Medical Billing Outsourcing – Common Problems and Benefits in 2023

Before making a decision, you should be certain that medical billing outsourcing is the best choice for your healthcare facility. Although outsourcing medical billing is undoubtedly not a good option for every practice, it does provide a more organized and long-term approach to revenue cycle management. For medical practices wishing to expand, the key benefit of outsourcing medical billing is its long-term viability.

Reasons for Outsourcing Your Medical Billing:

1. Lower cost:

An economy of scale is advantageous to billing companies. Production businesses’ costs per unit decrease when they generate more products. A billing company has many times more billing claims to submit than a private practice. They can now handle each bill for a minuscule fraction of what a private practice would charge because of this. The billing company may transmit these savings to your private practice.

• Variable Fixed Expenses

The major cost if you need to hire your own billing department will be personnel salaries. No of how well or poorly the business is doing, you must pay their salaries. They represent a fixed expense, in other words. In contrast, billing businesses charge a percentage of the total amount of the bill, so you will pay less if you submit fewer claims.

• Transparency

Some people mistakenly feel that outsourcing your billing entails losing control of your practice. Outsourcing your bills gives you more transparency and control. You can review the generated data whenever you’d like and monitor the process at any time. This gives you real-time analyses of your practice’s performance whenever you feel you need them.

• Credentialing

Companies can aid your practice with its certification in addition to helping with billing. Credentialing can be a time-consuming, intricate procedure that demands a lot of your work force’s time. Another benefit of outsourcing your billing is that you may leave this task to a billing business.

• Payment Notifications

Occasionally, a bill is not paid on time. For a small billing department, this is a hassle, but for a billing company, this is one of their areas of expertise. For instance, a billing business will send out payment reminders automatically, taking another task off your plate and allowing you to focus on your practice.

Frequent issues with outsourcing medical services that healthcare facilities encounter.

•             Security and Privacy of Patient Data Breach

The majority of data breaches happen in the healthcare industry, thus choosing an outsourcing company carefully is an important first step. Patients’ data and information can be vulnerable in various ways if medical billing and collections are not directly supervised and controlled.

•             Miscommunication Regarding the Processes and the Contract

If the medical facility and the outsourcing company have divergent interpretations of the contract, outsourcing agreements could end in a downward spiral. Rarely are contracts ideal. The language that is technical or legal might hinder communication and cause misunderstandings. As a result, suitable modifications to the terms and conditions should be recommended.

Conclusion:

The first step you need to take to embrace the expansion that outsourcing will bring to your company is to analyze the advantages and disadvantages of doing so for healthcare services. Additionally, knowing all of your possible partner’s qualifications might help you determine whether to proceed with the partnership or not.

One of the most important decisions you will make for your company is selecting the correct medical outsourcing partner. Even while thorough consideration of all the benefits and drawbacks of outsourcing can be time-consuming and difficult, it is still worthwhile.

E-care has been in the business for more than 28 years, serving more than 120 clients across the US as a Business Associate under HIPAA Privacy regulations. E-care has a thorough understanding of the HIPAA regulations and is able to inform our end users. We also frequently train and update the medical billing and coding employees on HIPAA process requirements. E-care upholds strict security and confidentiality standards, taking in mind the significance of PHI and privacy laws. Please call 1-813-666-0028 or visit ecareindia.com (HIPAA Compliant Medical Billing Company | HIPAA Compliance | Medical billing compliance) to learn more about e-care.

How To Enhance Your Billing Cash Flow With Dental Billing?

How To Enhance Your Billing Cash Flow With Dental Billing

Enhancing Cash flow or Monthly collections from Medical Billing Reimbursement is the primary and basic necessity of any Billing Company, In fact, Outsourcing Medical Billing Services and Revenue Cycle Management Solutions sustains a healthcare business partnership by guaranteeing increased cash flow and maximum reimbursement to their end clients namely the physicians, providers, dentist and medical groups. However, with Dental Billing, the possibilities of collections and cash flow majorly depend on having an efficient payment plan for the patients, as mostly the source is from Insurance payments and Patient out-of-pocket payments.

