Wisely Choose Your Orthopedic Billing Partner - PowerPoint PPT Presentation

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Wisely Choose Your Orthopedic Billing Partner


Our HIPAA-compliant billing services, industry presence of 15+ years, and a team of industry-best coders and billers make us a trusted orthopedic billing partner. – PowerPoint PPT presentation

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Title: Wisely Choose Your Orthopedic Billing Partner

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Wisely Choose Your Orthopedic Billing Partner
Outsourcing is Need of the Hour Nowadays, most
of the practices feel comfortable passing the
burden of billing and coding onto medical billing
partners. Billing companies have medical
specialty-wise billing and coding experts who
streamline the revenue cycle process for
healthcare practice. But not all medical billing
companies are the same, some of them may not
have RCM experts or processes. Choosing the wrong
billing service or outsourcing for the wrong
reason can quickly become a risk and lost revenue
nightmare. Hastily outsourcing billing and
collections without careful evaluation of the
company could lead to severe problems in long
term. Performing due diligence before signing a
contract with such companies can mitigate risk
and performance issues before they become
unmanageable. Consider this article, as a guide
to choosing your orthopedic billing
partner. Wisely Choose Your Orthopedic Billing
Partner Business Associate Agreement
(BAA) Fewer service rates are the only selection
criteria of most orthopedic providers. Many small
medical billing companies process a claim but
they are unaware of regulatory environment or the
insurance compliances.
Wisely Choose Your Orthopedic Billing Partner
Such billing companies have no privacy, security,
or document destruction policies, and may not
even know what a Business Associate Agreement
(BAA) is, let alone supply one to the practice.
When you are entering into a contract with
medical billing company ensure that your BAA
includes, a security policy, a privacy policy,
and have a breach notification procedure in place
and ready in case a breach occurs. HIPAA and
PHI Medical billing has been widely affected
since the HIPAA Omnibus Rule was introduced in
2013. All parties involved in managing patient
health information (PHI) are now required to have
rigorous privacy, security, and breach
procedures. Practices should draft and scrutinize
the BAA carefully and ask specific questions
about the security policy for electronic
communication. Note that, if the billing service
doesnt shred accounts receivable reports or
paper Explanation of Benefits, and these fall
into the wrong hands, the practice may still get
fined. The billing services security policy
should cover the details of protecting both
digital and paper personal health information
(PHI).  Practices should check about privacy
policies and procedures in the billing company.
Who has access to confidential patient data and
for what reason? Do employees use computer
privacy screens? Do electronic systems log people
off after approximately 10 minutes of inactivity?
Wisely Choose Your Orthopedic Billing Partner
Billing Expertise Dont assume that the billing
companys employees have up-to-date knowledge of
coding rules or Federal regulations. To provide a
more economical deal, billing companies might
assign lesser experienced billing experts for
your account. Billing companies might fall short
when it comes to training. Employees dont attend
annual society coding workshops. Their employees
may rely on years of experience and advice from
online coding discussion boards. An uneducated
workforce is dangerous. If billing service
employees are not receiving ongoing education,
they may not know regulatory rules or use best
practices for managing accounts. The billing
service employees should attend coding courses
each year. Practices should also expect the
service to be competent with ICD-10 coding and
aware of fraud and abuse statutes. Billing
Reports You should ask for various billing
reports which give an overall picture of your
collection activities. To determine whether the
service uses effective accounts receivable
processes, orthopedic practices should ask how
unpaid, underpaid, and denied claims are handled.
Ask for AR aging, rejections, payment trends, and
overall collection report. Reputable billing
companies have procedures for every medical
billing process.
Wisely Choose Your Orthopedic Billing Partner
Request copies of billing and collections
procedures, and sample reports. Ask for protocols
describing how credit balances, refunds, and
adjustments are handled and modify these
procedures for your practice. You also need to
clarify that the service will never change a
diagnosis or procedure code for any reason
without physician approval. Before outsourcing
orthopedic billing and coding services, practices
should carefully evaluate the billing company to
minimize risk and lost revenue. Medical Billers
and Coders (MBC) is a leading medical billing
company providing complete medical billing and
coding services. Our HIPAA-compliant billing
services, industry presence of 15 years, and a
team of industry-best coders and billers make us
a trusted orthopedic billing partner. To know
more about our orthopedic billing services,
contact us at 888-357-3226 or drop an email
at info_at_medicalbillersandcoders.com.
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