Medical Billing Outsourcing » Medical Billing Outsource

Medical Billing Services: How it is Useful to Medical Company

admin — Fri, 30 Oct 2009 12:11:35 +0000

Author: Pete Noland

Medical treatment of Business has changed significantly in recent years. It presents many administrative difficulties during the preparation of the insurance policy and procedures dealing with complicated claim forms. To avoid these complications, doctors seek help from outside. Hire and advise their representatives, attend seminars insurance company and provide them with periodic financial reports this process is known as medical billing outsourcing.

An efficient and precise medical billing service is of prime importance for the smooth functioning of any medical service provider. A comprehensive medical billing service will in turn secure speedy reimbursements for clients. Medical billing is the process of submitting and following up on claims to insurance companies in order to receive payment. It is useful for medical healthcare providers. Medical billing services also supports on-demand invoicing, batch claims processing and interactive electronic claims Submission and remission.

Medical professionals and medical companies, whether they are Small companies or big organizations, are benefited from medical billing services. This billing can be considered as a communication between Medicare providers and insurance companies.

One can get following benefits by using medical billing services:

Medical Data Entry – patient demographics, details like place date type of service, and referring physician, CPT and ICD Codes, and Modifiers are keyed into the billing system

Medical Claims Billing – electronic and paper

Appeals – make appeals for denials and incorrect payments

Payment Posting and Reconciliation Medical Claims Management Collections Management

Accessibility – 24 hours a day, 7 days a week

Medical billing business involves many other important services such as handling all patient billing inquiries, submitting reports to the doctor, posting payments, mailing patient’s statements and following-up all unpaid insurance claims.

Medical billing services assist physicians in saving money through payroll Generation, equipment reduction, eliminating shipping costs, and support software. Outsourcing to a Professional medical billing company is free from management problems. A number of leading outsourcing medical billing services companies offer medical billing assistance for medical billing needs. The company uses the database free of compensation, and established practice, and other Online.

Above article published on http://articlespile.com/medical-billing-services-how-it-is-useful-to-medical-company/

Health experts urge insurance, pay changes

admin — Fri, 04 Sep 2009 15:54:00 +0000

By Susan Heavey

WASHINGTON (Reuters) – U.S. lawmakers returning next week to work on major healthcare legislation need to focus on insurance market reforms, consumer rebates and other measures that will curb soaring costs over time, economic and health experts said on Tuesday.

The group of academics outlined dozens of changes in their report, from restructuring payments under the Medicare insurance program for the elderly and disabled to providing doctors incentive payments for helping avoid costly treatments or complications.

All of the proposals, some of which are already included in various congressional plans, together will help provide better care for patients while lowering costs over time, said Dr. Mark McClellan, a former economic official under President Bill Clinton and health official under President George W. Bush.

“We turned away from focusing just on short-term, isolated individual measures. While those small things like cutting Medicare prices across the board can have some short-term benefit, we don’t think steps like that are sufficient,” said McClellan, head of the Engelberg Center for Health Care Reform at the Brookings Institution, a Washington think tank that led the group.

Much of the national debate over efforts to reform the U.S. healthcare system and provide more Americans access to health insurance has centered around whether the government should provide its own alternative insurance plan and how much the overhaul will cost.

President Barack Obama, who made reform efforts a cornerstone of his campaign, has said he wants to pass a plan this year.

STRUCTURAL CHANGES

With congressional Democrats and Obama set to renew their pitch, the group said lawmakers need to ensure that final legislation includes various steps aimed at structural changes and payment incentives to reduce costs even decades from now.

While some of the group’s proposals are not new — such as promoting electronic health records and research that compares rival treatments — they join a chorus of other recent reports and comments that could help focus the debate.

“We believe that legislation needs to support a set of individual changes to help us get there,” McClellan told reporters in a conference call to discuss the report.

Among the recommendations are insurance industry changes that would make it easier to pool consumers who do not get health coverage from their employers, according to the group’s members, who hail from Harvard University and the University of California as well as other universities and think tanks.

Limits to employer tax breaks for insurance as well as a bidding process for private Medicare plans would also help foster insurance competition and lower costs, they said.

Robert Zirkelbach, spokesman for the industry group America’s Health Insurance Plans, declined to comment on the recommendations but said the group supports efforts aimed at containing costs and making insurance more affordable. The group represents Cigna Corp, UnitedHealth Group Inc and Aetna Inc, among others.

McClellan’s group also said payment changes are needed for doctors and other healthcare providers such as lump-sum, or “bundled,” payments for a treatment that would discourage costly mistakes rather than payments for each service.