Unlike other specialties, Dental is mostly covered only by high-cost insurance and most Dental procedures and treatments can be expensive and patients require a proper notification on what is covered by their insurance and what needs to be there out of pocket responsibility to ensure they are financially ready to take up the burden. By having a transparent approach physicians can efficiently plan for increased cash flow without payment delays. Read through this article to learn more about how to enhance Dental Billing and Coding Cash flow:

Specialty based experts

Dental Billing includes several nuances and Medical Billing Protocols to be followed to ensure timely Reimbursement. Let us look in detail at the Dental Billing Challenges to understand and eliminate them:

• First and foremost, not all insurance policies cover Dental Procedures. Making Insurance Eligibility Verification of Dental Verification a mandatory step in Dental Billing Process
• Acquiring Prior Authorization and Referral numbers for select dental procedures and treatments as stated by the patient’s Dental Insurance Policy
• Hiring and Retaining Dental Billers and Coders or a team of Dental Billing Experts has become the major reason for concern with the increased demand for experienced and trained Dental Billers and Coders.
• Many physicians and practices and Medical Billing Companies in US are struggling with a lack of experienced resources to handle Dental Billing. Challenges involved in finding a permanent fix in managing Staff attrition and absenteeism, and keeping up with the claims Timely Filing Limit (TFL)
• Accuracy and Completeness In Dental Claims processing, results in maximum payment and reimbursement, however processing such cleaner claims is challenging with the ongoing staffing issues
• Identifying if your Medical Billing Outsourcing Partner has Dental Experience and expertise and can carry out Dental Medical Billing with Maximum ROI.

Dental Billing requires an exceptional team of experts to help the Billing Company fetch targeted results, the best solution to achieve maximum ROI by handling all challenges smoothly is to find an experienced Dental Billing Partner. Offshore Outsourcing can help gain greater benefits while the Dental Claims are processed as per standards under HIPAA-compliant Medical Billing Companies.

About Ecare

E-care is one of the leading Medical Billing Companies in India. Dental Billing is one of the top services handled by e-care with a huge clientele of Dental Practices and Groups who have been with us for more than 20 years. With our expertise in Dental Billing, we can handle complete Dental Billing requirements with minimal transition periods. Our team of Dental Billing experts can guarantee increased billing collections. To know more about ecare and its services, visit us: http://www.ecareindia.com

Physician Credentialing Service Rules and Updates 2022

Physician Credential has become a fundamental part of Medical Billing and Revenue Cycle Management; as it helps Insurance carriers to ensure the providers meet the significant standards to ensure quality Medical Treatment and patient care. Physician credentialing also ensures that there is standardization with increased efficiency in patient care, thereby improving the business opportunity of Physicians and Medical Practices.

Medical Billing, Coding, and Physician Credentialing rules and updates are constantly updated and changed to meet the ongoing changes in the US Healthcare Industry, with such changes and updates, the physician credentialing process can become more cumbersome and laborious, however, having a checklist of documents to be submitted along with the Credentialing application and also having the CAQH and PECOS updated and keeping them current will avoid unwanted delays in Physician Credentialing Process.

Physician Credentialing Checklist:

• Updated Curriculum Vitae with a complete professional history in chronological order
• Credentialing Application duly filled accurately along with all supportive documents
• Educational and Medical Graduation Certifications
• Board Certifications
• Certification for Internship, Residency, etc.
• Current Medical License and State Licenses
• DEA Certifications
• Malpractice Insurance and Coverage details for 10 years
• CAQH Enrollment
• PECOS Login credentials
• W9, NPI, and CLIA certifications
• Driving License, Social Security Number
• Federal Tax ID and ECFMG Certificate Number
• CME activities for the past 3 years
• Work History with complete employment and affiliation details
• Explanation and supportive documents for career gaps if any

Listed above are basic documentation requirements for the Physician credentialing process, however, based on the type of insurance and the physician’s background the supportive documents required can be extensive, and delay the timeline to process the Credentialing Application. Therefore it is mandatory that the physician or the Credentialing team have a streamlined approach to avoid missing on any important documents or information and ensure smooth and faster processing of privileges.

