1. Office Managers/Administrators Performing Medical Billing.
We have often observed Office Managers struggling with performing medical billing effectively, efficiently, and timely. They simply do not have the time to devote to the process; which is typically beyond an eight hour work day. Managing the day-to-day interoffice and financial activities, providing customer service to the patients, and marketing/growing the organization leave little or no time for medical billing. This negatively impacts cash flow immensely.This is a costly approach that most providers face due to limited staff and resources... However, we have the solution for you!
2. Medical Billing Is Done And Completed Daily.
The superbills may have been entered, processed, and submitted to the payers. However, the billing & collection process has only just begun. Claim Rejections at the submission level (the claims haven't went anywhere), audit trail denials/rejections at the clearinghouse/direct submission level, and so on are just a small sector of the hurdles of medical billing. Getting paid for the service (s) provided is a whole different story which requires, sometimes, a lot of effort and expertise in getting the service (s) paid. The Medical Billing process (getting the claim paid) has only just begun... However, we have a solution for you!
3.If You Have Worked In The Medical Field, You Can Do Medical Billing.
We have acquired providers whom have made this major mistake which created major chaos and cash flow issues. Just because someone is familiar with medical administration, doesn't mean they can be a Medical Biller. It takes a unique individual with a lot of patience and diligence to be a Seasoned Medical Biller. If an individual commits themselves to learn the world of medical billing, than yes, they can become a good medical biller. Working in the medical field only provides them with a sense of familiarity. Guidance is required. In order to be a Seasoned Medical Biller with savvy skills, one would have to devote themselves beyond normal work hours to studying, attend educational seminars, teleconferences, webinars, and diligence to develop the knowledge base, skill set, and develop the strategies of medical billing. This mentoring process can take at least 3 (three) years to have a comfortable sense of knowledge of medical billing and sometimes longer. It all depends on the individual, their ability to grasp the concept of medical billing, and apply the knowledge. However, we have a solution for you!
4.Medical Billing is done by the Provider. Anyone Can Put A Diagnosis Code, CPT/HCPCS Code, and Bill the Claim.
The provider may be a coder. However, a Medical Coder is not a Medical Biller. However, a medical biller ensures: patient demographics is correct, patient insurance is correct/active, Prior authorization is/is not needed, provider demographic is correct/active, referring provider demographic is correct/active/required, ensures the responsible party is correct (Private Insurance, Worker's Comp, Auto Injury, Or Another Third Party Payer), claim is coded correctly (by the coder), the appropriate CPT/HCPCS codes are used and appropriate for the type, quantity, and the billing regulations and guidelines for each specific payer/insurance company is followed appropriate payer is submitted within filing statue And the list goes on... A Seasoned Medical Biller must know practically everything (per insurance company, patient, & encounter) that potentially can impact the claim during the entire billing process. The provider sees the same patients but each encounter, from the medical billing stance, can be and often is totally unique. However, we have a solution for you!
5. My Medical Biller (s) Does A Good Job.
How does one really know? We have acquired providers who thought the in-house or outsource medical biller was doing a good job. Just because someone comes to work, sit at the desk and creates submission reports detailing submitted claims doesn't mean they're actually doing a good job. The Aging Accounts Receivable Report, Write-off Reports, and Employee Activity Report illustrate the facts. They're meeting the prerequisites of medical billing by coming work, sitting at the desk almost all the time, entering and submitting claims to the clearinghouse/direct submission daily. We call this The Art of Perception Appearance. In other words, the medical biller is disguising the job. Ask yourself the following questions: Is the cash flow is low and, at the very least, meeting the level of production vs. collection ratio? Is follow up really occurring and is it occurring timely? Is the provider seeing more patients, providing more services/procedures and collections are still the same or decreased? We found the "process" was getting done but medical billing (which requires a seasoned level of expertise and involves extensive follow up on unpaid and denied claims) were not. Reports such as: Production, Aging, Write-offs, and Employee Activity can provide insight if used correctly. Reports don't lie. Analyzing the data and comparing them collectively can, at least, assist in identifying there's a issue of some sort.
Medical Billing is one of the most important responsibility in every organization. It's essential to the success/failure of any organization and is center of the providers, staff, and patients. Sadly, most Medical Billers do not take it as serious and treats this important task with no sense of urgency; which is required to be successful in medical billing. It's a lot of mental/repetitive work and requires a lot of patience along with diligence to persevere and overcome day-to-day. The cycle of medical billing never ends. However, we have a solution for you!
Call or Email Us Today! 866.531.8533
Seasoned Medical Billers Of Novelty Medical Billing Solutions, LLC.
