Medical Billing Archives - Advanced Reimbursement Solutions

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.

The Benefits of Outsourcing Your Medical Billing

As a healthcare provider, you will no doubt understand how frustrating and time-consuming medical billing can be. From negotiating disputes between patients and their insurance company to struggling to increase your reimbursement rates, medical billing takes your time and energy away from helping patients. Fortunately, there is another option. Consider just some of the many benefits of outsourcing your medical billing to a third-party company.

More Time to Spend with Patients

As an owner or manager of a medical practice, your time is incredibly valuable. By outsourcing your medical billing process, you will no longer have to sacrifice your time communicating with insurance companies and organizing billing; instead, you can focus your time on improving your practice or spending more dedicated time with patients. If you already have an in-house member of the staff who is tasked with medical billing, you can redirect their time to more productive tasks, such as developing digital marketing strategies for your practice and researching industry developments.

Increase Your Profitability

While a sole member of a staff or a small team may be able to send out statements to patients fairly regularly, a dedicated medical billing company will be able to work much more efficiently and quickly as that is their specialist area of knowledge. The faster bills and statements are sent to patients and claims are made, the faster money will be coming into your practice.

Improve Your Efficiency

A billing company is able to compile data and statistics about your medical practice in a regularly updated performance report. This will provide you with an objective report that compares where your practice is successful in achieving a high reimbursement rate and what services/areas of your medical practice need improving. This will not only keep you updated on your own performance but also the performance of the billing company.

Advanced Reimbursement Solutions is the medical billing company you can trust to handle all of your medical practices billing needs. We have offices located in Phoenix and Wilmington and are at the ready to assist you. Contact us today to book an initial appointment and learn more information about our process. We look forward to hearing from you!

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.

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.

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.

4 Proactive Medical Billing Tips to Maximize Your Revenue

The inconstant nature of U.S. healthcare is causing medical practices confusion when it comes to billing their patients. Issues like frequent alterations of billing rules and regulations are the reason behind the rejection and denial of claims across the country. As a result, medical providers are leaving over $100 billion of uncollected revenue annually on the table. Here are some of the billing strategies and tips you might want to use proactively to start maximizing on your practice’s revenue:

• Establish a clear medical bill collection process

You need to establish a good collection strategy to guarantee that your practice has financial health. The best way to achieve this is by forming a step-by-step tactic. Such an approach not only clarifies the procedure involved, but it also helps increase revenue cycles by certifying that all of your patients have been adequately informed about their responsibilities.

• Proper medical claims management

Most medical claims – about 80% of medical bills – contain errors that lead to rejection by insurance companies. As a result, your medical bill collection process becomes a cycle of claims submission, rejection, editing claims and resubmission. To avoid this problem, always ensure that all of your claims are double-checked for any inconsistency, unclear or incomplete information before resubmitting. Also, ensure that you edit the denied or rejected claims promptly.

• Reduce coding errors

Medical coders describe all of the performed procedures using standardized codes. As a result, it makes it easy for insurance companies to understand and process the reimbursement claims. But this doesn’t entirely mean that you cannot make common errors like mismatched, incorrect or missing codes. To be on the safe side, ensure that you always double-check before submitting a claim.

• Know when to outsource

This is one of the best tips available. Medical practices are always worrying about the current trends in medicine, patient satisfaction, and proper staff management. They also have to keep up with the changing billing regulations to avoid rejection and denials. At the end of the day, as they have so much to keep up with, it becomes easy to make mistakes.

That is why you need to outsource some of these non-technical activities to medical billing companies and focus your energies on other equally important events. For example, you can outsource billing to Advanced Reimbursement Solutions, a company in Phoenix and Wilmington that facilitates medical reimbursement needs for medical practices. Contact us today to book an appointment and learn more about helpful tips and how we can help.

4 Major Challenges Affecting Medical Billing Processes

Medical bill collections remain the backbone of healthcare revenue management. However, most providers experience numerous challenges with accurately and efficiently billing patients and other payers. The medical billing process can be nerve-racking for some providers since it involves various healthcare stakeholders and every step to getting paid depends on the previous interaction. As such, healthcare facilities must share information across departments and payers and ensure crucial information is accurately captured in every step.

