Last Updated on 5 months by Isreal Olabanji DST RN
Getting your medical claims paid as soon as possible is the primary goal of every healthcare provider when it comes to finances. The faster the claim comes out, the faster the money will arrive. Make sure your medical billing and credentialing services provider is equipped with the necessary software to save time and money. These areas can help you reduce your claims processing time.
Real-time benefit verification
One of the most valuable tools for reducing claims processing time is the verification of benefits. Having access to real-time verification of benefits can save your staff lengthy phone calls or be held up for a long time at insurance companies. In a busy office, the medical staff doesn’t have enough time to call the insurance company anyway. You can save time and money in your office by subscribing or purchasing real-time benefit verification software.
If you are still claiming paper invoices, then you may be missing up to 3 weeks or more in accounts receivable days. Most of the larger insurance payers offer electronic claim filing. You can choose between direct billing or set up an account with a clearinghouse.
A clearinghouse is a company that will accept all of your claims and sends them electronically to insurance payers for processing. They also have edits in place to check for errors on your claim to help avoid billing delays.
The main benefit of electronic invoicing, whether you use clearinghouse or direct invoice, is that it will speed up the processing of your claims. Paper billing can take up to 45 days to process, while electronic billing can take 7-21 days.
Choosing the best tools for your office
There are many software programs to choose from to help you with your efforts to reduce your claims processing time. Deciding on the program to choose will be simple if you follow a few simple tips. Assess your needs; find a system that is easy to use, find out if the software is compatible with your computer systems. Get quotes from multiple providers and weigh the pros and cons of each seller.
Medical coding goes hand in hand with billing
In the administrative management of a health center, there are many factors to take into account; It is not only about having efficient management of resources and ensuring the proper functioning of the medical center or hospital, but there are also other aspects that become more important day by day and are related to the income of funds for the payment of patients. Medical coding goes hand in hand with billing since in all states to be able to collect an invoice, the procedure code has a standard rate or they are included in a package predetermined by the health center.
Role of Medical coders
Medical coders play a key role in hospitals, private centers, and medical offices, which necessarily require them to be able to charge efficiently and with the proper documentation, as well as to report to state agencies what is required in each region.
The billing department works closely with the coding staff in a doctor’s office. In some cases, the same person performs the coding, billing, and collection tasks, but these are three different positions. While some of the aspects of each job intersect with the others, they also have very specific responsibilities.
The coder is trained in medical terminology, international billing, documentation management, medical audit, statistics, medical technology, among other key aspects for quality training. It requires several hours of continuing education to maintain the certifications that are achieved with a five-hour face-to-face exam in the United States.
The World Health Organization is the governing body for disease coding; it reviews and updates them through a committee made up of specialists from all areas.
Coding, billing, and collections
Everyone would agree that the primary function of a medical office is the care of its patients; however, to stay in practice and prosper, the practice must collect payment for services rendered. Coding, billing, and compilations are a vital part of medical office staff duties, and proper training and guidelines are vital to the successful fulfillment of these duties.
Collection of unpaid bills
Collections of overdue amounts are the least effective form of reimbursement. The longer an invoice is overdue, the lower the probability of collection, and the more money it costs the office for time and payment hours. This is the best reason of all to have an effective billing and coding staff in your medical office.
Coding, billing, and collections are important to a thriving medical facility, regardless of size or specialty. Proper training, continuing education, and instruction in current changes in insurance laws, codes, or practices are imperative. Up-to-date reference materials and equipment enable these staff members to have a positive impact on both patients and the doctor’s office.
Lower claim denials
A claim denied by a payer is a probable reason for a bill not being paid on time. When both the patient and the staff have done their due diligence beforehand, this is less likely, but it does happen. An appeal by staff may be necessary with any clarification or explanation. An appeal by the patient is another possible solution, but the patient should be informed of the possibility that they are responsible for outstanding balances.
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