Eliminating Skilled Nursing Facilities’ (snfs) Medical Billing Complication

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Medical billing for Skilled Nursing Facilities has undergone metamorphic changes ever since the Balanced Budget Act of 1997 came into effect 1998. One of the significant requirements under the new legislation is that Skilled Nursing Facilities are not permitted to unbundle services that are administered by contracted healthcare providers. As a result, most of the services provided to Medicare beneficiaries are to be bundled together and billed by SNFs under Prospective Payment System (PPS) in one consolidated claim. The SNF concerned is then responsible to pay for contracted services out of the per diem rate that it earns for caring a Medicare beneficiary.

While this imposition may have helped reduce potential fraud and abuse due to double billing by healthcare providers, SNFs have certainly had a hard time in understanding:

  • What services are covered under consolidated billing
  • What is billable under Medicare Part A
  • What is billable under Medicare Part B
  • State-specific Medicaid protocols and methodologies for SNFs Medical Billing
  • Commercial health insurance plans and their dynamics

Though most the services offered to a resident under Medicare Part A are allowed to be included in the consolidated billing, certain services deemed costly or requiring specialization must not be appended with the consolidated billing. Generally, physician's professional services; certain dialysis-related services, including covered ambulance transportation to obtain the dialysis services; certain ambulance services, including transporting the beneficiary to the SNF initially, transporting from the SNF at the end of the stay (other than when involving transfer to another SNF), and transporting round-trip during the stay temporarily offsite to receive dialysis or certain types of intensive or emergency outpatient hospital services; erythropoietin for certain dialysis patients; certain chemotherapy drugs; certain chemotherapy administration services; radioisotope services; and customized prosthetic devices are excluded.


The services that are excluded under Medicare Part A should be billed under Medicare Part B, which allows medically necessary services to be reimbursed under ‘Fee For Service’ (FFS) system. It is possible that SNFs may have not entirely been thorough with these procedures, resulting in billing inefficiencies.

Even as most of the SNFs need to bill Medicare Part A and Part B, there could be SNFs that operate under state-specific Medicaid ambit. And, because each of the 50 states in the U.S. may its own Medicaid program, SNFs should invariably have to bill under their state-specific Medicaid rules and regulations. This regions-specific compliance too may have had a considerable impact on SNFs billing.

Outside the public health insurance plans, SNFs encounter the second largest health insurance providers in commercial health insurance carriers. While CMS has set a uniform standard for reimbursements across the board, commercial plays may still have their own individualistic methods of SNF reimbursement. Thus, SNFs medical billing may have suffered from having to adapt to these multi-payer dynamics.

These SNF-related medical billing concerns necessitate the significance of SNF medical billing specialists that certified and competent to maneuver SNF medical billing executions under Medicare Part A, Part B, state-specific Medicaid programs, and commercial health insurance environment. Medicalbillersandcoders.com has been versatile enough to solve medical billing issues regardless of location, size, or medical disciplines; practices across the 50 states in the U.S. continue to rely on us for remedial and transformational medical billing services. With our nation-wide resource-base adept at multi-component and multi-payer health insurance environment, SNFs should be able to put their medical billing complication to rest.

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Reforming Nursing Facilities Medical Billing Amidst Dwindling Reimbursements

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Nursing facilities across the U.S. have somehow endured a series of Medicare/Medicaid cuts thus far, but the latest move by CMS to reduce reimbursement for so-called Medicare “bad debt” – Medicare co-payments not made by beneficiaries or state Medicaid programs – may bring them on the threshold of a major operational crisis. The new legislation has effectively brought down reimbursement rate for bad debts to 65 percent from what used to be 100 percent of unpaid co-payments under dual-eligible beneficiaries, and 70 percent for other Medicare bad debts. With most of the nursing facilities encountering dual-eligibles (Medicare & Medicaid beneficiaries), and federal law allowing Medicaid programs to opt out of making co-payments in most cases, it may be difficult to sustain quality and operationally viable nursing services amidst shrinking Medicare and Medicaid reimbursement rates.

Therefore, it is not unusual for nursing facilities adopting contingency plans to safeguard their operational viability. Amongst several options available to nursing facilities, the following seem to have been deemed strategically more sensible:


  • Laying off direct service staff

    Many nursing facilities operators believe that they would be able to off-set the effect of irrevocable bad debts with a reduction in their direct service staff. While they may be able to save considerable overheads, they may also be limiting their ability to sustain service quality.
  • Putting new hiring on hold

    With limited scope for generating or increasing practice revenues, it may be difficult for nursing facilities operators expand their staff beyond their capacity. That is why most of them are inclined to putting new hiring on hold, and optimize operational efficiency with existing capacity. Here again, they may either be limiting their scope of operation or quality against a likely increase in Medicare or Medicaid patients.
  • Pruning benefits

    Another plan that may increasingly be adopted is ‘pruning employment-related benefits’ – bonus, increments, promotion, and other amenities. While it may help substantially reduce cost, you could be harming staff’s morale and motivation.
  • Deferring or cancelling expansion plans

    Reduction in reimbursements may curtail nursing facilities ability to expand with new ventures, and be forced to continue with current capacities despite demand generated by growing Medicare or Medicaid population.

While these plans may be effective to a certain extent, they will certainly be limiting nursing facilities’ ability to sustain quality, motive staff, and look beyond myopic operational strategies. That is why, rather than protective plans, operators would do well to explore alternatives that can keep their facilities responsive to quality and growth demands. Medical Billing is the area which has answers to most of the operational issues. Therefore, operators should look at making their nursing facility medical billing as effective and efficient as possible. Significantly, operators will need to align their billing practices to Medicare/Medicaid’s policy on reimbursing bad debts from disowned co-payments or deductibles.

Medicalbillingandcoders.com remains the most comprehensive source for medical billing solutions, more so for Medicare and Medicaid billing. With a resource base of medical billing experts spread across the 50 states in the U.S., nursing facilities can look forward to instant, effective, and efficient nursing facilities medical billing that can help them sustain quality and grow with evolving demand for nursing facilities.

Medical Billers and coders (MBC) is one of the leading Medical Billing Companies in USA & help doctors to shortlist Medical Billing Companies, Medical Billing Services according to their preferences of specialty, city, software and services performed.

