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Medical Billing Services: Choose the Type That’s Right for Your Practice

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Medical billing service providers come in many different shapes and sizes. At one end of the spectrum are large Practice Management Companies, with an extensive network of support but sometimes rigid and expensive. At the other end are small, home-based businesses. With more and more programs offered through local colleges, mail order and online, home-based businesses are popping up everywhere. Somewhere in the middle of these two extremes is what we’ll refer to as Professional Medical Billing Services. When considering your options, it is important to understand what each type of medical billing service provider has to offer and which is best for you. This article discusses these common types of medical billing service providers and some of the services they offer.

Home-Based Medical Billing Businesses vary significantly from one to the next in experience, ability and services offered. Many are small start up businesses with only one or two employees. Some offer extensive experience from previous employment in a doctor’s office, others may have only one or two clients. While these service providers can offer the highest levels of customization, a small, home-based business can sometimes run short of management knowledge and business acumen to be there for the long term. And what happens to practice cash flow when the solo biller decides to take vacation? Most provide the core services of medical billing (discussed later) and many have other personal experience to offer ancillary services.

Practice Management Companies are typically larger firms that may have 100 or more employees. Most true practice management companies take a holistic approach to supporting your practice, in that they seek to handle all facets of managing the business- including medical billing, marketing, staffing, and even patient scheduling. Although some providers might be excited about the opportunity of having a practice management firm take all the “trouble” off their hands, others find it stifling to have someone else running their business. While their offering can be comprehensive, those providers interested in working with a practice management company should read service agreements and contracts carefully to make sure they know exactly how their practices will be “managed.”

Professional Medical Billing Services fall in between the extremes of home-based medical billing businesses and the practice management companies, leveraging the strengths of both and eliminating the weaknesses. With a few dozen employees, Professional Medical Billing Services can offer greater flexibility than a practice management company, but more structure than the home-based service. Clients often find medical billing services have the sustained network of support to eliminate interruptions to cash flow from vacations or unexpected leave time, while simultaneously offering personalized services tailored to meet their needs.

As you consider each type of medical billing company, it’s also important to think about what services you need, which services you can handle in-house, and what expectations you have your medical billing professional. Each of the types mentioned above should be able to offer the following standard services; though service delivery, flexibility and customization can vary widely.

Standard Medical Billing Services

Standard services offered by medical billing companies are generally similar across the range of companies discussed above. There will be variations in the level at which those services are provided. Again, experience and size play a key role in defining where the variations might be. Regardless, the following list identifies the most basic services provided by any well organized medical billing company.

Claim Generation and Submission Claim generation includes entry of patient demographic, insurance and encounter information into medical billing software. Claim submission is the process of sending that data to the carrier, either electronically through a clearinghouse, or via paper submission in the mail. With electronic medical billing, services should apply one or more “scrubbers” to the claims (and manual quality checks to paper claims). Scrubbers are quality assurance checks of diagnosis and procedural codes for errors or mismatches typically integrated into premium medical billing software programs.

Carrier Follow Up Carrier follow-up is an integral part of the medical billing industry- arguably the most important aspect. The quality of a medical billing service is often defined by the level of follow up they apply to claims and will have an enormous effect on reimbursements. Through follow up, medical billing companies are able to isolate those claims that may go unpaid, or partially paid, and work with the provider and carrier to make sure edits and resubmission (if necessary) are clean.

Secondary, Tertiary and Workers’ Comp Claims These special claims usually require special consideration and handling as they often entail additional documentation. Service providers can sometimes get bogged down in the details required for these unique claims if not experienced and prepared.

Practice Reporting and Analysis Reports can be generated through almost any medical billing software, but how often and with what depth will your medical billing service provide these reports? Reports provide critical information about avenues for practice improvement such as directions for growth, cost savings and ways to increase profitability. The importance of reporting cannot be overstated for monitoring the health of the practice. Reports should be provided at least monthly, and experienced medical billing service providers should be able to make recommendations on how the practice can enhance profitability.

Patient Invoicing and Support Patient invoicing is a very detail-oriented process, but if done properly it can significantly enhance practice revenue. Nonetheless, balancing accounts, printing statements, stuffing envelops and applying postage can be very time consuming. And once patient statements are sent, someone will inevitably have a question about their bill. A good medical billing company has the infrastructure to support patient inquiries with customer oriented approach showing they understand their conduct is a reflection of your practice.

Other Services

As most medical billing services are well experienced in the inter-workings of a medical office, other services that may be offered. Some lateral practice services might include the following.

