Blog - Advanced Reimbursement Solutions

Key Facts About HRA Insurance Plans

If you have a medical practice, then you’re well aware of the wide range of ways people pay for healthcare, from private insurance to out-of-pocket costs and more. Health reimbursement arrangements (HRAs) allow employers to provide insurance-like coverage for employees through a private savings account. Here are just some of the key facts to keep in mind regarding HRA insurance plans.

HRAs are Employer Funded

HRAs are a kind of employer-provided insurance intended to either replace or supplement traditional insurance. Patients with an HRA may or may not also have traditional insurance. If they do have traditional insurance, then you will usually bill that first. The patient can use the HRA for the remainder.

Employees Cannot Legally Fund HRA Accounts

Whatever money is available in the HRA is what’s available. If the HRA runs out of funds, then the patient will have to pay you out-of-pocket for the remainder.

HRAs are Different from HSAs (Healthcare Savings Accounts)

With HSA insurance plans, employees contribute tax-free income to a savings account, which they can then access as needed throughout the year. In contrast, the HRA does not count as income in any way, because the money never belongs to the employee. Where patients often use HSAs together with high-deductible plans and/or elective medical procedures, you’re more likely to see HRA insurance used together with standard insurance and non-elective medical needs.

Do you have patients with HRA insurance? Do you have questions about medical billing? Medical billing services like the ones offered through Advanced Reimbursement Systems can help bridge the gap between your medical practice and the many parties involved, including HRA insurance plans. To learn more information, set up a time to speak with one of our professionals in Phoenix, AZ or Wilmington, DE. Contact us today to book an appointment and get started.

5 Important Financial Practices for Healthcare Agencies

Along with primary clinical and medical treatment services, financial service planning is among the most important operations of your healthcare agency. How you manage your finances will have an overall impact on how smoothly your business runs. It is very important for all medical service providers to be realistic about their financial needs to avoid making costly financial mistakes in the future. Proper financial planning and medical billing management must be implemented to maintain the long-term financial health of your business. If you’d like to learn more information, you are warmly invited to learn about some of the best financial practices for healthcare agencies.

1) Create a financial timeline

Healthcare organizations should always have financial advisors, assistants and other appropriate professionals to help create a timeline for establishing deadlines for important financial objectives. This timeline should include a number of parallel tasks essential to the growth and maintenance of your business. To avoid the risk of delays and additional costs associated with achieving goals in your financial timeline, you should spend some extra time carefully studying how long it will take for you to achieve your goal(s) and exactly how much it would cost.

2) Set up multiple payment options

The state of money has come a long way since the days of cash and bank checks. One of the best options for convenient medical bill collection is to create multiple payment options. This allows for faster payments and helps in removing the potential burden of having to negotiate alternative payment plans with your patients. Also, there are medical billing companies such as Advanced Reimbursement Solutions you can use to offer much more convenient payment options for your patients.

3) Allow advance payment

Allowing patients to pay for clinical or medical treatments in advance through pre-funded accounts will provide the convenience of more effective medical bill collections. This will take the stress out of customer service payment processing and settling healthcare bills. Patients will thank you for giving them an easier payment option and you, the healthcare provider, are spared from the burden of having to chase payments.

4) Make use of modern technology

Your business can save a lot of money by switching to paperless methods of accounting and payment processing such as sending out billing updates through email and sending electronic statements to patients. You can also use this technology to follow up with patients about missed medical bill payments.

5) Establish clear patient financial policies

Make all of the services you offer and all billing and communications clear, concise and patient-friendly. Practice good judgment in the ways you communicate with your patients about bills, and establish policies for payment methods and debt resolution that are both consistent and clear for your patients to understand.

To learn more about the best financial practices for healthcare agencies, talk to the specialists at Advanced Reimbursement Solutions in Phoenix and Wilmington. Contact us today and book an appointment!

5 Qualities of a Great Medical Billing Specialist

The use of electronic health records and highly computerized databases is becoming standard practice in the healthcare industry. Consequently, the demand for medical billing and coding experts is high and is expected to grow by 13% in 2024. Finding the best medical billing specialist can, therefore, be a challenge to most healthcare practices, particularly startups and SMEs. If you’re looking for a medical billing specialist, here are five great qualities you should keep in mind.

Analytic Abilities

A medical billing specialist should be able to understand and analyze patient information as quickly as possible. Analytical skills can help them to accurately review patient details in previous medical records. They may also need to determine which codes to use for each treatment or procedure that was conducted. Analytic skills are also crucial in processing insurance claims and determining medical bills. Without these skills, your billing team may over-bill or under-bill patients, which can have devastating consequences on your practice.