The Value of Outsourcing Cardiology Specialty Billing Amidst Changes to Medicare Reimbursement Rates

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Any revision in Medicare reimbursement rates will have a direct impact on physicians’ medical billing, and cardiologists are not immune to the effects of frequent changes in Medicare reimbursement rates, announced by The Centers for Medicare and Medicaid Services (CMS) from time to time. While cardiologists or their billers could anticipate the extent of earlier revisions with a fair degree of accuracy, they might not have imagined what they would be encountering in 2013 – as per CMS would have to be prepared for a 2 percent cut over and above the possible 26.5 percent cut to fix Sustainable Growth Rate (SGR) formula. In addition to these general revisions, sweeping changes in rules governing evaluation of coders for certain high percentage cardio-vascular procedures, multiple procedure payment reduction, PQRS and e-prescribing, and value-based modifiers may potentially squeeze cardiologists’ revenues or operational margins.

One of the major changes that may hit cardiologists hard is the creation of new codes and payment levels for certain complex yet frequently encountered procedures. These new evaluation codes could potentially reduce payments from 20 to 27 percent depending on procedures. While representatives are negotiating with CMS for a more rational evaluation system, cardiologists or cardiology specialty billing will continue to be affected till such time when it may be revisited.

Another major concern comes from the CMS’ scheme for implementing a multiple procedure payment reduction to cardiovascular services. This could mean a reduction as high as 25 percent on the technical component of a service relatively less expensive than services performed on the same day. While this may not apply to office visits, most of the cardiovascular diagnostic and therapeutic services that happen to administer multiple services on the same day will certainly have to forgo a major chunk of their reimbursements.

As usual there would be bonus or penalty depending on compliance or non-compliance with PQRS and e-Prescribing – CMS has already made clear that cardiologists will receive 0.5 percent bonus for successfully participation in PQRS, and also be vulnerable to 1.5 percent penalty or reduction for non-compliance PQRS and e-Prescribing standards.

And, value-based modifier that adjusts payment for quality and cost of care could either enhance or decrease the eventual payouts to cardiology practices. While this system is not yet mandatory, you never cardiologists may soon be asked to be part of it under Account Care Organization (ACO) model.
Amidst these sweeping payments changes, cardiologists could be vulnerable to revenue losses, which in turn might jeopardize their sustenance and growth plans. This concern necessitates the significance of cardiology specialty billing that is competent enough to keep cardiologists’ revenue health positive despite the inevitable Medicare cuts.

Medicalbillersandcoders.com has successfully mediated physicians’ medical billing outsourcing decisions in the past; majority of Medical Billing Practices in varied disciplines across the 50 states in the U.S. have made use of our platform to source the right and competent medical billing professionals. Given our equally commendable cardiology-specific billing experience in the past during times of critical medical billing issues, cardiologists should be able to respond instantly and amicably to these Medicare-dictated billing challenges, and keep their practices clinically and operationally efficient.

Medical Billers and coders (MBC) is one of the leading Medical Billing Companies in USA & help doctors to shortlist Medical Billing Companies, Medical Billing Services according to their preferences of specialty, city, software and services performed.

Complications in Clinical Documentation Leading to Inaccurate Billing Codes

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Clinical documentation is a need that threads through the entire lifecycle of an inpatient treatment episode. The clinical documentation specialist checks the documents of a patient before or within 24 to 28 hours of admission to assess various aspects of the patient’s condition, reviews documents every two to three days, during patient stay, to check their progress, accuracy and assign proper diagnosis related group (DRG). Based on assessment, the clinical documentation specialist also sends feedback to the physician who corrects things if necessary before the documentation is used for preparing reimbursement claims.

As is evident, clinical documentation requires extensive documentation of treatment procedures together with their relationship to be used for preparing reimbursement claims. Seen from a reimbursement claim standpoint, anything that’s not documented doesn’t exist and such are coding complexities that the presence or absence of any fact in documentation affects the choice of code later, making it either accurate or inaccurate. This has become more so since the expected implementation of ICD-10-CM.

ICD-10-CM is much more nuanced than ICD-9-CDM. Whereas ICD-9-CDM included 59 codes for diabetes, ICD-10-CM has more than 200 codes for it. Additionally, for diabetes, ICD-10-CM has added a new provision called ‘poorly controlled’ to the already existing provisions under ICD-9-CDM, controlled and uncontrolled. 

Similarly, ICD-10-CM has also increased the number of categories for injuries to cover a larger set of possibilities and arrest the nuances of a wider range of physical specifications of an injury. For example, apart from various details to ascertain the character of an encounter, the ICD-10-CM requires the coder to code the size and depth of an injury. Also, ICD-10-CM contains multiple combination codes to account for relationships between various conditions. After wading through these details, it is not very pleasant to be reminded that the source of these codes is clinical documentation.

Effective clinical documentation requires a grid-like structure underneath the day-to-day healthcare activities involved in an inpatient treatment episode which will arrest medical details, record them and pass them through various phases of the treatment terminating with the discharge of the patient. This process has to be a mix of human effort (to interact with various parties involved) and technology (to record details and facilitate coordination among various specialties – healthcare and otherwise – that interact during the course of a treatment).

MBC’s Revenue Management Consulting can help you with this by performing a thorough analysis of your revenue management cycle and lubricating various points of interaction it has with other areas of operation ensuring smooth flow of data. This involves identifying gaps in your process and addressing them by replacing, if necessary, old software applications with new ones, blocking areas of revenue leakage and identifying areas of staff training.

Medicalbillerandcoders.com, the largest consortium of billers and coders in the US, has helped medical practices improve their finances by its Outsourced Billing and coding services which involve development of accurate electronic billing, intricate procedure coding, electronic filling of claims and a multi-layered application process - collectively resulting in reduced claim denials and enhanced core-business focus.

Medical Billers and coders (MBC) is one of the leading Medical Billing Companies in USA & help doctors to shortlist Medical Billing Companies, Medical Billing Services according to their preferences of specialty, city, software and services performed.

Tackling Reimbursement Challenges posed by Inpatient Coding with Professional Medical Billing and Coding!

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Clinical documentation is a need that threads through the entire lifecycle of an inpatient treatment episode. The clinical documentation specialist checks the documents of a patient before or within 24 to 28 hours of admission to assess various aspects of the patient’s condition, reviews documents every two to three days, during patient stay, to check their progress, accuracy and assign proper diagnosis related group (DRG). Based on assessment, the clinical documentation specialist also sends feedback to the physician who corrects things if necessary before the documentation is used for preparing reimbursement claims.

As is evident, clinical documentation requires extensive documentation of treatment procedures together with their relationship to be used for preparing reimbursement claims. Seen from a reimbursement claim standpoint, anything that’s not documented doesn’t exist and such are coding complexities that the presence or absence of any fact in documentation affects the choice of code later, making it either accurate or inaccurate. This has become more so since the expected implementation of ICD-10-CM.

