gain a lot by outsourcing their billing operations to off-shore destinations.

The best destination as of now for billing outsource is India as it offers allied benefits in terms of advanced technology, cheap and talented human resources, stable government, good communications infrastructure and quality certified firms.

Financial services outsourcing

Financial services outsourcing is picking up pace just as any other outsourcing field. Along with US based companies even the UK based companies have started outsourcing financial services. According to many economists the advantages of UK outsourcing are many.

http://www.bizbrim.com/outsourcing/billing-outsource.htm