As physicians are considering the use of medical billing servers to stop the hemorrhaging of cash from their practices, they are faced with a broad range of options. On the small end of the spectrum are individuals working from their homes. On the opposite end of the spectrum are companies that employ hundreds of medical billers and have thousands of clients.
In thinking through the billing options available, it is crucial to understand that medical billing is complicated and requires deep expertise and broad experience. When a specialty is involved, such as surgical billing, the requirements for success become even harder to achieve. Success requires that the medical billing company have a team that is well versed with the complex rules utilized by insurance companies to adjudicate surgical medical claims.
With surgeons facing ever increasing costs they must insure that money is not being left on the table because they have a billing company that is not a surgical billing expert. Surgeons must also be aware that that many billing companies that claim surgery billing expertise actually outsource their surgery billing to work at home billers. Situations like this are fraught with the risk since the remote workers are not working in a controlled and monitored environment.
One of the major drawbacks of hiring a company that does not specialize in surgical billing is their lack of familiarity with the procedures and the terminologies used. Even if the medical billing company serves one or two surgeons, they will lack the depth and breadth of expertise required for successful surgery billing. Moreover if the hired company does not specialize in billing for surgeons, then they will not have the expertise to effectively appeal denied claims or answer questions raised by the insurance companies.
A typical sort-coming with medical billing services that do not specialize in surgery billing is the inability to properly track and pursue insurance underpayments. These underpayments cost most surgeons about 10% of their potential income. If a medical billing company does not understand the mult-procedure rules and have a system that can track underpayments (and does not flag every payment on a second procedure as underpaid), they will find it difficult to capture this lost revenue is a systematic manner.
These billing complications extend to the patient collections arena as well. The patient collection process for specialists like surgeons is more complicated because of the large patient balances often owed, the complexity of the procedures/EOBs that must be explained to patients that do not understand their bills and the older population surgeons often serve. A medical billing service with expertise in billing for surgeons knows how to deal with these situations. Billing services without such experience will increase the risk of both lower patient collections and upset patients confused about their bill.
To avoid all these billing related pitfalls surgeons need to utilize specialized surgery billing services. It is not advisable for an internist to perform surgery, similarly someone without training in surgical coding and surgical billing is not qualified to offer reliable billing services for surgeons.
Copyright 2008 by Carl Mays II
Medical Billing Service Software
How wonderful it will be, if your Account Receivables is zero?
How great it will be, if your cash flow can be predicted with 100% accuracy?
As a healthcare provider, after taking all the pains of running the practice, after working very hard in serving the patients is not over-ambitious to think of the above. But what is the reality? Delayed reimbursements and piled up Account Receivables. Is there a way to over come these problems?
Yes, with StatCash billing system from Vision Infonet's medical billing services that is very much POSSIBLE!!!!!! A physician can:
Receive Insurance payments instantly with our StatCash Billing service. Keep AR at Zero, all the time. Make sure that the services are covered, before patient visits. Concentrate on patient care leaving all other burdens to us.
After all, providing Healthcare is physician's primary job.
What is StatCash System?
It is very simple. Serve patients and collect your money, instantly, without any delays, rejections, follow-ups and frustration.
What Vision Infonet does?
They take care of complete RCMS that includes
a) Confirmation of patient schedule: All the scheduled patients are called and their appointment is confirmed. Alternatively, if the patient wants to reschedule or can cancel his/her appointment, the same message is conveyed to the physician's office so that appropriate action is taken and the vacant slot is filled with other patients.
b) Insurance Verification: The insurance eligibility of the patients is verified to make sure that the specific service is covered by the payer. This will help to make sure that the claim is not denied by the payer for non-covered services.
c) Authorization/pre-certification wherever required.
d) Transcription: Medical reports are transcribed from the dictations of the physician.
e) Charge posting is done after proper coding of the visit.
f) We pay you 80% of the expected insurance collection within 48 hours of
the patient visit.
g) We pay the balance 20% within 45 days of service.
h) Sending of statements to patients, for their responsibility part.
i) Further, we provide you with our MDCare EMR/PMS for free for selected clients. MDCare EMR is a web-based, high-end
EMR with all the advanced features including scheduling, templating and charting, billing, POS and AR processing modules.
Example: If you are a physician:
1) For May 15 you have scheduled 30 patients, with no free time slots,
which include 4 procedures that require Authorization.
2) On May 13 we call all patients to confirm/cancel/reschedule their
appointments so that the freed slots can be refilled and all your
30 slots are full.
3) On May 13 we verify the insurance benefits of each patient and caution
about the terminated policies, non-covered services, deductibles etc.
4) We take authorization for the required 4 procedures.
5) On May 15 you will complete serving all the 30 patients with an allowed
amount of $ 10,000.00
6) On May 17, we will pay you $8000.
7) On June 30 you will be paid the balance 2000 by us.
Both Carl Mays Ii & Anil Moses are contributors for EditorialToday. The above articles have been edited for relevancy and timeliness. All write-ups, reviews, tips and guides published by EditorialToday.com and its partners or affiliates are for informational purposes only. They should not be used for any legal or any other type of advice. We do not endorse any author, contributor, writer or article posted by our team.
Carl Mays Ii has sinced written about articles on various topics from Cardio Training, Health and Finances. Carl is affiliated with a medical billing company that is 100% focused on billing for surgeons. To learn more about how a specialized billing company can help your practice please visit. Carl Mays Ii's top article generates over 12100 views. Bookmark Carl Mays Ii to your Favourites.
Anil Moses has sinced written about articles on various topics from Metabolism. Anil Moses is a post graduate in business administration and is associated with medical transcription,. Anil Moses's top article generates over 5400 views. Bookmark Anil Moses to your Favourites.
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