ICD-10-CM is much more nuanced than ICD-9-CDM. Whereas ICD-9-CDM included 59 codes for diabetes, ICD-10-CM has more than 200 codes for it. Additionally, for diabetes, ICD-10-CM has added a new provision called ‘poorly controlled’ to the already existing provisions under ICD-9-CDM, controlled and uncontrolled. 

Similarly, ICD-10-CM has also increased the number of categories for injuries to cover a larger set of possibilities and arrest the nuances of a wider range of physical specifications of an injury. For example, apart from various details to ascertain the character of an encounter, the ICD-10-CM requires the coder to code the size and depth of an injury. Also, ICD-10-CM contains multiple combination codes to account for relationships between various conditions. After wading through these details, it is not very pleasant to be reminded that the source of these codes is clinical documentation.

Effective clinical documentation requires a grid-like structure underneath the day-to-day healthcare activities involved in an inpatient treatment episode which will arrest medical details, record them and pass them through various phases of the treatment terminating with the discharge of the patient. This process has to be a mix of human effort (to interact with various parties involved) and technology (to record details and facilitate coordination among various specialties – healthcare and otherwise – that interact during the course of a treatment).

MBC’s Revenue Management Consulting can help you with this by performing a thorough analysis of your revenue management cycle and lubricating various points of interaction it has with other areas of operation ensuring smooth flow of data. This involves identifying gaps in your process and addressing them by replacing, if necessary, old software applications with new ones, blocking areas of revenue leakage and identifying areas of staff training.

Medicalbillerandcoders.com, the largest consortium of billers and coders in the US, has helped medical practices improve their finances by its Outsourced Billing and coding services which involve development of accurate electronic billing, intricate procedure coding, electronic filling of claims and a multi-layered application process - collectively resulting in reduced claim denials and enhanced core-business focus.

Medical Billers and coders (MBC) is one of the leading Medical Billing Companies in USA & help doctors to shortlist Medical Billing Companies, Medical Billing Services according to their preferences of specialty, city, software and services performed.

Solving the ‘Secondary Insurance’ puzzle at your medical practice

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Care providers encounter patients with more than one level of health insurance coverage – a secondary insurance to complement primary insurance. While secondary insurance has considerably reduced patients’ out-of-pocket expenses and facilitated treatment plans outside primary coverage, billing for two-levels of insurance coverage has not been that easy. Even as certain secondaries to Medicare are enabled with automatic crossover to Blue Cross and Blue Shield and require no additional pursuance, majority of big and small private insurance plans continue to be unlinked with Medicare or Medicaid primary coverage. It is this isolation of secondary plans from primary that makes billing secondary insurance more difficult.

Irrespective of whether primary insurance is automatically linked to secondary insurance, it is the responsibility of care providers to arrange for co-ordination. Often, it is the insurance verification, billing, and follow up department that takes up the responsibility of coordination of benefits. Strangely, a large of proportion of relatively smaller secondary bills is never pursued or delayed till they become ineligible to be reimbursed. The collective value of such omitted secondary bills may be thousands of dollars per physicians. Therefore, with so much of hard-earned practice revenues going unrealized, physicians need to investigate and formulate corrective measures to follow up and realize secondary bills in time.

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  • One of the primary steps to monitor secondary bills is to have access to your patient accounts and system reports that show balances and your aging out Secondary Insurance Account Receivables (A/Rs). If you see certain bills approaching or just about to cross 90-day limit, it should be alerted immediately to your billing department for immediate follow up with secondary insurance carriers.
  • Second, more than alerting your billing coordinating department of aging secondary bills, you should try to extract reasons for delay in reimbursements, and advice your staff for corrective measures based on the facts responsible for such delay.
  • Third, once you have found out aging secondary bills, and advised your billing department to follow up with requisite modification or proof, it is important that they are pursued within the stipulated time limit, usually within 90-days from the date of billing.
  • Last, it is always good to have a periodic review of your billing practices, particularly secondary insurance bills. Periodicity may range depending on the volume of secondary bills or ideally once every month. Review is an apt way to monitor the progress on secondary claims, and keep your practice’s financials healthy.
  • In addition to challenges mentioned above, secondary insurance may have policy-specific, provider-specific, and region-specific demands. And, if you happen to be a care provider dealing with multiple insurance networks and operating across multiple clinical destinations in the U.S., you may have to be conversant with these diverse requirements. It is these multiple challenges that warrant the intervention of an external medical agency in your internal medical billing practices.

Medicalbillersandcoders.com has traditionally been care providers’ first choice in medical billing and coding; care providers of varied sizes and disciplines across the 50 states in the U.S. have found our services catalytic to their clinical and operational efficiency. And, at a time when they need their secondary billing mediated more than ever before, our resourcefulness – competent billing professionals with credentials in maximizing secondary insurance reimbursements – in secondary billing should be comforting.

Medical Billers and coders (MBC) is one of the leading Medical Billing Companies in USA & help doctors to shortlist Medical Billing Companies, Medical Billing Services according to their preferences of specialty, city, software and services performed.

Pre-empting malpractice liability risk with superior EHR systems

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Electronic Health Record system (EHRs), which is the next order in clinical and operational documentation, is perhaps one of the significant technology additions to have happened to the health care industry. While care providers seem to have been convinced of its ability to elevate clinical and operational efficiency to a new level, they may still be inheriting malpractice liability risk more than ever before. Amongst many things that are intrinsic to EHR system, transition, design, implementation, application, and control issues threaten physicians’ immunity against lawsuits with respect to breach of HIPAA-mandated patient privacy and security.

As physicians begin to transit from manual to EHR-managed data centers, patient-specific data may be vulnerable to proliferation, exclusion, or faulty conversion during the process of transfer from paper to electronic medium. As a result of this inappropriate conversion, patients’ clinical management may suffer from inaccurate clinical decisions. When patients’ care gets compromised on account of such inapt transition, physicians will certainly be held accountable legally. Therefore, it is important to undertake data transition comprehensively as well as have an EHR system that can entirely accommodate such data transfer.

More than being liable for lacking in data conversion, it is the choice your EHR design, customization, and implementation process that could either make or break your case – those EHR systems that tend to deviate from HIPAA’s requirements may spell trouble for physicians who happen to own them or may be opting for such EHR platforms without knowing the eventual consequences. Therefore, it is essential that you exercise caution before deciding on an EHR platform – it is not the price or somebody else’s provocation that should drive your decision but how far you can sustain integrity in clinical documentation.