Consumers, too, need added incentives to stay healthy such as rebates on their insurance premiums for meeting certain health goals or reducing their risk for disease by quitting smoking or other steps, it added.

Above article published on

http://www.reuters.com/article/gc07/idUSTRE5805Z420090901?pageNumber=2&virtualBrandChannel=0

5 tips to help you save on health care

admin — Wed, 02 Sep 2009 10:27:45 +0000

By AMY HAMILTON

Being a savvy health care consumer has never been more important. With some people finding health care costs soaring as benefits dwindle, it pays to know how to make your coverage work for you.

Know before you go

It’s not enough to ask if a health care agency takes your health insurance. Your health care professional should be contracted with your insurance network. If you’re operating under a Preferred Provider Organization, or PPO, using a health care professional not on the list is going to cost a lot more of out-of-pocket dollars.

“You need to be very careful and definitely when you call to talk to a doctor ask if they are contracted with your insurance,” said Becky Weaver, office manager of Grand Junction dentist Scott N. Vandusen.

In general, Weaver said, clients are learning to check online or call their insurance companies before scheduling appointments.

However, health care professionals can move in and out of networks. If a health care provider moves out of your network, you’ll need to change medical providers or face paying more for the same services, Weaver said.

“People couldn’t understand why they kept having to pay so much even though they were insured,” she said about the misconception.

Save ER for emergencies

You should always go to a hospital’s emergency room during life-threatening situations; for example, if you believe you’re having a heart attack, experiencing a loss of consciousness, losing large amounts of blood, having seizures or convulsions, or experiencing numbness and paralysis, among numerous other serious conditions. However, not all afflictions require an emergency room visit, which can result in bills that are estimated to cost at least three times that of a primary care doctor’s visit.

“Sometimes you do need to go to the emergency room. In many instances, reasons for you to go to the emergency room could be handled at primary care,” said Kayla Arnesen, marketing director for Rocky Mountain Health Plans. “We have after-hours clinics that are very accommodating.”

Four urgent care facilities listed in Mesa County are: Med-X Urgent Care, 1060 North Ave. Suite N; Docs on Call, 3150 N. 12th St.; Family Health West Urgent Care-After Hours, 551 Kokopelli Blvd., Suite G, Fruita; and UCC of Montrose and Grand Junction, 517 N. First St.

Arnesen said it’s always a good idea to call your primary care doctor first unless your condition is so severe you cannot call.

Pediatricians, for example, typically have someone on call who can answer questions and potentially could save a costly trip to the emergency room. Arnesen called her pediatrician at 2 a.m. for advice when her child had a fever. She was advised to buy an over-the-counter drug.

“A $4 bottle of Benadryl solved the problem,” she said.

Focus on prevention

Many health care policies offer free or reduced-cost preventive services such immunizations, dental cleanings, eye exams and routine screenings such as prostate exams, mammograms, Pap smears, physicals and services for children. But don’t forget periodic screens for blood pressure, blood sugar and cholesterol, as well as testing for colon cancer and HIV.

However, if symptoms arise, it’s best not to try to ride out an illness in the hopes it will disappear, according to Dr. Dale Kliner of the Colorado Urgent Care Association. Waiting to seek treatment can sometimes result in worsening conditions that may require further medical care.

“More patients are being diagnosed with pneumonia after suffering minor conditions such as a cough, indicating that some patients are waiting to seek treatment, when their best interest is to act immediately,” Kliner said in a news release.

Go generic

The first question to ask your doctor after being prescribed a drug is whether it’s available in a generic form.

For customers of Rocky Mountain Health Plans, which make up 60 percent of Mesa County residents, getting a generic prescription can be a cost savings of 50 percent to 80 percent off name-brand drugs, said Kayla Arnesen, marketing director for the insurance company. Arnesen advised that patients first ask their physicians to prescribe a generic form of a drug, which may be easier than attempting to buy a prescription in its generic form once you get to the pharmacy.

“It’s a common misconception,” she said. “If generic drugs are available, they are just as safe as the brand name.”

Check your bills

Any number of mistakes on your medical billing could change the amount paid by your insurer or cause an insurer to reject the claim.

Be sure to check bills carefully for items such as correct account numbers, services administered and that the services were billed to the correct insurance company. Study your benefits booklet to be certain of your coverage.

If you locate a billing mistake, send a certified letter to your insurer and follow up in few weeks to check if it was corrected.

Don’t hesitate to call your doctor or insurance company if you have questions on a bill.

If your insurance company won’t pay for a service you feel is necessary, dispute it.