The rules and updates for Physician Credentialing are often revised, with the recent novel COVID 19 and global pandemic attack, many extents in the US healthcare industry went through significant changes, In line with that, Medicare also imposed certain Provider enrollment changes and updates as listed below

• **Beginning January 1, 2022, CMS no longer requires enrolling Medicare Diabetes Prevention Program (MDPP) suppliers to pay the provider enrollment application fee.
• **Physicians, Non-Physician Practitioners (NPPs), physician organizations, and non-physician organizations don’t pay a Medicare enrollment application fee
• **Institutional providers and suppliers like Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) suppliers and Opioid Treatment Programs (OTPs) pay an application fee when enrolling, re-enrolling, revalidating, or adding a new practice location.
• **The 2022 enrollment application fee is $631. 
• **The Medicare Enrollment Application Information webpage has more information.

Apart from the above updates on enrollment fee, Medicare and CMS has initiated Multifactor Authentication with PECOS (effective Jan 2022) and EMR (Effective April 2022). Additional starting July 2022, PECOS Scroll Functionality is activated to ensure the member reads and acknowledges certification terms and conditions before electronically submitting Medicare Enrollment Application.**

To know more about Physician Credentialing Process reach out to MGSI.

About MGSI

MGSI is a full-service Medical Billing and Revenue Cycle Management Company located in Tampa, FL. With over 25 years of expertise in the Healthcare Industry MGSI guarantees to reduce revenue loss due to delays in Physician Credentialing. MGSI has experience handling CAQH and PECOS Credentialing for all Government and Commercial Insurance carriers. To know more about MGSI and our services call 1-877-896-6474 or visit   Medical Physicians and providers Credentialing Services | MGSI (mgsionline.com)

Things to Consider While Outsourcing Your Medical Coding

The benefits of “Outsourcing Medical Coding” is not something that needs to be proved at the current era; Over the last few decades, the Medical Billing and Coding Outsourcing and Offshoring model of business has seen tremendous growth and has proved to be the most suitable choice for Medical Billing Companies.  Offshore-based billing companies with their cutting-edge operation strategies and quality standards have turned out to be a new revolution for US healthcare and Medical Billing, especially during the global pandemic. Nevertheless, if considering Outsourcing medical coding, doing a complete analysis and research until you get a suitable Medical Coding Partner is a must to ensure your claims are handled by coding experts matching your requirements and guaranteeing maximum reimbursement.

Proficient Medical Coding Skills, Cleaner claims, reduced denials and Maximum Reimbursement are the key requirements for a successful Medical Coding Process. Check on the below areas before considering Medical Coding Outsourcing:

• Certified Coders: Quality Standards in Medical Coding is of paramount importance and cannot be compromised. To achieve the Quality SLA (Service Level Agreement), ensure you are partnering with a Medical Billing Company whose coders are mostly certified by the American Academy Of Professional Coders (AAPC)
• Specialty Based Expertise: Checkout if your vendor partner have the expertise and experience handling your core medical Specialty. Ideally, an established Medical Billing Company should have multi-specialty expertise and encourage you to expand your business while leveraging on their expertise.
• Trained and Experienced Coders: Coders needs to be constantly trained with all recent updates related to coding, insurance, and industry-based changes. Staff retention plays a major role in achieving the quality SLA, and understanding Client based nuances and Payor related rules and regulations. This is mostly possible only by Outsourcing to an Offshore Medical Billing company whose expertise is retained with cumulative years of experience in the industry
• Time Advantage and Faster Claims Processing: Offshore Outsourcing has a time advantage of 9-12 hours, expediting the claims processing by having the offshore teamwork during US night hours and getting them processed proximately. Faster claims processing helps faster collection and eliminates claim denials due to delaying the Timely Filing Limit(TFL)
• Cost-Effective and Efficient: Outsourcing Medical Coding is cost-effective and the most prudent method as it offers the best of both worlds in terms of quality and profit.
• Compliant and Secure: Medical Billing partners should comply with U.S. federal and state privacy laws and HIPAA Compliance for safe and secure PHI management.