Significantly, physicians may have to contend with control and security issues – with EHR systems chances of data proliferation, hacking, and unauthorized access are going to increase. Physicians – who are generally non-inquisitive of data coming in from EHR channels – may not entirely be informed of adverse happenings at their EHR systems. Therefore, more than being happy with implementation, it is important that you monitor the functioning of your EHR platform on an on-going-basis. It is also important that you commission a support staff that can conduct and protect EHR operations as required by HIPAA mandate.

Though a bill that protects providers from malpractice and other liability (if they happen to use certified EHRs) is being contemplated on, physicians would still have to continue to safeguard integrity and the accuracy of the patient’s medical record till then.

Medicalbillersandcoders.com is essentially helping out hospital management or physicians practices that may be vulnerable to EHR-specific malpractice liability risk. The significant advantage of partnering with us is our ability to leverage our tactical knowledge in EHR implementation with technology alliances with some of the best EHR manufacturers. More than getting your EHR systems customized, it is our catalytic role in assisting transition to EHR-enabled clinical and operational documentation that is instrumental in our being a leading consortium across the 50 states in the U.S.
Medical Billers and coders (MBC) is one of the leading Medical Billing Companies in USA & help doctors to shortlist Medical Billing Companies, Medical Billing Services according to their preferences of specialty, city, software and services performed.

Managing Variable Healthcare Data with the Help of a Medical Billing Service

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Although healthcare data is presumably highly significant to clinical efficiency, its application is not limited to clinical circle alone – medical billing, operational efficiency, contribution to clinical research and macro healthcare policies are equally dependent on healthcare data. Therefore, the primary raw data collected needs to be processed and tailored-made to serve these diverse purposes. While we may have come a long way from what used be generic data computing systems to healthcare-centric data management systems of today, questions still remain as to their ability to retain, secure, and serve the purposes for which they are 
relied upon.

This primary concern brings us to contemplate on data warehousing techniques that can necessitate the broad range of data-related utilities, such as tracking orders, recording vital signs, admitting/discharging/transferring patients, aiding reference, sending bills, and helping in collaborative exchange of healthcare data across clinical and operational eco-system – care providers, patients, insurance carriers, research bodies, and the Federal Government. While technology vendors have made available multiple versions of data warehousing models, care providers and all the external stakeholders still doubtful of them being fully responsive to ‘Meaningful Use’ of healthcare data.

Even as the problem persists with understanding variable healthcare data, care providers can still persuade manufacturers, vendors, and implementing agencies to evolve technology platforms that best serve providers’ internal data requirements as well contribute to external stakeholders’ data necessities. More than the mere architecture of the platforms, it is the utility-factor that needs to be well-defined and agreed upon before engaging with your prospective manufacturers or vendor. While we emphasize the need for customizing healthcare data centers’ architecture and delivery in sync with variable health care data utilities, current EHR platforms available in the market offer somewhat near-perfect options – today’s EHR platforms are believed to enable variable health care data utilities such as electronic medical records generation, billing, coding, operational functions, e-prescriptions, and a host of clinical and operational utilities.

While care providers may be able to better understand and manage variable health care data demands with these latest EHR platforms, they may still need to assess their prospective vendors’ ability to come up with customization that best supports their unique data needs. Notwithstanding their ability to assess intrinsic and potential data requirements, they, being physicians with essentially clinical care as their focus, may be well advised to avail services of medical agencies that best understand such critical healthcare data issues.

Medicalbillersandcoders.com has a tradition of mediating clinical and operational transformation on behalf of care providers. And, at a time when variable healthcare data management has become critical to clinical and operational efficiency, our broad resource-base of medical billing experts across the 50 states and their substantial experience in managing healthcare data centers for practices of varied sizes and disciplines should augur well for the future of variable healthcare data management in particular, and the nation’s healthcare delivery at large.

Medical Billers and coders (MBC) is one of the leading Medical Billing Companies in USA & help doctors to shortlist Medical Billing Companies, Medical Billing Services according to their preferences of specialty, city, software and services performed.

EHR As a Means to Better Co-Ordinate and Control Care Processes

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The success of health care has always been determined by how best care providers are able to coordinate the care processes across the clinical cycle – right from the time patients are admitted till they are pronounced cured. While clinical decision often lies with the primary physicians, clinical management may be divided among several departments or intervening specialists depending upon the complexities of clinical cases. Each clinical constituent may have specific, limited interactions with the patient and, depending on his/her area of expertise, may come up with his/her own view of the patient. While each of such views contribute to the ultimate clinical outcome, they information largely remains fragmented into disconnected facts and clusters of symptoms. As a result, clinical decision-makers are increasingly reliant on systems that keep disjointed clinical views into a cohesive clinical data.

Just as internet and web medium continues to evolve newer systems of care co-ordination, EHR is thought upon as the best technology system ever. While there could be arguments in favor of or against EHR as means to control clinical process, there is little doubt as to its ability to decrease the fragmentation of care by improving care coordination. EHRs have the potential to integrate and organize patient health information and facilitate its instant distribution among all authorized providers involved in a patient's care. With a well-networked EHR across the clinical continuum, care provider can expect:

  • superior integration among providers by improved information sharing
  • to monitor and control the effect of medication
  • to seek entry at point of care or off-site
  • consistency of data, order sets, and care plans helping to implement common treatment of patients using evidence-based medicine
  • gain access to experts for rural health care providers by sharing best practices and allowing for specialized care through telemedicine,
  • have population management trended data and treatment and outcome studies,
  • be armed with more convenient, faster, and simpler disease management

These multiple utilities promise to be a positive influence on health care quality and convenience. Amongst a series of EHR-enables advantages, providers will primarily be benefited with

  • Instant access to patient records from inpatient and remote locations for more coordinated, efficient care
  • Superior decision support, clinical alerts, reminders, and medical information
  • Performance-improving tools, real-time quality reporting
  • Clear, complete documentation that facilitates accurate coding and billing
  • Ready interfaces with labs, registries, and other EHRs
  • Improved, safer, and more reliable prescribing

Providers, who are always dictated by clinical excellence, should welcome EHR as a means to enhance primarily clinical efficiency as well as operational efficiency at large. While internal staff can be acquainted with the functioning of EHR, implementation of EHR need necessarily be done by experts. Medicalbillersandcoders.com – who has been the first to mediate with critical processes and systems on behalf of care providers – have the experience and expertise to enable care providers with decision-supportive EHR systems. Our resource base, spread across the 50 states in the U.S., is capable of customizing EHR systems in sync with your practice sizes and disciplines.