Detail-Oriented

Attention to detail and accuracy are must-have skills when processing and coding medical insurance claims. When reviewing a patient’s records, a medical billing specialist must pay attention to both large and minor details so that they can understand and code each procedure correctly.

Solid Moral Values

A medical billing specialist must have strong moral values. That means they must be professional, ethical and fair. Working in this sector requires employees to keep patient information and records confidential. Medical billing experts with questionable character often fail to observe this regulation and can jeopardize your practice.

Social Skills

On a typical day, a medical billing specialist will communicate with supervisors about a discrepancy, contact nurses and other physicians to clarify issues, or discuss patient information and procedures. Therefore, it’s imperative they’re able to communicate effectively with other professionals so that workflow is smooth.

Tech Savvy

A medical billing specialist must be able to quickly adapt to changing technology. Currently, most healthcare facilities use electronic health records software to record, process and store patient information. Since technology is a must, all employees should be able to use the software effectively.

The demand for medical billing and coding specialists will continue to increase. If you need help, please don’t hesitate to get in touch with Advanced Reimbursement Solutions in Wilmington and Phoenix to consult with one of our experts. Contact us today and book your appointment!

Medical Billing Allowables: Why Charging More is Good Practice

Unlike most businesses expecting a bill to be paid in full, medical billing companies typically expect to receive a fraction of an outstanding amount. In medical bill collections, it is quite common for a $500 bill to be sent out with the expectation that only $300, $150, or far less than that will be paid back. Charging much more than one expects to collect, which is typically known as a medical billing allowable, takes care of this problem and boosts profitability by ensuring that an actual payment will be received. That is just one reason why charging more is good practice in medical billing management.

It Simplifies the Medical Billing Process

Because medical procedure costs vary, medical billing companies would be mired in the time-consuming task of maintaining multiple fee schedules if they tried billing patients and insurers the exact amounts owed. All of these fee schedules would require constant updating given that many insurance plans change their own fee schedules and the amounts they pay every year. This would also have a detrimental effect on any internal data that tracks and compares charge volumes in the medical billing process.

It Boosts Revenue

Most medical practices often see patients with out-of-network insurance providers. Some of these insurance plans pay a percentage of the charges that are billed. In this instance, charging more gives medical billing companies the chance to collect more money on that percentage.

It Maintains Legal Compliance

According to US law, a medical practice that accepts Medicare cannot charge an insurer or any other entity a lower fee than it charges Medicare. The amounts charged must be the same, or the practice risks breaking the law. Charging all insurance plans and patients the same amount helps maintain legal compliance, even if it is set at a higher fee schedule.

At Advanced Reimbursement Solutions, we understand the intricacies of the medical billing process. Our state-of-the-art billing system handles all stages of a medical claim in a manner that boosts profitability for physicians, surgery centers, and durable medical equipment providers. Contact us today to book an appointment and speak with one of our professionals in Wilmington or Phoenix.

Steps to Follow During a Medical Billing Process

The medical billing process is the process whereby a health service provider follows up on and submits a claim to an insurance provider for payment for any service rendered towards the patient. The health services rendered may include consultation, testing, procedure, or treatment. Despite the notion that the medical billing process is very complicated, it can be quite simple. Here are some simple steps to follow to ensure a quick and simple medical billing process.

Registration

The first step is to ensure that you register the patient. This step is easy for a return patient because their details are on file. However, when a new patient checks in, they should register and include any important information about their insurance. At this stage, it is important to ensure that any information that could be essential during a potential claim is captured.

Confirm Financial Responsibility

It is very important for a health service provider to confirm the financial responsibility. This means that it is essential to identify what services a particular insurance covers, as there are insurances that do not cover certain services rendered by a certain health service provider. Therefore, before rendering any services, ensure that you inform the patient that the insurance provider is not going to cover the procedures they have chosen.

Patient Check-In

When a patient checks in, he or she is required to confirm identity to the health service providers. If the patient is new, he or she will be given forms to register. If the patient is regular, confirming his or her identity is necessary by providing an ID, passport or driver’s license.

Patient Check-Out and Coding

During checkout, the medical report of the patient is sent to the medical coder. The medical coder will then put down information about the service rendered toward the patient and send this to the medical biller. This information may include the name of the provider, the name of the physician, the name of the patient, procedures, and services provided. Ensure that you use accurate CPT and HCPCS codes.

Entry of Charges

This is where the health service provider enters charges for all the services and procedures rendered to the patient in question.

Claim Submission

After the claim has been completed, it is then sent to the insurance payer for payment.