Above article published on
http://www.gjsentinel.com/hp/content/features/stories/2009/09/01/090109_9a_Health_Five_things.html

Spring Hill collects more on medical bills than county

admin — Thu, 06 Aug 2009 10:20:07 +0000

By TONY HOLT

Hernando Today

SPRING HILL – The Spring Hill fire district has collected at least 90 percent of its medical billing nearly every year since 2003 – a double-digit improvement compared to the county’s fire and rescue services.

For the five annual billing cycles beginning September 2003 and ending September 2008, Spring Hill Fire Rescue collected 90 to 91 percent of its net charges for patients who were transported and-or treated.

On average, the district failed to collect less than $208,500 per year since September 2003, according to records obtained by Hernando Today.

“That’s not too bad. That’s actually a pretty good number,” said Rajeev Rajagopal, co-owner of Managed Outsource Solutions out of Tulsa, Okla. “Whenever you’re dealing with ambulance calls, you have a lot of patients who may not have enough money for medical bills. That definitely falls into play.”

A perfect score is impossible because sometimes the patients are deceased by the time the billing process is filed, said Spring Hill Fire Chief Mike Rampino.

“I’m very happy about it,” the chief said about the numbers from the past six years. “It’s something to be proud of. We’re doing the best we can with what we have, and I’m proud of what they do.”

Hernando County Fire Rescue’s numbers also are considered better than average. For the billing cycle from April 1, 2007, to March 31, 2008, the department collected 80 percent of what it charged. During the same period the following year, the county collected 74 percent, but that number is likely to increase as some patients complete their payment plans, said Hernando County Fire Chief Mike Nickerson.

“Our net collection rate of 75 to 80 percent is consistent with, or higher than, the regional average and is an improvement from the average 70 percent collection rate by our previous billing company, dating back to 2006 and prior,” Nickerson said.

During his presentation with county commissioners last year about medical billing, board members said the county’s collection rate was slightly better than the local hospitals, which were at 75 percent.

The district’s annual average of $208,500 worth of uncollected bills is still too high for Fire Commissioner Rob Giammarco.

“If we have money that’s outstanding, we need to get it,” he said. “We have to cover all the bases … We need to do better, especially in these tough fiscal times.”

Above article published on

http://www2.hernandotoday.com/content/2009/aug/06/
ha-spring-hill-collects-more-on-medical-bills-than/

Minnesota goes electronic today with medical billing

admin — Mon, 20 Jul 2009 13:50:54 +0000

By Jeff Hansel

The state of Minnesota is turning a corner that no other state has dared face in the same way.

A 2007 law takes effect today, requiring “electronic billing of all health care claims.”

The effort to eliminate paperwork, standardize billing terms and reduce errors will save an estimated $60 million per year, said David Haugen, director for the Minnesota Department of Health’s Center for Health Care Purchasing Improvement.

“We think the savings potential has been estimated pretty conservatively,” Haugen said Monday.

Mountains of paperwork pass through the nation’s health care system daily and, often, no two forms include the same definitions for the words written upon them.

Now, Minnesota has defined a standard set of terms that all health providers, including doctors, dentists, chiropractors and hospitals, must use when billing for a health care claim.

“Each year, more than 55 million medical bills, known as health care claims, from these health care providers are processed in Minnesota, resulting in significant transactions costs — and opportunities for savings,” the Minnesota Department of Health said in a statement.

The changes “may be especially challenging” for small health providers, Haugen said. Most offices already have begun implementing the changes.

“I’m sure it’ll save a lot of money and help everybody. Some offices will probably have a little harder time,” said Connie Reinhart, office manager at Amethyst Dental Care in Rochester. Her office has already been using the new system and is putting final touches in place. She has already noticed quicker turnaround on claims, both for patients and for the dental office.

“We do ours through a clearinghouse. You just send it and in seconds they’ve got it,” Reinhart said. She also expects to save postal costs.

It’s about twice as expensive to send paper instead of electronic forms, Haugen said.

“I think there’s growing interest and growing acknowledgment that there’s really some potential for savings,” he said.

What happens if a health provider prefers paper and ignores the law?

Haugen said the statute encourages voluntary compliance but allows fines of up to $25,000 per year. If every state saved as much as Minnesota expects to, more than $3 billion could be saved annually nationwide.

“I think we’re very hopeful that the country as a whole will take a look at Minnesota and expand that dialogue about how we can reduce these health care administrative costs and how we can streamline these health care administrative transactions,” Haugen said.