Medical Billers and coders (MBC) is one of the leading Medical Billing Companies in USA & help doctors to shortlist Medical Billing Companies, Medical Billing Services according to their preferences of specialty, city, software and services performed.

Does Expanding Outpatient Physicians Really Help Stabilize Your Hospital Revenues?

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Hospitals that hitherto have been troubled with in-patient operational losses may just have found a solution in outpatient mode. Contrary to stagnant inpatient volumes and revenues, outpatient volumes seem to have picked up in recent years. As a result operational revenues at hospitals seem to be firming up. It is also worthwhile to be informed of some interesting statistics unearthed by the research agencies – Fitch’s research has found the average operating margin to have shifted from 2.6% in 2010 to 2.7% in 2011 while Moody’s have estimated it to be hovering around 2.5%.

While outpatient mode may have marginally helped offset inpatient downturn, it is expected that hospitals’ outpatient windows will further gain from steady decline in inpatient cases – the decline in patient volumes, which previously was in sub-decimal, seems to be heading towards double-digit figure (prominent research agencies currently estimate it to be around 9%). Coupled with this dip in inpatient volumes, the recent health care reforms may force hospitals to operate at negligible profit margins. With so much pressure behind, hospitals should look at outpatient mode not as an option but necessity to sustain and grow.

But expanding outpatient windows has its own challenges – finding competent physicians or doctors, cost associated with their overheads, deciding on disciplines to be more aggressively followed under ‘outpatient’ category, and not but not the least the likely billing challenges on account of expanding outpatient services.
Recruiting physicians for outpatient services will be a primary challenge. As every hospital begins to scout for talents from a limited pool, the aspirants may begin to command higher price. The initial cost of hiring may temporarily be result in negative revenues. Therefore, hospitals should be prepared for such scenario and be optimistic of eventual turn around in revenue margins.

Second, it may not be viable to pursue every discipline under ‘outpatient’ category – hospitals should explore their intrinsic competence and decide on disciplines that are demanded most in their location of operation.


Last, the shift to outpatient services may give rise to unprecedented increase in billing activities. The sudden increase in billing may prove to be unbearable or burdensome to in-house or the billing services provider. Unless it is eased by a superior billing intervention, it may prove to be responsible for delay or denial of claims.

Notwithstanding hospitals’ capacity to alternate to outpatient mode with larger physician base, it is advisable to be mediated by people who are sensible in clinical and operational issues. Medicalbillersandcodes.com has time and again proved to be an able ally in times of clinical and operational crisis. Our resource base spread across 50 states in the U.S. offer instant remediation for billing, coding, RCM, AR Management, and a host of clinical and operational issues. At a time when hospitals’ stand on the verge of a major shift from inpatient to outpatient mode, MBC may well be your platform for prosperity.

Medical Billers and coders (MBC) is one of the leading Medical Billing Companies in USA & help doctors to shortlist Medical Billing Companies, Medical Billing Services according to their preferences of specialty, city, software and services performed.

Keeping your Clinical Focus Intact with Analysis-Backed AR Management Solutions

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Every year physicians in the U.S. lose thousands of dollars in the form bad debts. These so called bad debts are Account Receivables that have surpassed the admissible time limit or deemed impossible to be followed up. Once Account Receivables are allowed to languish for more than 120 days, it is difficult, if not impossible, to get them followed up and claimed. It really requires a dedicated AR management practices to monitor and keep ARs active. While care providers’ internal billing staff may be relied upon to a certain extent, they have often been found to be limited in their ability to analyze the reasons behind pending reimbursements, devise strategies to reduce AR days, and speed up realization of claims. But, because these tasks essentially decide the providers’ financial health and progress, they need to be arranged somehow or sourced from somewhere. Therefore, outsourced AR management services seem to be the only way out.

While outsourced AR management services could have right answers to solving AR puzzle, you certainly need to judge your prospective AR management service providers’ credentials on certain parameters:

Ability to analyze long-pending ARs: AR analysis is believed to extract reasons for delay, denial, or long-pending ARs. The reasons so extracted are supposed to be vital leads in resubmitting, following up, modifying, or adjudicating long-pending ARs. Amongst several possible reasons, your AR management partner should be able to cull out reasons such as:
  • Claim denial occurring due to patient’s non-eligibility of the insurance
  • delays due to adjudication issues
  • pending for request of clarification or documents
  • denials due to errors in coding and charge entry
  • delay in payment due to insufficient funds with government aided insurance carriers
  • filing of the claims beyond the claims filing limit
Ability to devise systematic corrective measures: Reasoning alone will not suffice; your ARs will be converted into real revenues only when they are backed up with instant, effective, and corrective measures. While most of the AR management providers are generally believed to knowledgeable, it is always safe to be informed of their ability to:
  • Process and systematically follow up with the insurance carrier for paper as well as electronic claims to improve reimbursements.
  • be conversant with knowledge about the insurance companies’ policies and procedures that help process claims
  • Keep records of past AR events that may come useful in dealing with similar future events.
  • maintain good rapport with the insurance company will help the physicians’ office or the physician billing company in solving the issues more effectively
  • handle major rejections and in prioritizing claims
  • verify explanation of benefits, and preserve final payment documents for future use
While ascertaining your prospective AR management service provider is inevitable, you being care providers may not want to be distracted from your primary focus: clinical excellence. Medicalbillersandcoders.com has precisely been an operational partner for medical billing and allied services. With a resource-network across the 50 states in the U.S., we promise to keep your clinical focus intact with some of the best analysis-backed AR management solutions. While our AR management solutions have been inclusive in our total RCM solutions, you can also get them customized exclusively to your practice needs. 

Medical Billers and coders (MBC) is one of the leading Medical Billing Companies in USA & help doctors to shortlist Medical Billing Companies, Medical Billing Services according to their preferences of specialty, city, software and services performed.

Transforming Your Data Centers into Secure, Instant, and HIPAA-Compliant

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Medical data has significant utilities – as vital source of reference for subsequent follow-ups, collaborative clinical management across the clinical network, Medical Billing, information bank for clinical research, and macro health care policies. While most of the practitioners may have a system for storing, retrieving, and sharing the data across the health care eco-system, they are increasingly susceptible to natural disasters, system-related snag, and hacking from unscrupulous sources. And data lost – either to natural disasters, system-related snag, or hacking – can have wide repercussions:
  • It may hamper your ability to coordinate your patients’ clinical administration
  • It may hold you back from contributing to collaborative clinical management
  • It may leave you without evidence while audit inspection, follow ups, or resubmission of your medical bills with Medicare or private health plans
  • It may project you as non-contributory to clinical research, and above all
  • It may depict you as non-participatory in macro health care policy missions


Because of these likely consequences, not only are physicians obligated to have their medical data stored but also have them secured from the threats mentioned earlier.