At Advanced Reimbursement Solutions in Wilmington and Phoenix, we facilitate medical reimbursements and have our very own claims program. We are capable of handling all stages of your medical claim. Contact us today to book an appointment and learn more about our process!

Ways to Improve Your Revenue Cycle in the New Year

Most medical practices can find ways to make organizational improvements – particularly when it comes to the medical billing process. Becoming more efficient with medical bill collections is a great way to improve your revenue cycle. Of course, these improvements require the implementation of several strategies, which we’ll take a look at in more detail.

Improve Your Channels of Communication

All good medical organizations need to be transparent with their patients. Your patient will appreciate an honest and reasonable estimate prior to the administration of any services. You should also make a habit of informing your patient when any payments are due, and highlight the ways in which they can pay. Clearing up any confusion is important because when patients are unclear about payment issues, it can lead to delays and decreased revenue cycles, which could have been prevented otherwise.

Submit Claims Electronically

Modern medical practices shouldn’t be dealing with endless piles of paperwork. Submitting insurance claims electronically will improve accuracy and speed up your revenue cycle. If administrative tasks are becoming too cumbersome in your workplace, it might be worthwhile outsourcing your medical billing management to a medical billing specialist who could help free up some spare time for you to concentrate on more pressing tasks in the workplace.

Automate Your Processes

Administrative costs can grow when medical organizations continue to insist on using manual processing to check eligibility and authorizations for coverage. Automated, electronic authorizations could cost much less per transaction when the number of resources used to process the transaction manually is taken into account.

Check Eligibility

Are you regularly checking the coverage of your patients? It’s your responsibility to do so before providing services. However, during busy periods, it’s easy for things to get overlooked until after treatment has commenced, resulting in the patient being hit with unexpected costs. Avoid this by implementing a means to check patient coverage electronically.

Get the Help You Need

Don’t sit back while your cash flow situation gets worse – consider taking advantage of the services offered at Advanced Reimbursement Solutions and take back control of your revenue cycle. With transparency, efficiency and incredible attention to detail, your medical practice could save money, reduce paperwork and offer better customer service by availing of our services. Advanced Reimbursement Solutions was tailor-made to increase profitability and overturn underpaid, delayed or denied healthcare claims in the commercial sector, and our business is to improve your business! Contact us today to book a consultation in Phoenix or Wilmington and get started.

How to Prevent Medical Billing Errors and Promote Effective Medical Billing Management

Improper payment solutions can cause huge compliance issues for medical practices around the country. Coding errors and other issues involving the medical billing process, both intentional and accidental, can lead to some practitioners paying out hefty sums. But what’s the solution?

Choose a Reliable Medical Billing Specialist

Why continue with the hassle of medical bill collections when you could outsource instead? There are plenty of medical billing companies to choose from which help small, medium and large medical practices reduce the amount of time spent dealing with accounts, increase cash flow and completely avoid costly coding errors. By outsourcing, your practice could improve customer satisfaction, increase revenue and improve your operations. However, it’s important to know what to look for in a medical billing specialist.

A Committed, High-Quality Partner

As a healthcare provider, you’ll want to work with a medical billing management team that respects and appreciates the hard work you do, and you should be able to rely on this team to be committed to receiving the highest possible reimbursement for your claims. When your billing and administrative needs are fully met, you can concentrate on your main working tasks with complete professionalism. To achieve this, you need a medical billing specialist that gets the job done while maintaining first-class provider/patient relationships.

Knowledge and Experience

Before partnering with a medical bill collections agency, ensure that they have requisite knowledge of the Correct Coding Initiative. This is a national program designed to prevent improper payments, and all good medical billing management providers will be aware of it.

Communication is Key

If your patients have questions regarding their balances or claims, it can take a lot of time out of the working day to deal with them. A good medical billing specialist doesn’t simply help to keep your finances under control – they will also answer patient queries.

Find Out More

If you’d like to simplify the billing process at your medical practice, why not get in touch with Advanced Reimbursement Solutions to find out more? Our expertise could help you to increase your reimbursement levels by a great deal. Don’t delay – increase your profitability by contacting us today and booking an appointment at our office in Wilmington or Phoenix.

Best Medical Bill Collection Practices

There are many different things that should be considered prior to referring a patient’s account over for medical bill collection. Medical bills are often detailed and extremely intricate. With a variety of insurances and policies, it’s important to have knowledgeable individuals who can effectively review billing and ensure that both patient and medical practice are being compensated appropriately. Our professional and highly trained staff can help.

