Blog Archives - Advanced Reimbursement Solutions

Medical Bill Collections: Is Your Practice Crossing the Line?

In recent years, healthcare practices have become more aggressive in their medical bill collections. With the high costs of providing services, it is extremely important for practices to maximize reimbursements which largely depend on patient payments.

You can lose thousands of dollars if sufficient strategies are not geared towards collecting deductibles, coinsurance, and copays. Collecting these expenses from your patients is as important as collecting from insurance companies. But some efforts can lead to poor customer service. So, when do medical bill collections cross the line?

Not Giving Enough Time for Payment Preparations

Some practices don’t give patients enough time to make payment arrangements. This can discourage patients from coming back to your medical facility. It is wiser to give them enough time to make arrangements before initiating the collection process.

Overlooking Delinquent Bills

After offering services, most patients will not have the urgency to pay on time unless they’re prompted. Therefore, remind them of their bills when they visit and encourage them to pay.

Allowing Bills to Accrue

Unless it is an emergency, it is not good practice to allow patients to accrue bills even when they cannot pay. For example, allowing them to continue receiving treatment without paying sends the wrong impression about your practice. If you want your medical bill collections to be better and make your patients happy, avoid the mistakes above and adopt these strategies:

Advise Your Patients in Advance

Before patients visit your facility, inform them of your collection policy. This way, they will be more prepared to make payments on time. This is particularly important for patients who have to meet a certain deductible on an out of pocket basis.

Offer Self-Pay Discounts

For self-pay patients, offering discounts for timely payments can make a huge difference in your cash flow.

Offer Different Payment Plans

Out of pocket expenses can be extremely high for some patients. And the best way to manage them is to offer different payment options. That way, patients can continue receiving treatment without feeling the huge burden of paying bills.

Get Started

For your facility to offer great services and satisfy patients, you must find the right process to collect coinsurance, deductibles, and co-payments. Advanced Reimbursement Solutions wants you to have the best process. Contact us today to consult with an expert in Phoenix or Wilmington. We look forward to speaking with you!

How to Retain the Best Medical Billing Specialist

The Bureau of Labor Statistics (BLS) estimates that the demand for medical billing management specialists will increase by 13% between 2016 and 2026. This implies that the medical industry is growing faster than the national average for all occupations. So it will continue being extremely difficult for medical practices, particularly SMEs, to attract and retain top talent. Why?

Let’s face it. There are other medical practices out there. So what makes you unique from the herd? Offering more money can only do so much. The best medical billing specialist will be considering many options. The good news is that there are ways to attract and retain these specialists. And here are some simple ways to do just that.

Improve Your Employee Engagement

A 2016 Gallup study warned that only 32.7% of employees are fully engaged at work, which is unfortunate considering the amount of resources companies spend attracting, recruiting and onboarding new hires. If you want your medical billing specialist to stick with you for a long time, you must up your game.

Career Growth

Although this isn’t easy for startups and younger companies, it is important. Most medical billing specialists want jobs that allow them to advance their careers. So find ways to show them where they can go and how to get there. Show them that you can provide the right resources and guidance for professional development.

Upgrade Your Technology

Take a look at your billing management software and your computers. Nothing frustrates a talented employee more than outdated software or hardware. It makes them efficient and implies that your medical practice has no interest in investing in the latest technology.

Recognize Hard Work

Everyone likes to be appreciated for their hard work, and a medical billing specialist is no exception. So whenever you notice any improvement, please appreciate them. Employees who are appreciated feel more engaged and are more likely to be highly motivated to continue working with the same company.

Mission and Purpose

Finally, it is important for any employee to understand why and what your practice or billing company does. They need to believe in the mission, so when on-boarding, make it a priority.

The medical billing management industry will continue growing exponentially. Companies that find the right talent will succeed in their mission and purpose. Advanced Reimbursement Solutions wants you to succeed by retaining the best billing specialists. Contact us today to consult with an expert in Phoenix or Wilmington.