Despite the long process, effective billing is vital for optimizing healthcare revenue. Here are four common medical billing issues and ways you can streamline and boost the process.

Failure to Capture Patient Information

The medical billing process typically begins at the first point of contact or interaction with a patient and a healthcare facility. During this contact, front-end staff must gather information that forms the foundation for billing and collection.

Getting accurate information begins with patient scheduling and registration. That forms the foundation by which claims may be billed and collected effectively. It’s also imperative that front-end staff verify health insurance status and coverage.

Most claims get rejected for eligibility issues that are avoidable if providers ask the right questions about eligibility. Therefore, regularly retrain your staff on patient registration and remind them to check eligibility status for every patient.

Not Enlightening Patients About Financial Responsibility

The main objective of medical billing is to gather the entire amount of services offered. However, most healthcare facilities often experience challenges collecting payments from patients due to an upsurge in patient financial responsibility.

To increase patient revenue, healthcare institutions must implement financial policies such as estimating costs of services, enlightening patients regarding financial responsibility, and getting some balances during a visit. As a service provider, you must simplify patient bills. Confusing medical bills from multiple payment requests and medical jargon can be difficult for patients to understand.

Using Manual Claims Management Processes

Submitting a claim goes beyond pushing a button. As such, providers must employ robust data collection tools, create effective communication channels among staff and streamline rejections management processes. Automating the medical billing process can assist providers to recover reimbursements from rejections on time. With an automated process, you can identify causes of rejections, manage resolutions and minimize write-offs.

Inaccurate Coding

Inaccurate coding is one of the leading medical billing challenges. We strongly recommend that healthcare institutions and providers use regular ongoing training programs.

At Advanced Reimbursement Solutions, we understand that medical billing and coding can be confusing. To learn more about medical billing processes and medical coding, please contact us today to schedule an appointment with our team members in Wilmington or Phoenix.

Outsource Your Medical Billing to Save Time and Money

If you are finding that your staff is spending too much time chasing after long-overdue reimbursements, it is likely time to look into specialized services to help your practice perform this task more effectively. Stand-alone surgical centers and durable medical equipment vendors often find that the reimbursement process is time-consuming, confusing, and they don’t feel like they receive the funds that they deserve.

We all know that the medical billing process has increased in complexity since the introduction and growth of HMOs and the like, and all signs point to this being the case for at least the near future, if not longer as health care in the United States continues to evolve. Outsourcing can help streamline your billing and reimbursement processes and let you focus on caring for your patients.

Outsourcing can help your practice improve both aspects of billing and reimbursements. Key benefits of outsourcing medical billing and reimbursements include:

• You free up the time of key staff members to focus on non-administrative tasks and feel that they are making a significant contribution to the practice.

• Receipts and profitability increase because the outsourced team only focuses on proper coding and billing.

• The practice receives the remuneration that it deserves for services rendered and providing durable medical equipment.

Focus On Medical Care, Not Medical Billing

Ongoing training to keep your staff updated on changes to medical billing codes and reimbursement levels for services and durable medical equipment can become onerous. Additionally, a low level of collections and reimbursements can add stress to the office atmosphere and have a negative effect on staff morale. The staff will begin to feel bogged down by administrative tasks that diminish the sense of value that they feel they are providing to the practice.

Outsourcing your medical billing allows you to rely on an expert team that is up-to-date in medical coding and understands the billing complexities that can make a significant difference to the amount that you are reimbursed, as well as the timeliness of payment. The less time that you and your staff are spending on medical billing and chasing down reimbursements, the more time that you can spend focused on your patients. Advanced Reimbursement Solutions is your medical billing and reimbursements partner who will help you to streamline your accounts to increase efficiency and profitability. Contact us today at our office in Wilmington or Phoenix to get started!

