Here’s a fact: hundreds of millions of claims are denied by insurance companies in the US every year, amounting to billions of dollars. If you don’t have an efficient medical billing claims system, just imagine how much money your medical institution or healthcare organization is losing. Perhaps it’s time to review those rejected claims, get paid for them, and ensure that rejections are avoided in the future.
The process of insurance eligibility verification is not as simple as cross-checking data. There are hundreds of insurance providers in United States alone—and they all update their plans frequently. Unchecked details lead to insurance claim denials. Unfortunately, many details fall into the cracks because hospitals, clinics, and other healthcare organizations often lack the manpower to focus on this task.
Medical billing can be an extremely complicated process. This is why many healthcare institutions and providers hire an offshore company to handle their medical billing, in efforts to improve their accounts receivables and cash flow. There are some very reliable medical billing companies in India. The best ones have over 16 years of experience. They are ISO-certified, SSAE16-certified, are certified members of the HBMA (Healthcare Business Management Association), and comply with all applicable regulations (such as the latest HIPAA rules). They provide end to end medical billing services, including denial management, coding services, medical records indexing, insurance eligibility verification, and other services like Physician Credentialing, data conversion etc.
For most hospitals, clinics, and private practices, the answer to this question is a resounding yes. If you take a closer look at your accounts receivable management, you will likely find that ignored insurance claims are the reason for slow cash flow. And you are not alone. Over 200 million insurance claims are denied every year in the US—and many of those denied claims are no longer followed up, leading to loss in income. Like many other billing companies yours is probably losing a huge amount of reimbursement because of underpaid, unpaid, or delayed insurance claims. Denials are usually caused by coding errors, and unattended claims remain ignored for years because of irregular (or non-existent) follow up efforts.
The operational success of healthcare service providers hinges on the financial ecosystem. It is important that cash flow is maintained so as to keep the operations running smoothly. Healthcare billing solutions are rightly touted as the best foot forward for the sector. A large number of healthcare providers rely on outsourced billing solutions offered by service providers with commendable experience. Healthcare providers have witnessed better payment receivables due to adequate follow up action. Here is a quick preview of some of the reasons for the need of outsourcing healthcare billing. Continue reading “Healthcare Billing Solutions – A Must Have For Today’s Healthcare Industry”
Aging account receivables greatly impact the revenue cycle. It is of paramount importance to ensure that cash flow is seamless and streamlined through efficient processes. Prioritizing action and follow up in time barred denials is important to the financial health of entities. For an efficient workflow and improved financial prospects, it is imperative to shorten the Accounts Receivables (AR). We focus on the need for better denial management services to maintain lower aging in AR. Continue reading “Shorten the Accounts Receivables Cycle with Denial Management Service”
An endless list of Medical Coding Services may make it difficult to make a choice of the right service provider in India. However, on the contrary to apprehensions, it is possible to make the right choice through the use of a few selection criteria. The following tips will help to wade through the clutter to zero in on the best organization in India for Medical Coding Services. Continue reading “How to Find Top Notch Medical Coding Services in India”
With healthcare being linked to insurance in most cases, it is important to verify eligibility to ensure lower denials. At the pace with which administrative procedures are executed in healthcare, it is highly possible that incorrect or insufficient information is updated during billing. This results in a tedious and entirely avoidable process of denials and delays in clearance of claims. We take a closer look at the benefits of proper insurance eligibility verification in medical practice. Continue reading “How Insurance Eligibility Verification Helps Medical Practices”
Utilizing the services of medical professionals with the right credentials lends confidence to patients. Beset with reports of poor medical intervention and rejected insurance claims, it is important to choose the best physician. Physician credentialing helps patients and payers of patients’ bills alike through the review of various parameters of physician competency. This concept of enrolment is explained in brief below, which will give a fair understanding of the process and its benefits.
Learn more about physician qualification and by extension, competency
The qualification of a physician can, to a certain extent is indicative of competency. Physician credentialing involves the collation of information pertaining to completion of training by the doctor and subsequent board certification. This is then followed up with verification on the authorization granted to the physician to prescribe medications. Continue reading “Everything You Need to Know About Physician Credentialing”
Changing Payment Methods:
At this time of US healthcare evolving into different payment methods and moving from traditional Fee for Service payments, it is important for billing companies to ensure that their end clients get paid all their claims either by insurance payments or patients to maximize their revenue and reduce write off of unpaid claims due to passing appeal limit and timely filing limits.
On the other hand, Billing companies also need to ensure that every claim is paid the correct amount as per the Fee Schedule, Contracted rate, UCR etc. and are not underpaid. Underpayments and failure to appeal on underpayments cause significant revenue loss to providers.
In order to achieve the above, a very strong Accounts Continue reading “How an effective WFM tool can save millions of dollars of AR in Medical Billing”