Benefits of Outsourcing with Ecare:

Ecare – A 20+-year-old offshore-based Medical Billing Company based in India. With more than 100+ Medical Billing Companies across the U.S, ecare has expertise in handling various medical Billing software for more than 28+ Specialties. As a premier organization for Medical Billing and Coding in India, ecare offers the cost-effective billing solution and guarantees maximum reimbursement and increased ROI. Read through to understand the benefits of Partnering with Ecare:

• End to End Medical Billing support
• State of Art Medical Billing and Coding Services with flexible pricing models
• Multispecialty Medical Billing with expertise in multiple Billing software
• Faster Claims submission and faster reimbursement
• 98% Quality
• Twin certified with ISO and HIPAA compliant for safe and secure PHI

To know more about Ecare and our services call 1-813-666-0028 or log on to Healthcare Outsourcing Services | Healthcare Outsourcing Company | E-care India (ecareindia.com)

Strategies to Eliminate Provider Credentialing Challenges

Strategies to Eliminate Provider Credentialing Challenges

Challenges in Provider Credentialing Process are inevitable owing to the meticulous detailing and nuances involved. A streamlined and strategical approach is a basic prerequisite to ensure accurate and timely Provider Credentialing. Let us understand the challenges involved in Provider Credentialing before we discuss the strategies to eliminate them.

• Provider Credentialing processes are complex and laborious. A duly filled provider credentialing application with all supportive certificates, licensure and documents are the basic requirements for timely credentialing.
• Accuracy and Completeness in all information and documents provided are crucial to avoid unwanted delays and rejections
• The enrollment process differs with every insurance carrier requiring expertise in State-wise insurance knowledge on the Physician Credentialing process.
• Maintain CAQH Profile current
• Regular follow-up with Insurance            

There are various factors that can affect and delay the physician credentialing process as incomplete or inaccurate credentialing Applications or supporting documents or inept or unskilled Credentialing staff. Outsourcing Provider Credentialing to a credentialing expert can help eliminate such delays and save time and cost. Discussed below are a few important tips to eliminate such challenges in Provider Credentialing Process.

Accurate and Complete Information:

Accuracy and completeness are basic when handling provider credentialing applications and documents. As even a typo or tiny error can lead to unwanted delays and reprocessing.

Credentialing Document Checklist:

With the huge list of supportive documents to be produced along with the credentialing application, possibilities of missing any of mandatory documents, however having a checklist will help avoid such challenges help submission of cleaner and complete application.

Regular Follow-up:

Providers are required to follow up regularly with the insurance company after the submission of Credentialing Application until the successful completion of the Credentialing Process. This is mandatory to ensure the insurance company prioritizes your application and processes them on a timely manner and communicates any additional information required to process the application, Failing to follow up can lead to unwanted delays and missing to get the process on time.

Outsourcing Provider Credentialing Process:

To eliminate the above-mentioned provider credentialing challenges the best choice would be to outsource Provider Credentialing to a well-established Credentialing Partner as most of the challenges involving inaccurate and incomplete documentation can be eradicated with the help of Credentialing software and upgrades tools used by the Medical Billing Companies. Understand the benefits of Outsourcing

• Software used in Physician Credentialing can store all your information and data and help retrieve them as and when required. Tracks physician credentials and licensure and notifies on expiry to keep them up to date
• Credentialing staffs have in-depth knowledge of regulations and career-related specifications
• Regular follow-up from the time of enrollment to the complete process by saving time the effort for physicians to focus completely on patient care

About MGSI

MGSI is a full-service Credentialing and Medical Billing/Revenue Cycle Management Company located in Tampa, FL. With over 25 years of expertise in the Healthcare Industry MGSI guarantees to reduce revenue loss due to delays in Physician Credentialing. MGSI has experience handling CAQH and PECOS Credentialing including all Government and Commercial Insurance carriers. To know more about MGSI and our services call 1-877-896-6474 or visit https://www.mgsionline.com

Why Is Dental Insurance Verification Important?