Photo: Numbers And Finance by kenteegardin licensed under Creative commons 2

How Outsourcing Medical Billing Can Benefit Your Practice

Have you considered outsourcing your medical billing tasks to a dedicated service provider? Billing operations can be quite demanding, not to mention expensive, to operate in-house. What’s more, you’re always required to keep up with the constantly changing regulations in medical billing or risk non-compliance.

The good news is that it’s now possible to outsource your entire medical billing process to a highly specialized company. Let’s take a look at some ways outsourcing can benefit your practice.

Increased Patient Satisfaction

It’s never easy to juggle the demands of patient care with time-consuming administrative tasks such as billing. If you manage a medical practice, you may well be aware that in order to serve patients better, you must dedicate enough time and attention to each patient.

It makes a lot of sense, therefore, to outsource your billing and effectively reduce the burden on both yourself and your staff, so you’re free to focus on what you all do best – patient care. When every member of the staff is focused on taking care of patients’ needs, patient satisfaction is bound to improve. With happier patients and a happier staff, you have a happier business to run.

Faster Reimbursements

A steady cash flow is vital to the survival of every business. If you’d like to reduce the amount of time it takes to collect payments for each medical claim, then you may want to outsource to a medical billing specialist. Since the billing company submits each claim quickly, with minimal or no errors, you can be sure of receiving payments from payers in much shorter timeframes.

Increased Revenue

Partnering with a professional billing company can increase your practice’s revenue. The company will work hard to eliminate common inefficiencies, submit every claim in a timely manner, and follow up on each claim to ensure faster reimbursements. This level of efficiency, combined with the reduction in overheads – since you don’t need billing staff – ultimately results in considerable increases in revenue for your practice.

Ensuring Billing Compliance

Medical billing companies have a thorough understanding of billing processes, and they’re always up-to-date with the latest industry rules and regulations. This is essential to ensuring that your practice is always compliant with the most current billing regulation. So, what does this mean for you and your staff? No billing laws to worry about and more time to provide quality care to patients.

Outsourcing your medical billing process to Advanced Reimbursement Solutions can help your practice improve patient satisfaction, increase revenue and ultimately thrive. Contact us today at our Wilmington or Phoenix location for more information about our comprehensive medical billing management solutions.

A Note About Online Security and Medical Billing

Those who have worked in medical fields for a long time know that the move toward keeping information in the cloud has been an extremely positive one. Fewer errors and mix-ups, more complete records, and greater ease when transferring information from one office to another are just a few of the positive benefits of keeping your medical billing process in the cloud.

Many practices have opted to hire a medical bill collections company such as Advanced Reimbursement Solutions to deal with bill collection processes for them. As with any online activity, security is of the utmost concern. You must make sure that the company you hire for medical bill collections has a high level of security and integrity so that information is not stolen. So, what kinds of online security concerns should you keep in mind when hiring a medical billing management company?

Encryption

Encryption is a basic internet security measure through which information is encoded so that it cannot be read by outside parties. There are several different levels of encryption, which basically refers to the complexity of the “code.” A range of companies, apps, and programs use encryption, ranging from banks to messaging apps to proprietary companies. Make sure that your medical billing company is using a high-level of encryption so that your patients’ data cannot be stolen.

HIPPA Compliance

HIPPA has set forth a variety of guidelines related to how medical billing specialists deal with private patient information when collecting medical reimbursements. HIPPA covers not only the ailments and treatments of a patient, but also the fees that the patient has paid and the specific clinics and practitioners a patient has visited. It’s important that your medical billing company has expertise in HIPPA compliance so that your patients’ and your practice’s safety and privacy is ensured.

Cloud-Based Back-Up in More Than One Location

When you store information in the cloud, there is a physical back-up, a server, that physically exists. Make sure that your medical billing company stores information in a cloud that has more than one back-up location. This is extremely important due to floods, fires, and other disasters that can damage a physical server.

Client Communication

Any company you work with should have your interests in mind and be available to you through simple communication methods. With clear communication, any concerns you have can be cleared up right away.

Advanced Reimbursement Solutions helps practices like you collect reimbursements from HRA accounts. Call us today so that one of our team members in Wilmington or Phoenix can connect our expertise with your medical billing needs safely and securely.