Choosing a Medical Billing Management Program? Avoid These Costly Mistakes

If you’re just starting your practice or restructuring, a medical billing management program is often the first thing to consider. Billing isn’t one-sided. So you want a program that benefits you, your patients, and insurance companies. Fortunately, it is extremely easy to get any billing program. Just request for quotes and you will be shocked by the many offers you’ll receive. But getting the right program that works well with your medical billing process can be frustrating. In fact, some practices make hasty decisions only to regret them after losing thousands of dollars. If you don’t want to be one of them, avoid the following common mistakes.

Overlooking Future Requirements

Most practitioners focus on what they need when starting. They invest in billing programs that only solve the challenges they’re facing today without thinking about the future. This can be due to financial constraints.

As an entrepreneur, it is important to remember that your practice will grow. The number of patients will double, and billing constraints will kick in. Therefore, it is better to get a good medical billing management program that can adapt to these changes.

Picking Renowned Brands Only

There are many popular billing programs today. But popularity doesn’t always mean they’re the best for your practice. It is not uncommon to see practices make a decision based on the ‘talk in town’ and later abandon the software.

Focusing on Features Instead of Functions

The competition for software-based services is cutthroat, and companies go the extra mile to outshine each other. As a result, most providers focus on features to make their products attractive to medical practitioners.

Features are great, but they should not surpass functions. Remember, a user-friendly interface and great customer support are only good as long as the software satisfies the requirements of your practice. So focus more on its functionalities.

Opting for Complex Programs

Let’s face it. Some medical billing management programs offer so many features that they’re too complex. And a complex system tends to take time and effort for employees to understand.

Therefore, it is important to choose a program that is specific to your practice. This doesn’t mean the software isn’t great, but you know what’s good for your practice. So choose a program that makes business operations efficient.

Getting the right medical billing program for your practice can be easy if you know what you want. Advanced Reimbursement Solutions helps practices get the right software to make them secure, profitable and efficient. Contact us today to consult with a specialist in Phoenix or Wilmington.

5 Back-Office Strategies to Improve Your Medical Billing Process

The front desk staff in any practice plays an important role in checking in patients, collecting data, and verifying insurance. But there’s more happening than meets the eye. Most of the medical billing process is usually performed in the back of the office, so it’s imperative to have the best team. If you want your back-office team to do a great job and improve your revenue, here are five simple strategies to try.

1. Train back-office staff on setting up payment plans

The front desk employees are usually the first ones to see the need to set up payment plans for self-paying patients or those with outstanding balances. However, the real arrangement is conducted by the back-office employees. And it’s important for these plans to be fair and consistent.

It can be a great idea to have back-office employees who understand how to set up payment plans, so train them. This will also help reduce pressure on your front desk employees to make decisions about waving payments. It is not uncommon to find employees who let emotions cloud their judgment and decisions under immense pressure.

2. Reconcile forms and claims every day

It is important to seek clarification from various stakeholders as soon as a question about the services offered arises. Your medical billing specialists should be well conversant with the appropriate modifiers. Reconciling forms and claims every day ensures you’re submitting clean forms. And clean forms are paid faster because they stand up to audits.

3. Analyze denials

Your back-office team can take time to analyze denial claims and create processes that address them. An in-depth analysis, for instance, can identify issues with modifiers, outdated codes, and other issues which slow down your medical billing processes.

In the long run, tracking denials will help you reduce mistakes and get rewarded with prompt and higher payments. At the same time, it will help you develop processes for rectifying and refilling denied claims on time.

4. Check on your account receivables every day

Although most claims are usually settled within 30 days of submission, some may take longer. As such, it is important to follow up on aging reports and review any claim that’s more than 30 days old.

5. Follow up on patient balances

Although your front-office employees inform patients about their balances, it can be a great idea to have someone at the back-office call them to ask for payment. Most practices outsource this task, but making regular follow-ups yourself could speed up the process.

The medical billing process isn’t a walk in the park. It needs collaboration between front-office and back-office staff. If you do it right, you can improve the process and boost your revenue.

Advanced Reimbursement Solutions wants to improve your billing process. Contact us today to schedule an appointment with a specialist in Phoenix or Wilmington.