With the increase in medical claims submission on a day-to-day basis, Insurance Verification has become a crucial part to ensure Patients’ Insurance Eligibility and Coverage Benefits to determine necessary medical services that are covered by their respective insurance carriers. Dental Insurance Verification is mandatory as not all procedures and services are covered under Dental Insurance therefore verification of the patient’s insurance coverage and benefits are mandatory to help the Dental Physician and Practice and the patients are clear on the payment liabilities prior to the procedure. This also helps avoid claim denials and increases the first pass ratio.

Dental Services cost an arm and a leg these days, making it quintessential for the provider and the patient to vary their financial responsibilities. Concurrently, having smooth billing services with proper Dental verification staff assigned to each and every claim from an in-house billing setup does not sound practically possible; as Insurance Verification calls at times may require longer holds to gather the required data from the insurance representative. Thus, it requires a dedicated staff or team to handle such a crucial process. By Partnering with an Outsourced Medical Billing Company, Providers and Medical Practices can leverage their expertise and resources while focusing on their daily cores.

Benefits of Insurance Eligibility Verification

• Helps understand patient’s Insurance Coverage benefits.
• Helps analyze payment obligations and responsibilities
• Know out of network coverage benefits and eligibilities
• Rectify Demographic data mismatch
• Helps cleaner claim submission with reduced chance of denials
• Increase overall collection and patient satisfaction

Benefits of Outsourcing Dental Insurance Verification

• Reduce the cost of staff management and Insurance Verification Call expenses
• Solution of Staff absenteeism and attrition with on-time insurance verification on day to day claims
• Save time and cost Staff training with new and updated protocols and payor related changes and guideline
• Experienced agents with complete knowledge of handling insurance verification calls and other means of gathering required information to expedite the overall process
• Quality claims submission with maximum reimbursement and reduced denials percentage

Choose the Best Partner for Dental Verification

Choosing a well-established and experienced partner to handle your Dental Insurance Eligibility Verification can be challenging and need to spend a considerable amount of time on doing some homework noting your primary requirements and expected expertise from the partner by doing complete research on various Medical Billing and Revenue Cycle Management companies. This one-time task of choosing the right partner for your Dental Verification company will eventually save a lot of time, effort and cost in a long run. With an offshore-based Dental Verification and billing partner, you will be able to gain double the benefits comparatively.

About e-care

E-care India is one of the pioneering offshore Dental Verification and Medical billing companies based in India that promises to avoid the risks involved with missed Charges. With 20 years of experience in the industry, e-care’s 3 delivery centers have been providing end-to-end Dental claims processing and Insurance Verification services seamlessly to its clients. To know more about e-care and its services call 1-813-666-0028 or log on to http://www.ecareindia.com

Understand and Eliminate Revenue Leakages in your Medical Practice

Medical Practices and Physicians undergo a lot of complexities in terms of processing the claims and acquiring the due reimbursement for the services performed. Adding to it unnoticed revenue leakage can cause serious financial repercussions. Vigilant measures in claim processing and tracking paid vs denials and low-paid claims should be part of everyday Medical Billing to block loopholes leading to revenue leakage.

Understand and Eliminate Revenue Leakage In Your Medical Practice

Revenue leakage in Medical Billing can happen in various scenarios while most of it goes unrealized by the physician and the billing team, some surfaced revenue leakages are consciously overlooked due to lack of staff, time and cost involved to get deep into analyzing and clearing them.

