The medical coding and billing process is, without a doubt, rather complex. Healthcare billing can take anywhere from a few days to several months, depending on the severity of a patient’s case. There are many ways to ensure better medical claims, which can ultimately increase acceptance and submission rates for first-pass claims. There are many ways to ensure that your billing process goes without a hitch from when a patient enters your practice. One of these ways is outsourcing billing operations to a third-party medical billing providers. Doing so removes a lot of overheads from your in-house staff, effectively diverting their focus to bettering patient care.
Medical billing is a complex and continuing process. It takes the most steam from your staff if you manage in-house billing operations. To properly understand why you should outsource your billing to a third-party billing company, we have created this guide highlighting some essential steps that help achieve a successful billing process.
Towards better medical claims processing – the first step is:
Even your regular patients must verify their insurance eligibility and information before making an appointment at your practice. The fact of the matter is that insurance information can change at any time. Before each visit, your first-contact staff (receptionists or appointment schedulers) must ask patients about their insurance information. Any changes in the insurance information can definitely impact the benefits or authorization information. Consequently, it is worth taking the pain to double-check such important information right from the start.
Maintaining correct coding practices is essential for ensuring the submission of better medical claims. What’s more, it is also essential to inform an insurance payer regarding what a patient is essentially receiving treatment for, in addition to the methods of treatment. It is vital to use correct diagnosis codes for elaborating on a patient’s treatment method. The use of accurate HCPCS and CPT codes is also important for providing additional information on the services rendered by a physician. These steps are incredibly important, as an insurance provider can only make a correct assessment if they have claims with correct modifiers and codes.
Payment posting is the last step which involves the posting and deposit functions. At this stage, the billed amount to a patient shall be zero if paid already in full, or it shall reflect an amount the patient owes. At this step, an insurance company’s responsibility must have been met. Adopting best practices for billing and claims submissions is vital to ensure seamless reimbursements.
The three significant types of billing systems include:
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