Most of the medical data these days are managed on EHR – which is a comprehensive platform for storing, retrieving, and sharing clinical and operational data. While an EHR can integrate clinical and operational functions with unbelievable ease, it is by no means guaranteed that it will stand the test of the threats highlighted earlier. As responsible care providers, it becomes your priority to have backup facilities for data stored in your EHR systems. One easy way to ensure data-readiness is to copy them from your EHR sources to portable USB drives that can be preserved securely elsewhere.


An important thing to remember while converting or transferring medical data into portable USB drives is that care should be taken to encrypt the so transferred data. The significance of encryption is that it will save your stored medical data from being easily decoded by hackers. With HIPAA being severe on breach of patient privacy and safety clause, protecting data privacy has become more than a mere necessity. HIPAA’s security rule comprises required and recommended actions to ensure the security of protected patient health information. Moreover, the Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and Reinvestment Act of 2009, supports HIPAA by imposing stiff penalties on healthcare organizations found guilty of data breaches. Among the penalties: fines up to $1.5 million and the burden of notifying the media (as well as patients) if the breach involves more than 500 records.

Along with this data-back plan and adherence to HIPAA’s privacy and safety norm, medical data should also be made available just in time – power outages should not an excuse as any data not available just in time may well be deemed as data denied. Therefore, physician facilities should have USP facilities to run data centers interrupted.

Managing medical data management as per HIPAA’s directive could be an extended burden to physicians, who are centrally focused on clinical care. This is where experts may have an interventional role in transforming care providers’ facilities into secure, instant, and HIPAA-compliant data centers. We, Medicalbillersandcoders.com, have been a responsible partner to care providers seeking data-related advice; practices of varied sizes and disciplines across the 50 states in the U.S. have stood to gain from our data backup plans & advice, and been able to respond to HIPAA’s safety and security norms positively. As medical data management continues to influence clinical and operational efficiency, our team of experts in data management is committed to transform your data centers into secure, instant, and HIPAA-compliant.

Medical Billers and coders (MBC) is one of the leading Medical Billing Companies in USA & help doctors to shortlist Medical Billing Companies, Medical Billing Services according to their preferences of specialty, city, software and services performed.

Negotiating Justifiable Contract with Health Insurance Companies

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Care providers operate in an environment characterized by multiple payors – Medicare, Medicaid, and a host of private health plans. The prevalence of such multi-payer is reason enough for differences in rates at which care providers are reimbursed despite the clinical procedures more or less being the same. Adding to this heterogeneous payor-environment is the regional differences wherein a physician practicing in an urban state gets reimbursed more than its counterpart in a rural state.  Are we simply to believe that these are irreversible factors, and physicians are left with no avenues but to accept what is offered?

Certainly, multi-payor system and regional factors should never hold you from claiming what you really deserve. If you happen to be as good a care provider as your counterpart in a metropolis, you are entitled to be reimbursed on par with the best rates. This is where your negotiation skills come into the fore – convincing you’re your payors as to why they should reimburse you at the rates given in the fee schedule, equivalent to the CPT codes, and to the maximum extent possible.

The extent to which you can negotiate is often decided by your being in a particular network – HMO or PPO. If you are a HMO provider, your negotiation is limited to Medicare or Medicaid fee schedule.  Medicare, being public plan, reimburses you at a rate which is comparatively less than a physician gets by being a provider in PPO. At best you can insist on getting reimbursed on par with what the admissible CPTs deserve.  But, to insist on being paid at CPT-equated level, you will certainly need to back up with clinical and quality credentials – care excellence, EHR implementation, and compliant coding and billing practices.


If you happen to PPO provider, being supported mostly by private carriers, can expect variable and maximum scope for negotiation – by being in the PPO network, you can expect to be paid at rates higher than in Medicare fee schedule.  But your payors are not going to be convinced unless you support you claim with valid reasons and proof. Amongst many ways through which you can negotiate better deals with your payors are:

• Keeping track of history of your claim submission and eventual realization:
This will provide with variance in your expectation and eventual pay out. When such variance are brought to the notice of your contracted payors, payors may be inclined to have a relook at the existing reimbursements, and may even amend with higher rates.

• Being aware of the rates offered by other plans:
This will help you compare your reimbursements with what your counterparts in the similar field are paid by other plans elsewhere. When these differential rates are brought to your payors notice, they may be inclined to revise to higher rates provided your quality of health care is as good as it is elsewhere.

• Being aware of geographic advantage:
If you happen to practice in an area that distinctively know for medical care quality, you try to force this into your advantage; payors are generally convinced of relatively higher level of quality care in urban and metropolis.

• By threatening to walk out temporarily:
If your payor is not open to the idea of negotiating, you may consider coming out of the contract. And when you start billing 100% to your patients, patients in turn may switch sides to payors that offer maximum coverage. This may force your original payor reconsider his original stance.

All these seemingly possible tactics would have to be carefully implemented. Care providers, who are primarily focused on clinical job, may be found wanting tactically. This is where medical billers would be sorely required. Medicalbillersandcoders.com – with a thorough understanding of multi-payer reimbursement environment – continues to mediate justifiable contract with health insurance companies across the 50 states in the U.S. Irrespective of your being HMO or PPO, our expert team of insurance contract negotiation is essentially driven by the motto: “maximizing your reimbursements”.
Medical Billers and coders (MBC) is one of the leading Medical Billing Companies in USA & help doctors to shortlist Medical Billing Companies, Medical Billing Services according to their preferences of specialty, city, software and services performed.

What makes Outsourced DME Billing Superior?

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Physicians who are part of DME services now face an important operational decision: whether to persist with in-house billing staff or entrust to external sources. The long-held belief that in-house billing staff would manage DME-related billing complexities seems to have failed them recently – most of the in-house-staff-managed DME billing are reported to have high incidence denial, delay, or under realization of DME bills from Medicare, Medicaid, and private DME health plans.  And, now that physicians strongly feel the reason to replace in-house DME billing, should they be embracing outsourced DME billing straight away? Yes, but not before they have debated pros and cons of DME billing outsourcing.