Possible Revenue Leakage Causes in Medical Practice:

• Insufficient of Incomplete Demographic data
• Missing Prior Authorization and Referral
• Omission of Insurance Eligibility Verification
• Incorrect Documentation leading to Coding Errors
• Incorrect Charges
• Billing Errors
• Patient Charges such as copay, coinsurance and patient balance not collected
• Physician Credentialing not updated
• Underpayments due to fee schedule changes
• Absence of regular Denial Management and AR Follow up

Listed above are a few major reasons for revenue leakage in Medical Practice. Understanding your Practice setup and Medical Billing nuances can relieve from unnoticed revenue leakage. Taking caution while processing claims and ensuring complete knowledge about the patient’s insurance coverage, fee schedule for the service to be provided,  insurance payment percentage and patient responsibility percentage for the said procedure and patient care can fix revenue leakage to the hilt. Taking care of the below list areas are critical steps to eliminate Revenue leakage:

• Round off and write offs are too be carefully handled keeping in mind every single penny contributes towards the revenue dip
• Collection of upfront payments such as copays, deductibles, and patients out of pocket payments are duly collected and recorded on file.
• Verifying In-network or OON patient care and collections are done accordingly.
• Verifying each and every claim to ensure all due payments are collected before closure.
• Following the timely filing limit (TFL) for new and denied claim submission to avoid denials or payment delays
• Streamlined and strategical billing and coding to ensure efficiency and quality.
• Ensuring all teams involved and all the scopes handled are worked towards achieving the standard quality of claims processing.
• Leverage on the expertise and experience of Medical Billing Partners to avoid inconsistency in quality and efficiency
• Outsourcing end to end RCM services for Revenue goals to be achieved.

Engaging yourself in everyday billing functions and monitoring claim processing for quality and standardization and analyzing cash flow vs payment denials and delays is crucial to avoid potholes in your practice monthly finance. However, as a physician or medical practitioner with a primary focus towards patient visits and procedures or unanticipated emergencies inpatient care engulfing most of your day mandatory billing-related functions can also take a backseat or get delayed. However, partnering with a Medical Billing Service Provider can be the best solution.

About MGSI

MGSI is a 25 year Medical Billing Company in Tampa, FL rated A+ from Better Business Bureau and adhering to HIPAA Compliance, MGSI assures the highest level of security and PHI protection. MGSI provides complete Revenue Cycle Management services to more than 600 physicians, physician groups across the nation. Partnering with MGSI can help ensure all payments due to the practice and physician are collected to the maximum with no delays. To know more about MGSI and our services, call 1-877-896-6474 or log on to http://www.mgsionline.com

Ultimate Guide to Understand Reasons for Cardiology Billing Outsourcing

While there are various reasons for opting Cardiology Billing Outsourcing;   physicians, practices and Medical Group who are new to the Medical Billing Outsourcing model look out for a guide to walk them through the various pros and cons along with some expert advice on deciding the best for their Billing System. This article aims to be the Ultimate Guide to understand the reasons for Cardiology Billing Outsourcing.

Ultimate Guide to Understand Reasons for Cardiology Billing Outsourcing

Cardiac Procedures with their unique technical and process-related complications need billing experts with the experience to ensure quality billing and maximum collections. Quality Billing comes with adequate specialty-based experience, which is gained by handling huge numbers of claims on a daily basis. A stand-alone Medical Billing Company processing claims for huge clientele have their Billing and Coding Staff handle claims from various scenarios, this in turn makes them the best choice ensuring efficient Billing Service. Listed below are few reasons for Cardiology Billing Outsourcing.