On Dec. 15, health providers and insurance companies will also have to electronically file “adjustments to or denials of” claims.

Above article published on http://news.postbulletin.com/newsmanager/templates/localnews_story.asp?z=2&a=407954

Two studies assess cost of doc-office paperwork

admin — Wed, 01 Jul 2009 10:24:14 +0000

While how much of a medical practice’s administrative overhead can be classified as “waste” is still open to debate, two new studies posted on the Health Affairs Web site attempt to put a price tag on these clerical tasks and on how much a medical practice must spend before it can extract a check from an insurance company.

In one study, researchers calculated that the annual cost of performing billing-related tasks comes to about $85,276 per physician. In the other, it was estimated that the total cost of the nation’s physician-health plan interactions is somewhere between $23 billion and $31 billion.

The authors of the first study concluded that automation could be helpful in reducing claims denials, ensuring coding compliance and reducing days in accounts receivable, and that standardization of benefit plans “appears to offer great potential” to decrease costs. The authors of the second study noted that their high-end estimate of physician-health plan interaction costs, $31 billion, is equal to six times the amount the federal government spends on the State Children’s Health Insurance Program.

The studies were co-sponsored by the Commonwealth Fund and Robert Wood Johnson Foundation

Above article published on

http://www.modernhealthcare.com/article/20090515/REG/305159992

Why Outsource Your Medical Billing

admin — Mon, 08 Jun 2009 09:56:11 +0000

Outsourcing is a common practice when it comes to medical billing. Most doctors will at some point find themselves outsourcing their medical billing to an at-home specialist, a professional medical billing company, or a practice management company. Here are some of the reasons doctors choose to outsource their billing.

It saves time. Medical billing is an immense task. Outsourcing to a medical billing firm can take much of that burden off your shoulders. It will save you the time you need to concentrate on healing your patients.

It saves resources. If you’re running a small practice, your staff may not be able to focus exclusively on billing-or have the necessary expertise. Practices that don’t outsource often can’t afford to have one employee focus on billing without giving attention to other clerical duties. A medical billing firm will have the knowledge and experience to take care of all the medical billing issues that arise with your practice, and free your staff to concentrate on other aspects of running the practice.

It reduces rejected claims. A great deal of rejected claims come back simply because of errors in coding. Hiring a medical billing firm to focus exclusively on billing can cut down on errors and save you revenue in rejected claims.

It provides added security. It’s a well-known fact that most cases of fraud come from within a company. If you outsource your medical billing, you’ll have an outside eye looking at your finances and providing checks and balances that you and your staff might not have the time or ability to provide. If there are inconsistencies in your finances, a medical billing company will have a good chance of spotting them.

You’ll get your money faster. Most practices with limited resources can’t designate multiple employees to concentrate on billing. This means it takes longer to submit claims, follow-up can be inconsistent, and your money comes in later than it could. With a medical billing firm, your claims will be submitted more quickly and follow-up will be more persistent-all adding up to more and quicker revenue for your practice.

It improves your business. Many doctors say that you don’t just need an M.D. to be in private practice anymore-you also need an MBA. An experienced medical billing company doesn’t just send out claims-it’s also a valuable business partner. A good medical billing firm will provide you reports, often monthly, detailing the financial health of your practice, and can recommend ways to boost profitability as well.

It helps you negotiate with insurance carriers. Your medical billing company can give you the detailed information you need to successfully negotiate a contract with a malpractice insurance carrier. Knowing your costs and your utilization patterns will go a long way toward giving you the upper hand in insurance contract negotiations.

Above article published on

http://www.vendorseek.com/why-outsource-billing.asp

Outsourcing medical billing

admin — Thu, 04 Jun 2009 15:51:59 +0000

In today’s competitive economy outsourcing medical billing seems to be a great option for the health care companies. Now the question arises as where

to outsource medical billing. The best possible destination as of now for outsourcing medical billing seems to be India. Let us look at the benefits of medical billing outsourcing to India.

Why outsource medical billing to India

Availability of advanced infrastructure
Availability of cheap and efficient human resources
Availability of quality certified firms
Good communication and internet facilities
Proved track record
Data Confidential, retention, destruction protocols
Availability of service level agreements
Stable government
Continuously improving economy

These are the reasons that make India stand apart from the rest as far as medical billing outsourcing is concerned. India job outsourcing market is also blooming in the field of help desk and IT services.