Credentialing Credentialing may be of particular importance to new practices. This process of “signing up” with carriers for the first time can be tedious and overwhelming, especially when just starting out. Credentialing services are also an asset to established practices as another way of growing into new business. Many medical billing companies bring the experience of working with carriers to help make your credentialing painless.

Medical Coding A natural extension of the medical billing service is medical coding. Coding is really the first step of the billing process, preparing the diagnosis and procedural information for entry into the medical billing software.

Transcription With wide experience in the medical practice support field, it is natural for many established medical billing companies to broaden their offering to include transcription services. The familiarity with HIPAA requirements and in-depth knowledge of the insurance industry support this natural addition to practice support services.

HIPAA Compliance The detailed requirements of HIPAA are not limited to healthcare practices, they extend to anyone handling patient information. Medical billing services well versed in the responsibilities outlined by HIPAA often develop programs to assist their clients in maintaining compliance.

Summary

Partnership with the right medical billing service is vital to your practice’s success. Just as with finding a good accountant or lawyer to support your practice’s needs, it is imperative you are comfortable with your medical billing service provider- they are the key to your revenue flow. There are many different types of medical billing service providers to choose from, each with its own set of pros and cons. The key is deciding what type of medical billing service provider you are most comfortable with and growing an open working relationship that will help you reach prosperity.

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Finance

The First 4 Steps to Get Massage Therapy After a Car Accident

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When I was hit by a drunk driver, the last thing I wanted was to mess with insurance. The other guy’s insurance company was willing to pay for massage therapy. But I didn’t have the time. And as a result, I was not fully protected.

Massage Therapy is one of the most effective healing tools available. It calms the muscles and mind down after a traumatic incident. It increases blood flow to the muscles, which increases healing. A great massage therapist will ask about the accident, and learn which muscles were tightened and harmed during the accident. As a result, your body will heal. Massage Therapy is the science of healing muscle. It is the only industry focused exclusively on healing muscle tightness and soreness. Seek out a massage therapist immediately if you are in a car accident to prevent those muscles from staying tight because of whiplash or injury.

I have outlined the steps describing how to get massage therapy for a car accident (or any accident) with the other person’s insurance company paying for it. These steps are the first 4 steps you should take immediately. Within 24 hours of the accident, take these steps to protect yourself. You must act quickly, or you may forfeit your care to the insurance company’s policies. To ensure you are well, follow these 4 steps below.

1. VISIT a Doctor or Chiropractor for a Doctor’s Note

You need a doctor’s recommendation for a massage. It’s a medical recommendation, like any other activity or prescription. Schedule a single doctor’s visit, and have your doctor recommend massage therapy as treatment. If you are injured on the weekend, visit a 24 hour clinic. Any doctor can prescribe massage therapy if you ask for it. But you must ask for it.

2. TREAT Yourself Immediately

The insurance companies have a policy called having a “Gap in Care.” It means that if you are not getting your treatments consistently and immediately after the accident, then you are not really hurt. If you are going to get massage therapy to remedy accident pain, then start immediately. And don’t stop getting regular treatments until you are better. Changes to your treatment plan or providers is fine, but do NOT stop getting some sort of treatment, or the insurance companies will claim you have a “gap in care.” And they will not accept your claim.

3. BEWARE of Delayed Pain

Whiplash can show up several weeks after accident. What happens is that the body goes into hyper-protection mode, as a safety measure. It pours adrenaline, and other chemicals into your body for several weeks to protect you from hurting (so you can escape the dangerous land of other cave people, ya know, with deadly mountain lions and other creatures). Then your body starts repairing weeks later. That repair period is when the pain really start.

Often, you won’t seek immediate treatment because you feel fine, then you start feeling really bad weeks later. Continue your massage therapy treatments for at least a month to make sure you prevent serious whiplash from affecting your productivity. The insurance companies understand this too. So continue treatment for at least month. And longer if you are genuinely in pain.

4. ASK Questions of the Insurance Company

Some insurance companies pay as you go. Other insurance companies want to pay out the claim at the end of treatment. Ask them lots of questions on their process. The adjustor is simply following a set of rules. If you can learn the rules, you can make the most of the claim (and save yourself a lot of headaches). Work within the system, not against it. Some great questions include, “How does the claim process work?” “Can I get checks as I submit receipts, or do you pay out all at once towards the end.”

Regardless of what happened, everyone involved wants to see you get better fast. So act quickly. And start a consistent treatment, and continue with it, until you are better. Good luck and Feel Better!