Arguments in favor of DME Billing Outsourcing
  • Primary argument in favor of outsourcing DME billing is that it will bring a fresh perspective to hitherto stereotype practices – outsourced DME billing providers, with their specialization, could iron out deficiencies, and improve realization. The in-house staff, on their part, will be able to concentrate on clinical priorities, and prepare reliable data for DME billing and coding.
  • Second, care providers need not worry about capital investment associated with training people and installing system for DME billing; an outsourced service comes with a ready-combination of trained people and systems. Moreover, with a large clientele, it will be easy for your prospective service provider to pass on the economies of scale.
  • Third, outsourced DME billing providers are supposed to have good terms with payers and agencies. Their being well-acquainted with Medicaid, Medicare, and private health plans should help care providers in knowing, negotiating, and responding better to dynamics of DME billing. Likewise, DME billing providers can save you from accepting health plans that are either operationally non-profitable or non-supportive of DME services.
  • Last but not the least, DME billing providers can be relied upon to keep A/R days within the permissible limit – with supposedly superior expertise in ICD and HCPCS coding, there should be little need for Decreased denials and/or front end rejections: as a result of expertise in ICD-9 and HCPCS coding, for re-filing, rebilling or appeal.


Arguments against DME Billing Outsourcing
  • Primary argument against outsourcing DME billing is that it involves lot of deliberation while selecting a prospective service provider from so many operating in the market – the chosen provider may or may not turn out to be a suitable one; sometimes, it may turn out to be inferior to your in-house DME billing.
  • Second, outsourced DME billing may initially need to be synchronized with your operational environment. And, when DME billing needs to be customized to your requirement, there will be likelihood of DME billing cost being escalated.
  • Last, mobility may sometimes be an issue – your outsourced DME billing provider may not be logistically near your clinical facility. Therefore, there could be considerable time gap between what you need and what you eventually get from your DME biller.

Because pros outnumber cons, physicians should consider it operationally viable and profitable to entrust their DME billing to outside service provider. With operational burden taken out of their minds, they can focus on clinical priorities, which essentially decide their competitiveness. Medicalbillersandcoders.com has veritable success as leading DME billing service provider; a great majority of care providers across 50 states in the U.S. have benefited from our specialized, economical, and collaborative DME billing services. And, as the demand for outsourced DME billing services is likely to increase in coming days, we hope to leverage on our nationwide DME billing specialists in bringing you operationally profitable billing solutions.


Medical Billers and coders (MBC) is one of the leading Medical Billing Companies in USA & help doctors to shortlist Medical Billing Companies, Medical Billing Services according to their preferences of specialty, city, software and services performed.

Challenges and Opportunities of Durable Medical Equipment Practice (DME)

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The necessity of Durable Medical Equipments (DMEs) had never been so high – in U.S. 30% to 54% of those over 65 years have some form of disability; around 75% to 90% of such disabled require some form of DME to keep them mobile or enabled. It is also estimated that around 1.5 million people are currently in need of wheelchairs and braces. And, when you add the population that is likely to be in need of other forms of durable medical equipment – prosthetics, orthotics, and supplies (DMEPOS) – it will be some opportunity to people involved in Durable Medical Equipment services: physicians, pharmacies, and manufacturers/suppliers. But, because DME services are physician-recommended, we are more interested in how physicians themselves can recommend, source, and administer DMEs.

While physicians can benefit immensely from an integrated DME management, there are challenges on way – being equipped with a Medicare enrolled and recognized pharmacy, sourcing supplies from bidders authorized by CMS, and showing up as participating supplier, who accept Medicare approved fees on DMEs.

Physicians who are willing to have pharmacies attached with Medicare Part B approval need to have a full-pledged Medicare Part B recognized DME supplies. The importance of having Medicare approved DMEs at your pharmacy is that it enables patients to have access to DMEs that are fully covered and reimbursed from Medicare Part B.

DMEs cannot be freely traded at your pharmacy; you need to apply for authorization from CMS. First, you need to apply by filling up Form CMS-855S for all likely suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). Applications are verified by National Supplier Clearinghouse (NSC) before being certified for compliance with DMEPOS Supplier Standards, as set forth in 42 CFR 424.57

Physicians in DME services are expected to be responsible – being responsible means agreeing to accept Medicare-approved amount as full payment. Physicians that accept this clause will stand to collect only 20% of the approved amount after the patient has paid the part B deductible. Though not mandatory, being partner in sharing monetary responsibility may have disguised benefits, such as goodwill and patient-initiated referrals.

While suppliers recognized by CMS are generally dependable, there have also been cases of sub-standard supplies. Accepting any supplies without thorough inspection may prove to be clinically inapt or underperforming. Therefore, physicians from time to time need to verify suppliers’ credentials and report cards as and when they are published by CMS.

Notwithstanding these possible challenges ahead, physicians in DME services should have ample scope for revenue generation. Consider the scenario when Medicare will be extended to every U.S. citizen – with a majority of current Medicare beneficiaries yet to utilize DME benefits, DME practice itself will be a major attraction amongst practitioners. And, with strategic partnership with medical billing providers, physicians can expect to overcome these incumbent challenges, and become more than being just survivors.

Medicalbillersandcoders.com has always responded positively to every clinical and operational challenge. Whether it is billing and coding, EHR implementation, or ICD-10 transition, we have been the first to assume responsibility. Medical practices of varied sizes and disciplines across the 50 states in the U.S. would readily endorse us as most dynamic and comprehensive source for overcoming clinical and operational challenges. And, at a time when DME practitioners find themselves in between opportunities and challenges, we are hopeful of helping them overcome challenges and realize opportunities.
Medical Billers and coders (MBC) is one of the leading Medical Billing Companies in USA & help doctors to shortlist Medical Billing Companies, Medical Billing Services according to their preferences of specialty, city, software and services performed.

Overcoming DME Billing Challenges with a Medical Billing Service

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There is a distinctive difference between billing for Durable Medical Equipment (DME) services and other clinical procedures – durable medical equipment services are ancillary to the primary clinical purpose, and their admissibility is subject to certain conditions.  Physicians since long have found these conditions tricky and challenging to understand, and often either been denied or underpaid for DME services, which may either have been
  • Deemed medical unnecessary,
  • Uncertified by Medicare/Medicaid/private health insurers,
  • Beyond the permissible reimbursement level
  • Lack of solid grounding in the Healthcare Common Procedure Coding System (HCPCS), which governs level II codes designated for DME equipment and supplies
While physicians have the right to recommend DMEs as part of a clinical treatment, they will have to back their recommendation with sufficient proof of them being medical necessary. Proving medical necessary alone will not suffice; it is equally important to know whether or not patient’s health insurance coverage supports DME services. With Medicare, Medicaid, and even certain private insurance schemes cautious about supporting exorbitant DMEs, physicians would do well to be verify whether or not patients’ health plans support DMEs.