Above article published on

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

Outsourcing Medical Billing

admin — Thu, 21 May 2009 09:17:51 +0000

In the past few years there is a dramatic change in the medical field and its treatment. Initially, while processing the insurance claims there are many administrative difficulties during the preparation of insurance policy procedures and dealing with complicated claim forms. To overcome with these obscurity doctors look out for outside help, and hire representatives to advise them, attend information about insurance company seminars, and provide them with regular clear financial reports.

This is process is called as medical billing outsourcing. Outsourcing Medical Billing acquire a profound working knowledge of the technologies and processes that are decisive to successful Business Process Outsourcing and afford a absolute scale of Back Office Outsourcing services in the areas of Medical Billing, Claim Adjudication, Call Center and Financial service. The most of the physician time is saved by means of medical billing outsourcing process. So that, physicians can much more concentrate on curing their patients. A medical billing firm will have the knowledge and experience technocrats to take care of all the medical billing issues. It makes free the other staff to concentrate on other aspects of running the practice which leads to added security to finance and transactions

Above article published on

http://industrialupdate.wordpress.com/2009/05/18/outsourcing-medical-billing/

What You Need to Know If You Are a Medical Practice Considering Outsourcing Your Billing

admin — Mon, 18 May 2009 10:30:03 +0000

By Dallas Alford

More and more medical practices are outsourcing their billing which has become a viable business option due to rising operational costs, declining reimbursement rates and an increase in the cost of technology that is required if an in-house effort is pursued.

In short outsourcing can dramatically improve a practices financial results and allow them to gain operational efficiencies if the correct vendor is selected for outsourcing.

The key to successfully outsourcing your billing is to do your due diligence before selecting the firm that is going to handle your billing. A little work up front can mean the difference between selecting a firm that becomes a part of your team and produces positive results or a firm that could essentially negatively impact your bottom line.

Use the following criteria to assess prospective vendors:

Specialization – Make sure the firm you are looking at has billing experience in your specialty. Although as the provider you are ultimately responsible for the coding, you want a billing firm that is knowledgeable in your specialty so they can rework any denials and act as a coding reference for your practice.

Reports – Make sure the billing firm is going to provide you with 24/7 access to the practice management reports that you would normally have if doing your billing in-house. Some firms have been known to withhold such data from their clients because their work was sub-par and they did not want their clients to see the results of their work.

HIPAA – Discuss with the firms you are considering their policies and procedures they have in place to protect your patient information. The last thing you want is for your billing firm to expose your private patient information and ultimately ruin the relationship you have with that patient or even worse lead to a potential lawsuit.

Staffing – Inquire about the education level and experience of the billing firms staff. When was the last time they attended a coding seminar? Some billing firms are notorious for being understaffed which can lead to slow claim submission and therefore negatively impact your cash flow. Ask the firm how long it takes them to submit your claims once they are received. Generally speaking claims should be submitted within 48 hours of receipt.

Collection Benchmarks – Regardless of whether you outsource or do your billing in-house a few rules of thumb apply. On average you should be collecting between 95 and 100 percent of your adjusted charges within 60 days of submission. At any given point you should not have to much more than a months worth of charges outstanding with 10 percent of your total insurance A/R balance greater than 90 days.

How to do your due diligence

As usual ask for references and make sure and actually call them. It may even be worth going and visiting those references and talking with them face to face. Make sure and ask your references about these key points:

Collection results – Talk to that current client and ask them where they stand in terms of the benchmarks discussed above. If at all possible ask that client if you can see their insurance A/R aging. A quick look at the aging will tell you whether or not that billing firm is doing a good job.

Meetings – Ask references if the billing firm makes themselves available for face to face meetings. A billing firm should get together with their clients at least once a month to discuss any issues that need to be addressed.

Reports – Is the billing firm providing that client with their reports or is getting the reports like pulling teeth? If not, there may be an issue of just how good of a job that billing company is actually doing.

Staffing – Are the firms staff communicating with the clients office staff on a daily basis in terms of additional items needed to process claims? Do the staff educate the providers about coding issues that arise?

Agreement – Review the contract the firm has their clients sign and make sure it includes things such as services to be provided, costs of all services, confidentiality agreement, terms for termination and adherence to regulations.

Outsourcing your billing can be a huge benefit to your practice if done properly. If you follow the above steps, at a minimum, you will feel better about the firm you choose to move forward with and the overall experience will be both a positive and profitable one.

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that is focused on helping business owners improve cash flow. Services include full service medical billing for healthcare providers, cost segregation studies for commercial property owners and an array of other services for general businesses.

Above article published on

http://ezinearticles.com/?What-You-Need-to-Know-If-You-Are-a-Medical-Practice-Considering-Outsourcing-Your-Billing&id=1435465