Years ago, visits to the doctor’s office were a different experience: Physicians had a greater capacity to focus more on one-on-one conversations and best practices.
But like almost everything else in our society, technology has made modifications to day-to-day life in the medical field. HIPAA laws and stricter regulations, plus the adoption of EMR (electronic medical records), have made the practice of medicine a completely new industry – where the bottom line is just as important as bedside manner.
However, not all change is bad. According to an article published in The American Journal of Medicine, EMR can result in a positive return on investment. The only caveat is knowing how to efficiently conduct medical billing and collect receivables – and judging by the estimated $125 billion left on the table by doctors in the U.S. every year, that’s no easy feat.
But help is available.
Luckily, a complete revenue cycle management is available for your practice. Your company needs a qualified medical biller who is experienced in the timely submission of technical claims to insurance carriers.
Sometimes, front-of-office staff will make innocent mistakes in billing. But these slip-ups can result in unexpected audits by the Office of Inspector General (OIG), fines, and worse, especially if they are recurring issues.
Some estimates show that downcoding – the act of being overly cautious (rather than accurate) about coding, and therefore billing – can cost an office up to $40,000 in lost revenue in just one year.
Some medical professionals do this to be careful, in an attempt not to get audited. But ironically, downcoding can make it more likely to signal the need for a government audit.
Certified coding medical billers know how to ensure the proper use of compatible CPT/ICD-10 diagnostic codes, which will alert an insurance payer as to the necessity of certain medical treatments. In addition to increasing the amount of “first pass” claims submissions, it will help result in fewer out-of-pocket costs for your patients. Plus, your staff won’t waste precious time and money on accounts receivable.
Administrative tasks can also be less cumbersome by outsourcing your medical practice’s billing responsibilities. Your staff will have more time to spend on offering high-quality care and service to your patients.
Qualified billers will help mitigate any worries you have about changes in regulations. And as everyone in this industry knows, they are always in flux. Patient information and requirements are ever-changing, especially for those with Medicare and Medicaid; and in order to submit claims properly, the person doing so will need in-depth knowledge of the major insurance companies.
Medical billers will assist you with verifying a member’s eligibility for certain services before they’re carried out, which will save money for both the doctor and the patient – while also increasing the likelihood for long-term relationships.
Medical billers work off of facts, not hearsay or opinions. While harnessing the power of Medical Group Management Association (MGMA) key performance indicators, trained billing professionals can routinely examine your performance and make modifications to increase profitability as changes become necessary.
Many doctors’ offices focus on coding but let payment posting fall by the wayside; doing so can be financially catastrophic. A reputable medical billing company will ensure that any claim denials are correctly amended and that it’s done in a timely fashion.
Whether you already employ state-of-the-art technology or you need to streamline your current billing systems, outsourcing your medical billing will enhance your business’ cash flow and boost revenue.
ProMD Practice Management can help your practice achieve a considerable increase in revenue in a matter of months. Founded in 2004 by a team of physicians and health services administration professionals, our staff is experienced with billing services, timely charge posting, collections, and detailed monthly billing and collection reports.
To learn more about how ProMD can make your practice run like a well-oiled machine, call 888-622-7498 or fill out our online form to request a billing assessment.