Clear Documentation and Policies

The medical billing process is highly complex, which is why it’s necessary to have a professional and reliable system in place that will handle all your medical bill collections. Our effective method for documenting and relaying communications about the collection process will ensure that each patient’s medical bills are organized and that no detail is missed. Aside from the documentation process, our collection policies that are set forth clearly outline the payment collection procedure, which ensures that each staff member and patient receive the same communications and expectations. Well-established communication between patient and staff guarantees faster reimbursement.

Payment Options and Multiple Forms of Payment

Providing patients with a simplistic payment process is key for reimbursement of any kind. It’s important to have clear, well-defined payment options that patients can relate to, so they can decide what works best for their financial situation.

At Advanced Reimbursement Solutions, we specialize in developing payment plans for patients who are unable to pay their bill in full. Offering a variety of ways for patients to pay medical bills (by credit card, debit card, check etc.) also allows for faster reimbursement and overall patient satisfaction.

Advanced Reimbursement Solutions has offices located in Wilmington and Phoenix. We can take care of every stage in the medical billing process, allowing you to focus on what is most important: quality medical care for all your patients. Contact us today to book an appointment and learn more.

In-House Medical Billing vs. Outsourced RCM

If you work in the healthcare sector, you must recognize the importance of Revenue Cycle Management (RCM). Even though the most important reason to run a healthcare center should be to provide your clients with reliable healthcare, it is still a business that needs to make profits. Medical billing is complicated, and you may not be able to do it without the help of a medical billing specialist. The process may take up a lot of time and effort. It requires patience, precision, and knowledge. If you own and run a medical practice, it is common to be torn between outsourcing your medical billing process and using your in-house staff. They are both viable options with different benefits and challenges.

In-House Medical Billing

If you choose in-house medical billing, all the responsibilities of following up on claims and coding fall on you. It may not be a good option if you do not have a certified medical coder working for you. You need to employ staff members to help with the processes of submitting and following up on claims. The members of staff must keep up with emerging trends and regulations; if they do not, your practice will suffer. Even though in-house billing gives you some more control over the processes, it can be time-consuming. It may also cause the practice to lose a lot of money in cases where the members of the staff do not have sufficient knowledge in the processes.

Outsourced RCM

Outsourcing is an excellent choice if your members of staff do not have much knowledge or experience in medical billing processes. Medical billing service takes care of the processes so you do not have to worry. This option helps you to avoid losses and allow your employees to focus on the primary purpose of your practice.

The choice you make should depend on the needs of your business. If you choose to hire a medical billing specialist, ensure that they have sufficient knowledge and experience. Advanced Reimbursement Solutions is a full-service company that can help your practice with its medical billing and other needs. We can help you to increase profitability while offering expert medical care. Contact us today to book an appointment in Phoenix or Wilmington and get started.

Should I Outsource My Medical Billing Process?

Although implementing an electronic health record (EHR) can significantly streamline communication and internal workflow within your practice, technology alone won’t be enough. Healthcare is going digital at a breakneck speed, and so many regulations continue to be rolled out. While most physicians prefer outsourcing technology, there are some things to consider when it comes to outsourcing the medical billing process. Before considering outsourcing, here are a few things you should know.

Benefits of Outsourcing the Medical Billing Process

Despite having a few limitations, outsourcing your medical billing process is a great move that can help you allocate your human and financial resources more efficiently. Here are four ways outsourcing can improve your practice.

1. Minimize administrative duties

By working with a reputable medical billing company, you’ll spend less time and money keeping your staff updated on medical coding changes, subsets, and modifiers. Also, your staff will spend less time preparing claims or keying in information for submission. This creates time for your physicians to focus on patients instead of trying to get pre-authorization from insurance companies.

2. Automate insurance verification

Most medical billing companies automate insurance verification. This enables you to save money you would otherwise spend on personnel in charge of insurance verification. In addition, you’ll have access to patient information such as their deductibles and eligibility for particular diseases or injuries.

3. Boost cash flow

Partnering with a trusted medical billing company can boost your revenue potential because you get paid fast, spend less when it comes to on-going training and spend less on staff. Ultimately, this reduces your operating costs while increasing revenue collected in your practice.

4. Enhance patient satisfaction

Outsourcing your medical billing process means you can spend more time with your patients, leading to you providing better quality care.

Contact Us

The healthcare environment continues to change rapidly, and finding ways to reduce costs and boost revenue cycle management is critical. Outsourcing your medical billing process can offer the best of both worlds. For more information, contact us today at Advanced Reimbursement Solutions in Phoenix or Wilmington and learn more about outsourcing medical billing.