Group Practices Remain Competent by Outsourcing Medical Billing - PowerPoint PPT Presentation

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Group Practices Remain Competent by Outsourcing Medical Billing


Group practice owners face an unprecedented number of challenges today. Outsourcing medical billing services could help them to remain compliant with billing guidelines and receive accurate insurance reimbursement for delivered services. – PowerPoint PPT presentation

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Title: Group Practices Remain Competent by Outsourcing Medical Billing

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Group Practices Remain Competent by Outsourcing
Medical Billing
Medical Billing Challenges for Group
Practices Group practice owners face an
unprecedented number of challenges today, from
adding or replacing providers getting rendering
providers enrolled adopting new technologies up
to receiving an accurate reimbursement for
delivered services. Any group practices success
is reliant on strong Revenue Cycle Management
(RCM) team, error-free timely claim
submissions, and quick accurate reimbursement
from private and government payers. That said,
its not unusual for group practices to have to
wait weeks or longer to receive payments. Even
when reimbursement is received, its often much
less than they charge for services. Even though
group practice owners want to work on medical
billing, due to their busy schedule they cant
much time towards it. Outsourcing medical billing
to a reliable and professional medical billing
company that focuses on this aspect of healthcare
delivery frees up more time so that practice
owners can focus more on patient care. In this
article, we discussed some of the key aspects
of medical billing outsourcing and how group
practices remain competent by outsourcing medical
Group Practices Remain Competent by Outsourcing
Medical Billing
Group Practices Remain Competent by Outsourcing
Medical Billing   While billing for various
payers most group practices face
specialty-specific billing challenges. If your
RCM/billing team doesnt include billers and
coders from the same medical specialty then
practices might face claim rejections and
denials. Group practices struggle in finding
specialty-specific billers and coders. Hiring
such specialty-specific RCM experts could cost a
lot or group practice may not have that number of
claims to submit. The medical billing company is
associated with multiple group practices of the
same specialty in your area. So they might have a
team of specialty-specific coders and billers who
are well-versed with payer-specific and medical
specialty-specific billing guidelines. Connecting
with such medical billing company will not only
increase your practice collections but also keep
your medical billing process error-free. Receivin
g claim denials in medical billing is quite
normal. But having a competent denial management
team ensures, you are working on denial codes and
resubmitting corrected claims. Not all group
practices can afford to have a fully
functional denial management team due to cost
constraints. Ideally, the denial management team
should include coders, billers, Accounts
Receivable (AR) experts, benefits verification
executives, and providers.
Group Practices Remain Competent by Outsourcing
Medical Billing
Medical billing company hires industry experts
from various medical billing background to work
in the denial management team. Medical billing
company ensures that every submitted claim should
get paid which ensures lesser write-offs. As
mentioned earlier, even though group practice
owners want to focus on medical billing, they
cant dedicate much time. Receiving an accurate
reimbursement for delivered services is a
challenge for group practice owners. Some of the
reasons include administrative burden, ICD-10 impl
ementation, pay-for-performance, contract
management, Affordable Care Act, No Surprise Act,
and constantly changing billing guidelines.
Managed care contracting is an integral part of
medicine for virtually all healthcare providers.
Not managing or accepting bad contracts will have
a severe negative impact on group practice
revenues. Medical billing company helps group
practices to get all their rendering providers to
get enrolled for all major payers. Provider
enrollment and credentialing is a tedious and
time-consuming process and most group practices
tend to bill as out-of-network for some payers.
Getting your all rendering provider credentialed
and enrolled is really crucial. Even though
reimbursement amounts for out-of-network are
usually much higher than in-network, sometimes
the difference between 6,000 and 40,000, payers
makes them much more difficult to collect. There
are a variety of unpublished and unknown internal
edits, third-party contractors, and double-sided
red tape that has to be navigated.
Group Practices Remain Competent by Outsourcing
Medical Billing
  • Outsourcing is More Cost Effective than In House
  • Outsourcing medical billing is more
    cost-effective than in-house billing for various
    reasons. Some of the key reasons are discussed
  • In-house billing involves a lot of operational
    overheads apart from salaries and employee
    insurance. The in-house operational overheads
    include finding and retaining highly trained and
    certified billers and coders licensing for
    software clearinghouse fees statement fees and
    postage (including the cost of printing)
    computers, laptops, and other hardware.
  • In-house billing might lead to lesser practice
    collections. Medical billing company shares
    insurance coverage report for every patient
    visit. This helps practices to collect
    co-payments and deductibles at the time of
    service only. Insurance coverage report also
    helps in sharing exact cost estimates with the
    patient which helps them to understand patient
  • On average, the cost of reworking on denied
    claims approximately ranges from 15 -25. If
    your group practice is receiving higher claim
    denials, the cost of rework is also high.
    Experienced billers and coders from medical
    billing companies ensure fewer number of denied
    claims. The medical billing company tracks the
    claim status of every submitted claim and
    resubmits the denied claim on time.

Group Practices Remain Competent by Outsourcing
Medical Billing
  • Billing errors can create a potentially large hit
    on your revenue. Errors include inefficient
    collection policies, incorrect coding, errors
    with patient registration and insurance
    verification, and lack of documentation with a
    claim. Using wrong modifiers or procedure codes
    to receive more reimbursement could lead to
    external payer audits.
  • Most medical billing companies offer flexible
    billing options where you can choose a billing
    plan as per your group practices requirements.
    You can either hire an experienced biller or a
    coder as FTE (Full Time Equivalent) basis where
    that expert resource will be working on your
    billing account as a full-time resource. Or the
    medical billing company will charge a fixed
    percentage of your monthly practice collections.
  • Medical Billers and Coders (MBC) is a leading
    medical billing company providing complete
    medical billing and coding services. We assisted
    group practices of various medical specialties in
    receiving accurate insurance collections from
    private and government payers. To know more about
    our billing services and pricing plans contact us
    at 888-357-3226 or drop an email
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