How to Recruit a Top-Tier Medical Billing Specialist

Most practices need a medical billing specialist. As the demand for quick processing of claims, answering patient billing concerns, and liaising with insurance companies continues to grow, finding the best talent can be nerve-racking. So if you want your practice to thrive in this highly competitive industry, get the best medical billing specialist. Wondering how?

Here are some general tips for hiring the right specialist for your practice:

Search the Right Places

Most employers looking for a medical billing specialist often search the wrong places. A few managers are venturing out of the traditional recruitment processes, and are succeeding.

Write Down Their Job Expectations

Work performance should start when hiring. So make sure you put job expectations in writing when choosing a medical billing specialist. This ensures everyone is on the same page. And when doing so, move beyond the usual duties and responsibilities sections, and outline them in detail.

Medical billing is dynamic. If you have not updated your job expectations for a long time, it’s high time to do so before seeking a specialist. That way, you attract the best candidates.

Patience Pays

You need a medical billing specialist every day. But that doesn’t mean you select the first candidate or company you see. Finding the right fit can take time. If you rush, you might end up losing thousands of dollars.

Don’t Ignore Reviews

Most medical billing candidates tend to stretch the truth on their resumes. Therefore, look at reviews of companies.

The demand for medical billing specialists is on the rise, and practices that get the best talents will succeed. Advanced Reimbursement Solutions wants to see you succeed, and we have the tools and people available to help you do so. Contact us today to consult with a medical billing specialist in Phoenix or Wilmington. We look forward to hearing from you!

5 Signs It’s Time to Change Your Medical Billing Management Company

The medical billing management company you work with can make or break your practice. After all, you rely on their services and workflow to remunerate your staff and keep your business running seamlessly. A slight mistake can, therefore, have a huge impact on your business. With so much at stake, you can’t afford to make mistakes. Sadly, some practices wait until it’s too late to change their medical billing companies. If you don’t want to make the same mistake, here are just some of the signs to watch out for:

Dwindling Level of Service

How long does it take your billing company to respond to your concerns? An ideal company should be proactive and contact you when they detect any anomalies. They should always have a standing appointment to report anything about your revenues. When issues arise, the company should respond promptly. They should act more like a partner than just an ordinary vendor.

Increasing Number of Denials

Denials can occur due to several reasons, such as wrong coding and inadequate documentation. But if your denials are on the rise, and it takes time to resubmit or appeal, it may be a sign of a serious problem.

Average denial rates of about 5% are not unusual, but if they’re higher or increasing, it’s time for a new medical billing management company. Rising denial rates reduce your cash flow and can adversely affect your running operations. A good billing company should understand the importance of cash flows and keep denials low.

Uneven Revenue Collections

The quick submission of claims is important to your revenue cycle. Any delays can adversely impact your cash flow consistency. In addition, delays can also lead to filing issues. You don’t want to keep payers, especially those relying on Worker’s Compensation, waiting for too long because they have short timelines to submit their claims.

Patient Volume and Revenue Don’t Match

Ideally, when the number of patients increases, you should notice a corresponding increase in revenue. But if your revenue collections are stagnant, it’s a sign of an underlying problem. For example, an uneven ratio of revenue collection to patient volume could indicate you’re losing money.

Lack of Transparency

If you’re not getting the right reports, you should think twice. Your medical billing management company should present all the data you need. If you discover they’re hiding some details, it’s time to part ways. Companies with good internal processes have no challenge generating information about your clinic’s performance.

Medical billing management plays a key role in any practice. When you get the right company, your growth will be seamless. But if you get it wrong, it could lead to slow and inconsistent growth. Advanced Reimbursement Solutions in Phoenix and Wilmington takes pride in helping you grow with the right company. Contact us today to speak with a medical billing expert.

What’s the Difference Between Medical Billing and Medical Coding?

While the terms medical billing and medical coding are often used interchangeably, they actually refer to two very distinct but related practices. The key to understanding the different responsibilities associated with each practice is to know the different tasks associated with each role.

