One of the biggest nightmares for a medical practice is a pile of pending claims. Timely filing is one of the major factors that costs healthcare professionals millions of dollars every week. When it comes to timely filing, every insurance payer has its own claim submission guidelines that varies from state to state. The deadline to submit the claim to payers can vary from 30 days from its actual date of service to 360 days. The difference in these timelines further complicates the process for the medical billers.
Just like any business, physicians and medical practices require faster turnover of cash flow to meet their expenses. Physicians expect their billing staff, either in-house or outsourced, to work efficiently in order to be reimbursed from insurance companies in a timely manner.
However, choosing to outsource medical billing has many benefits. One of the most important factors that sets them apart from in-house billing is their capability to streamline the revenue cycle process. Professional billing companies reduce the possibility of a claim from hitting the timely filing limit through their own internal audit. The predefined quality measures and reporting system of an established medical billing firm minimizes the risk of rejected claims. Some of the possible factors that may cause a claim to be rejected include inappropriate or missing information, clerical error at the biller’s end, conflict with the insurance guidelines and incorrect patients’ payer information.
In the electronic claim submission, the EHRs are integrated with clearinghouses to send claims to payers. Claims submitted to the clearinghouse are rejected due to incorrect information. The claims rejected by the clearinghouse stay in their database unless they are resubmitted with the updated information. The process of getting reimbursed from insurance companies can be a complicated, especially when several claims get denied on a regular basis. These denied claims need to be resubmitted with the proper resolution within the timely filing deadline.
At Physicians Revenue Group, Inc., we believe in submitting a clean claim in the first time. Our strong QA and reporting transparency results in 0.01% timely filing denials. We believe in a coordinated approach when it comes to revenue cycle management. Our mantra is to leave no money on the table. We ensure that every claim is thoroughly scrubbed before being submitted to the insurance company in a timely manner. When working in-house, it is easy for practices to fall behind on filing claims. Losing revenue due to timely filing is upsetting. By outsourcing medical billing, the practice staff can focus on other administrative and patient-related tasks such as obtaining patient demographics and insurance information. Contact us today to learn how we can assist your practice in maximizing reimbursements and streamlining your entire revenue cycle.