• Struggle with In-house billing staff management
• Attendance, attrition, and training related issues causing Billing delays
• Difficulty keeping atop of the billing and coding guidelines and adhering to them
• Missing out on the fees schedule updates from CMS and Medicare
• Revenue loss due to incorrect fee value for the service rendered
• Delayed or lapsed Physician Credentialing
• Inefficient Denial Management/AR follow-up leading to increased Old AR and revenue loss

To overcome or eliminate the above billing slips and achieve financial goals are the major reason for opting Cardiology Billing Outsourcing. Offshore Outsourcing has proven to yield maximum benefit comparatively. Offshore Outsourcing is no more a novel approach and has been well established with proven records of better ROI. Given below are the benefits of Offshore Outsourcing

• Timely Insurance Eligibility Verification avoid denials due to incorrect information
• Accuracy in capturing Demographic details leading to Quality Billing and Coding
• Certified Cardiology Coders from AAPC
• Payment Posting experts analyzing fee schedule for maximum reimbursement
• Reduced Denials and Maximize  Collections
• Complete Revenue Cycle Management Services
• Compliant with HIPAA regulated policies and ensuring secured PHI transactions
• Software expertise and Implementations of Artificial Intelligence for Upgraded billing functions

Quality and Revenue growth are the major requirements for any Medical Billing Company, by transitioning to offshore outsourcing not only do they achieve maximum revenue flow, but also the complete benefit right from staff maintenance to quality billing and coding yielding a stress-free billing experience.

With complex specialties such as Cardiology Billing where claims processing can be vulnerable to denials even with experienced billers and coders, expertized approach and streamlined process is quintessential, a well-established Medical Billing Company with years of expertise in the industry handling various specialties are fundamental requisite to any practice, medical groups or billing companies.

About e-care

e-care is one of the top Medical Billing Companies in India providing end-to-end revenue cycle management services for more than two decades.  With our experience and expertise, we service Billing Companies in the US, Medical Practices, Physician Groups, Individual practitioners with multi-specialty billing requirements. Our team has a clear understanding of Cardiology billing and can ensure maximum reimbursement.

How to Stabilize Healthcare Revenue Cycle after COVID Pandemic?

How to Stabilise Healthcare Revenue Cycle after Covid Pandemic?

The effects of the contagious and deadly Corona virus attack has tremendously affected the financial aspect and stability of many business. Healthcare, Medical Group and providers being the vanguard were impelled to encounter the severity of the COVID and Pandemic sequel.

COVID and Pandemic Effects on Healthcare Sector and Billing Companies 

Owing to the new normalcy of pandemic and social distancing patient appointments, direct visits, treatments and surgical procedures were postponed. Specialties like, Dental, Imaging Centers , In-patient set up which did not require immediate attention were made to shut down completely for months together, arising a question about their business continuity and financial stability. While the uncertainty still exist, business have adapted or implemented ways to pull up the gear and overcome the loss. This article aims to list out the measure for Medical Billing Companies to Stabilize Revenue Cycle Management.

Adapting to Changes

The first and the foremost step towards fighting against the crisis and overcoming the challenges is to adapt to the changes and work out a strategical protocol to sustain through the uncertainty. For instance to abide by the social distancing during pandemic many practices in an effort to keep the operation running have started telemedicine. Implementation of telehealth has helped majority of the healthcare sectors to sustain during and post the massive hit.

Stabilizing and Recouping

There are various factors to be considered while trying to rebuild. With the new changes in effect to be adapted to, medical practices and the billing team should be well prepared to face the challenges involved with the changes and to keep themselves atop. While billing and coding for telehealth procedures can be a first-hand experience to many, working out a solution to handle telehealth billing process is mandatory step of stabilizing. Ensuring the billing process are handled with expertise and efficiency can help stabilize the business financially.