How are They Both Related?

Medical billers and medical coders both work together to keep a healthcare practice running smoothly. Because of the important roles both of these providers play, individuals are often highly trained and prepared for success on the job. Both roles are critically important to the healthcare practice, and if either of them is not performed correctly, the results can be very detrimental to both patients and the healthcare agency. The modern healthcare industry heavily relies on skilled and certified medical billers and coders to record and manage each patient’s healthcare billing account.

What Does a Medical Coder Do?

Medical coders are health professionals who analyze a patient’s records to figure out what procedures were performed by a doctor, nurse, surgeon or related healthcare professional. They closely analyze these procedures in order to assign the right procedure or diagnosis code for any services received by the patient. This is a very important process in order to ensure the correct procedures are being performed and the correct diagnoses are being given. Because of the important role medical coders have in the healthcare services industry, they are often relied upon to get more info about a patient’s medical history.

What Does a Medical Biller Do?

Medical billers are involved in entering these into data logs and processing insurance claims. They are responsible for making sure that every patient is not being billed incorrectly. Medical billers often use highly advanced billing software for this process, which allows inputting medical codes and insurance claims to be sent to the insurance company for payments to be made. Because medical billers deal directly with insurance companies, they are expected to have a thorough understanding of the claims process and all other requirements that must be submitted in order to process the claim. They are also responsible for making sure the correct information was submitted to the insurer and that the billing format, all corresponding fields, and any supplemental documents to support the claim were included in the reports.

Advanced Reimbursement Solutions has a highly qualified professional staff of medical billing experts that can increase the efficiency of your billing operations. Contact us today for a professional consultation with one of our specialists in Wilmington or Phoenix.

4 Medical Coding Mistakes That Can Destroy Your Patient Satisfaction Score

Medical billing management is an integral part of modern healthcare. After a patient visits a doctor or medical facility, their insurance gets billed. But the healthcare world is changing to meet new regulations, and medical billing specialists should do the same.

In most facilities, medical billing takes place outside the clinic. Many medical billing companies now offer their services remotely, and accuracy is imperative. A minor error can make patients infuriated. Why?

Imagine receiving medical billing errors that force you to spend many hours on the phone. As if that’s not enough, you’re forced to pay for services you didn’t receive.

The surest way to maintain a good relationship with your patients is to avoid such mistakes. And that responsibility lies heavily on your medical coding. So to give you an edge, here are four coding mistakes to avoid.

Balance Billing

Balance billing is not a walk in the park. Sometimes it’s needed, and other times it’s illegal. It is not uncommon to find health plans suing out-of-network providers for failing to balance bill their patients. The best way to avoid such mistakes is to know the law and verify the patient’s insurance before billing.

Code Mismatch

As a medical billing specialist, your team should know that diagnosis and treatment codes must always match. A common mismatch that often gets patients mad is an upcode. In such a case, the insurance company will reject the billing and the patient will be held responsible for any additional costs.

Failing to Verify Insurance Coverage

Medical insurance coverage varies widely on conditions, procedures, and treatments. It’s the responsibility of healthcare providers to verify every patient’s insurance coverage. Keep in mind that the coverage can change at any time. And sometimes, patients don’t know about it. So before billing, always double check and validate insurance coverage.

Duplicate Billing

When a patient is billed twice or more for the same service, it results in duplicate billing. This error can originate from a doctor or a nurse when they request for a patient to be billed for a service or prescription. Sometimes, it occurs when a patient gets billed for several “first days” in the facility. This mistake can be so enraging because patients may have to spend many hours on the phone trying to remedy it.

Medical billing management is not cakes and ale. It takes a good team and a great system to get things right and enhance patient satisfaction. For assistance, get in touch with Advanced Reimbursement Solutions to speak with an expert in Phoenix or Wilmington. Contact us today to schedule an appointment and get started.

The Importance of the Medical Billing Process

Medical billing is a vital component of every medical practice, as accuracy is essential for fast and efficient operations. The process needs skilled professionals who can interpret and record medical details accurately and still maintain patient confidentiality. But why is the medical billing process so important?