Reimbursements are subject to the condition that physicians or patients source the admissible DMEs from payer-recognized vendors or manufacturers. While this condition may endorse payers’ commitment toward quality DMEs that last long and are competitively priced, physicians will certainly be put through the process of identifying Medicare/Medicaid/private insurer recognized vendors or manufacturers.  What is more interesting is that Medicare has designated certain pharmacies that can only supply admissible DMEs. Therefore, physicians’ task of identifying and sourcing DMEs has certainly become more complex than ever.

DMEs have grown to be clinically superior and functionally perfect these days. While appreciation in quality has facilitated clinical efficiency and patient well-being, price has been a major issue. Payers have not been all that receptive to the idea of supporting DMEs that are not operationally viable. Medicare/Medicaid too has its own reservations against highly-priced DMEs, and has put a ceiling on DMEs reimbursements.  Physicians, therefore, need to be aware of these restrictions while encountering patients that require DMEs well beyond their insurance eligibility.

Lack of solid grounding in the Healthcare Common Procedure Coding System (HCPCS), which governs level II codes designated for DME equipment and supplies, has largely been responsible for physicians’ below par realization of DME bills. In fact, if we revisit payer reports, wrong codes, absence of modifiers and insufficient narration seem to have contributed to drastic fall in reimbursement of DME bills. With care providers transiting to a more streamlined coding practice in ICD-10, DME-relevant codes will further get emphasized.

But for physicians, who are already reeling under a series of health care reforms, DME-related challenges may prove to be simply unbearable.  In-house staff, who are generally tied with clinical duties, may not be able to stretch beyond their general billing capability. The situation prompts an external medical billing intervention that can offer DME billing as part its comprehensive medical billing services.

http://www.medicalbillersandcoders.com/
Medicalbillersandcoders.com has verifiable success in DME billing services for practices across the 50 states in the U.S. The experience of negotiating DME claims with state-specific Medicaid policies, Medicare, and a host of private health plans is itself proof of our competence. With a team of DME billing experts at your service, challenges associated with ascertaining DME necessity, Medicare/Medicaid/private health insurers’ approval, permissible reimbursement level, and Healthcare Common Procedure Coding System (HCPCS) might just be the thing of the past!

Medical Billers and coders (MBC) is one of the leading Medical Billing Companies in USA & help doctors to shortlist Medical Billing Companies, Medical Billing Services according to their preferences of specialty, city, software and services performed.

Managing Holiday Season Resource-Crunch with the Help of a Medical Billing Company

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Healthcare is perhaps one of those few professions which are exception to the general rule of eight hour-a-day duty – professionals are required to stretch beyond their usual duty hours, and may even have to be on a 24×7 vigil. As a result work-related fatigue has been more common, which is undesirable from clinical point of view. Fortunately, holidays offer welcome-break from the rigors of work, and help professionals revitalize their mind and body. Generally, holidays in U.S. are season-driven – most professionals opt for holidays during Christmas.

While professionals can look forward to a long-awaited break this Christmas season, there is something whose rhythm cannot simply be ignored – medical billing, processing and claim realization. But, when the majority of resources – either internal staff or external resources – are expected to be on leave for a considerable period,  a large portion of medical practitioners’ bills may remain unprocessed, unrealized or piled up as account receivables, which are potentially detrimental to financially viable clinical operations.

During such resource-crunch times, medical billing companies – with enormous, flexible and agile resource base – should keep your reimbursements unaffected. While you may have conceded to the idea of outsourcing from medical billing company, you should still arrive upon the best source among many billing companies offering their services. The following factors should help you determine whether or not the medical billing company in question is credible and competent enough to fit into your requirements:

  • Is the company open to the idea of risk-sharing?
    Many companies are open to the idea of operating on a risk-sharing model – being able to share operational profit or loss equally with their clients, i.e. medical practitioners. Therefore, it is better your prospective medical billing company is comfortable with this clause.
  • Will the billing company earmark a separate account representative?
    Medical billing company manages many portfolios, and a single-contact may not be able to answer queries from multiple clients. Therefore, it is better to know if your prospective medical billing company will be able to appoint an account representative exclusively to look after the affairs of your medical billing process.

  • Will your billing company pursue denials astutely?
    Denials if not pursued may end up as irrecoverable. Therefore, it is necessary to know in advance whether or not your prospective medical billing company is credited with astute denial management.

  • Will your filing be on time?
    Claim submission if not done on time may well get rejected. It is the responsibility of your medical billing company to keep you alerted about filing deadlines, and knowing that your prospective billing partner is sensitive to filing deadlines really helps.
  • Will my Practice Management be integrated with EHR?
    The success rate of reimbursement is often decided by how best your PMS is integrated with EHR system. Therefore, your prospective medical billing partner should be capable of implementing a single and integrated platform comprising both PMS as well as EHR.
  • Will it offer customization?
    Outsourcing an entire range of general solutions may not make sense – few processes may be irrelevant or may have to be customized to your billing needs. Therefore, it is crucial to know whether or not your prospective billing company can offer the right mix of services to your practice.
  • What about its success rate with A/Rs?
    The credibility and competence of a medically billing company is built around its ability to reduce its clients’ A/R days to permissible limit. Verify your prospective biller’s credentials in A/R management before entrusting your billing management.
  • Is it familiar with technology demands?
    Medical billing is increasingly being managed by technology – clinical documentation, billing, coding, claim submission, realization, and reporting are all serially managed over a well-networked real time computing. Therefore, it is important to know whether or not your prospective billing company is sufficiently equipped with these technology demands.

Medicalbillersandcoders.com – being the largest consortium for medical billing services – has demonstrated its worth as reliable, broad-based, and flexible medical billing partner for practices of varied sizes and disciplines. Our intense resource-deployment during times of resource-scarcity has helped practices to keep their reimbursements and revenues unaffected even during holiday season. As practices are about to enter another holiday season, we assure them of everything that they anticipate from an ideal billing partner.

Medical Billers and coders (MBC) is one of the leading Medical Billing Companies in USA & help doctors to shortlist Medical Billing Companies, Medical Billing Services according to their preferences of specialty, city, software and services performed.
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