Offshore Outsourcing to Reduce Cost of Service

Offshore Outsourcing has been proven  to be the best choice providing a complete solution for billing companies struggling through the pandemic repercussion. Billing Companies from across US have adopted this method to survive their business and keep them afloat during and post these period of uncertainty. Recent research has proved that offshore outsourcing option has benefitted for Medical Billing Companies across US to handle the billing smoothly and productively during the grim hours. With outsourced medical billing you get the advantage of various benefits like:

• Experienced billers and coders to meet your requirement
• Expertise in handling multi-specialty billing on any platform
• Back office support to handle all your Revenue Cycle management needs
• Billing staff with adept skills and knowledge to handle on-going changes and ensure maximum reimbursement
• Increased First pass rate and reduced denials to keep you cash flow intact

About ecare

ecare is one of the top Medical Billing Company in India providing end to end revenue cycle management services for more than 2 decades. With our experience and expertise we service Billing Companies in US, Medical Practices, Physician Groups, Individual practitioners with multi – specialty billing requirements. Our team of Billers and Coders can easily adapt to the challenges and current requirements and ensure we render quality service at a competitive price.  Are you struggling or looking for support with Healthcare Revenue Cycle, visit our website: Healthcare Outsourcing Services

Strategies to Prevent Medical Billing Claim Denials for Better ROI

Strategies to Prevent Medical Billing Claim Denials for Better ROI

Medical Billing Claim denial or rejections are inevitable; however it can be controlled by taking appropriate steps. Claims denials and rejections are often seen as one, however there are significant  difference which needs to be understand to ensure they are processed accordingly to benefit maximum reimbursement.

Claim Rejections: Rejected claims are the ones that did not even make it through for the insurance to review, which means they got rejected at the clearing house itself or got rejected at claims adjudications level. These claims did not go through because of various reasons like missed or incorrect details. Typo or formatting error etc. Once these errors are corrected they can be resubmitted for claims processing.

Claim Denials: On the other hand, claim denials means they were denied by your insurance carrier and can mean delayed or lost revenue. These denials are areas of concern for most of the billing companies as they might turn out to be time consuming and incur additional cost to get them corrected and appealed with insurance with multiple follow ups.

In this article we will discuss in details about the strategies to prevent Claim denials with better ROI.

How to prevent Medical Billing Claim Denials:

• Common cause of claim denials are incorrect and inaccurate information. Incorrect Patient name, DOB, POS, Insurance details, inaccurate diagnosis and procedure are some common errors that can lead to claim denial
• Using a patient portal to capture patient information and verifying the information helps reduce denials due to incorrect patient details
• Ensure prior authorization requisition is checked and acquired and submitted along with the claim
• Keep a watch on the ongoing updates and changes in the Billing and Coding guidelines and ensure the respective team is aware of the same.
• Regular audits to check on repeated errors and keeping a tab on the same to avoid repetition will greatly help in minimizing claim denials.
• Educating your team with the audit feedbacks and on the billing and coding changes helps curb denial percentage to a greater extend.
• Tracking and analyzing should be part of your day to day task to ensure you are closely monitoring the claims processed vs paid and unpaid or pending. This will help you understand if you are on the right track towards your financial goal.
• Having an efficient AR follow up and denial management team is quintessential to ensure every denied claim is reworked and appealed with the turnaround time and followed up until they are fully paid

Taking the necessary steps to keep claim denials at minimum will result in increased cash flow. Neglecting denials may lead to lost revenue affecting the financial aspect of medical billing services. It is crucial that denials are prevented to ensure the revenue goal is achieved and earn better ROI.

Outsourcing Denial Management and AR Follow up

Outsourcing Denial Management can be the best choice to achieve the target results and financial goals. Offshore outsourcing has proved to yield maximized ROI by handling Denial Management and AR follow up along with the entire revenue cycle management more efficiently and strategically. With an offshore Medical Billing Company handling your claim denials, you can be rest assured that you claims will be appealed on time and followed up until full reimbursement is collected. Offshore outsourcing assures increased cash flow by collecting the lost and delayed revenue and also keeping claim denials at minimal.

About E-care

E-care is one of the leading Medical Billing Companies providing Denial Management and AR follow up along with complete Revenue Cycle Management Solutions. With more than 80 clients across various states in US and being a multi-specialty billing company e-care can provide dedicated and focused billing services to all our clients ensuring maximum collection and reduced denial percentage. To know more about e-care and its services log on to http://www.ecareindia.com