Patient Care

Medical billing gathers information on diagnoses and treatment through alphanumeric codes. The information comes from different sources such as medical notes, lab results, transcriptions, and electronic records. The codes are then transferred to the medical billing system. The system makes it fast and easy to access patient information and add updates.

Compliance (Regulatory and Contractual)

Medical billing management is part of many federal and state guidelines. Health Insurance Portability and Accountability Act (HIPAA) is the most significant when it comes to compliance. HIPAA requires every medical practice to protect patient information. Also, insurance companies bind medical professionals by the use of contracts which include negotiated rates for specific treatments and procedures. An accurate medical billing process ensures medics comply with this contract.

Insurance Claims

The medical billing process is a necessary step when submitting medical claims to insurance companies. It indirectly has an impact on medical care, especially when it comes to insurance reimbursement. Physicians will have to list the underlying conditions and preconditions and provide it to insurance companies for reimbursement. It is not the best idea to leave your staff in charge of the medical billing process. Hiring a professional medical billing company is vital to avoid errors and increase profitability in your medical practice.

Keep Information Current

Medical billing helps to manage patient accounts and ensures that they stay up to date. It takes a lot of time and effort to look for patient accounts that are not well-maintained. Also, a lot of revenue can be lost as a result of mismanagement. A high-quality system makes updating patient information seem effortless.

Smooth Flow of Payments

Medical billing enables the smooth operation of payments. Medical billing companies need to know the different public and private insurance plan policies and medical regulations. Also, they should be able to follow up a claim, appeal submissions, adjust billing, post payments and manage collections. Effective management is vital for revenue flow in any practice.

Ultimately, it is essential to have accurate patient details to avoid getting into trouble with insurance companies. Hiring a reputable medical billing company like Advanced Reimbursement Solutions is crucial for effectiveness. Contact us today to book an appointment with a team member in Wilmington or Phoenix and get started.

6 Strategies to Boost Your Medical Bill Collections

Managing medical bill collections can be a challenge for healthcare providers. And the fact that over 70 million Americans have pending medical bills or debts adds salt to injury. So if you want to improve your billing collection process, here are six simple ways to do so.

Allow and Automate Financial Assistance

Some patients are eligible for financial assistance. So instead of accumulating bills until they’re written off as bad debts, allow your patients to get financial assistance automatically. With the right technology, you can perform financial assistance screening when registering new patients. This allows your practice to determine whether a patient is eligible for financial assistance. This can increase your chances of collecting payment.

Verify Patient Data

Most data needed for medical bill collections is usually obtained at the point of access. As such, ensure the data is correct for an efficient collection. When the data obtained is wrong, or entered incorrectly, it creates an obstacle when it comes to getting paid.

Verify Eligibility

The process of verifying eligibility can be time-consuming. To increase your odds of getting accurate data, employ both EDI and web-based searches. Scheduled batch queries enable you to check for new updates and changes in insurance coverage, while real-time queries give you the opportunity to get current information about a patient. Both strategies give room for collecting accurate information, improving patient expectations, and getting updates quickly. Taking time on eligibility verification also minimizes your chances of denials, which can increase your medical bill collections.

Set Up Payment Plans

With the right technology, you can set up suitable deposit and payment schedules for your patients. Most healthcare practices are even using retail-style collection techniques, such as upfront deposits and secure storage for credit card information to boost future collections.

Create an Easy Process of Collecting Payment

Most medical practices are now using online systems that allow patients to post payments. These practices often report increased medical bill collections. You can borrow a leaf and take your practice to a new level.

Make the Billing Process Simple and Clear

The surest way to improve your medical bill collections is to remove obstacles in your payment processes and make it clearer. For instance, you can consolidate family payment information, bills from the lab, physician, and hospital, and provide online payment plans. These approaches can even reduce the cost of your billing process.

Medical bill collections can be improved with the right approaches. To learn more, please consult the specialists at Advanced Reimbursement Solutions. Contact us today to book an appointment and speak with a member of our team in Phoenix or Wilmington.