If you know a friend who would like this article, please forward it, or submit it on Facebook, Twitter or Digg. If you have friends in Dallas / Ft Worth, Texas, forward our website to them today. We look forward to meeting you and your friends soon.

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Finance

Hazard, Risk and Insurance (Part 2)

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Every human action can cause a risk. This risk depends on a variety of actions a person does. In terms of insurance, risk is the possible loss that a person could experience and the dangers posed by the possibility of something happening but not knowing when and what will happen. To deal with these risks we need preparation and proper protection. Hence the importance of insurance more visible when a person afflicted with calamity, even if the disaster did not want every person.

Not counting how many losses to be borne by society due to the disaster happened. So be thankful, if you have take out, do not need to be confused to find money to repair damaged houses or cars that had stalled due to flooding. Simply add a claim to the insurance company, then you will get compensation.

Risk Forms

1. Pure – This forms if there will cause the loss or does not cause loss ( breakeven ). Example: Risk of Fire, Casualty Risk.

2. Speculative – That may cause the loss occurred, does not cause loss or profit ( gain ). Example: Production, Monetary ( Foreign Exchange ).

3. Fundamental – Risks in case of impact can be very large losses or catastrophic nature. Example: War, Earthquake, Air Pollution.

4. Special (particular): Risk that if it does, the impact of losses is local, not comprehensive or not catastrophic. Example: Fire, Accident, Theft.

Risk Management

1. Risk Identification

This stage is to identify the risks faced by any human being either personally or risks faced in the process of business activities.

2. Risk Evaluation

1. The frequency is rare, the impact of low loss / small
These risks need not be insured because it rarely happens, and if there is a low impact / small.

2. The frequency is rare, the impact of high losses / major.
This risk needs to be insured and insurance companies are still willing to close / cover this risk

3. Frequency is used, the impact of low loss / small.
This risk classification is identical to 1, which needs to be done is prevention so that does not happen often.

4. Frequency is used, the impact of high loss / large.
In this risk is the opposite mindset between the client and insurance companies. Customers want this risk can be insured, but insurance companies may not receive because the frequency it happened often, and the impact of losses is also high.

Risk Control

1. Financial Control

Buying protection insurance by paying an insurance premium ( Customer Transfer The Risk Of Insurance Companies ). Bear their own costs such risks, the impact of weakness if the loss is high enough to threaten the business activities.

2. Physical Control

Eliminate risk. But this is not possible because of the risk will always exist and may occur, so that needs to be done is that the risk minimization, minimize the risk by providing incident prevention equipment and complete response equipment to deal with risk.

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Finance

Bid Farewell to Your Worries With Non Owner Auto Insurance

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Planning for a fun-filled trip in a rented car? Non owner auto insurance is the prime thing you need to plan before you can begin to plan your clothes! It is a known fact that driving to various destinations is an integral part of our lives. Accidents, too, cannot be neglected at all. Every one understands that driving involves a great amount of risk with the ever growing traffic on the bustling streets. Many a times, while borrowing a vehicle from friend or kin you ensure that complete care is taken. However, the chances of an accident cannot be completely denied. No matter how dear you are to your friend, paying the bills for the damage is something no one loves!

What if you are provided with complete coverage of the accident? Sounds interesting and relieving? Well, this kind of insurance policy offers you the benefit of claiming insurance for the vehicle that you do not own! If you are already feeling secure about the whole thing, then there is more for you. This insurance not only covers the damage to the vehicle but also provides you medical insurance, in case there is an injury. If you are the kind of person who tends to rent a car often, this insurance is something that you must grab and fetch the benefits.

Another major category of people who can definitely benefit from the insurance is the people who are into driving vehicles professionally for a company or an individual. In this kind of job, the frequency of driving is very high. At the same time, the exposure to high risk of accidents is inflated. Non owner auto insurance plays a significant role in case of any mishap. Dealing with the consequences in such a situation is much smoother with the insurance and medical coverage benefit you get. It is true that one needs to be extremely cautious while driving a vehicle, whether it is your own or someone else’s However, a policy like this can prevent you from getting into a tight spot.

If your life revolves around renting or borrowing cars and driving them for various reasons, investing into this kind of insurance policy can keep you free of worries. Although it may not be one of the most popular insurance policies amongst the rest of the insurance related to automobiles, it serves a great purpose and is one of the most essential requisites in today’s life. No matter how safe you are as a driver. It can be someone else’s fault that can cause some serious damage to the vehicle.

Prevention is always better than cure. Opting for the policy is a very wise decision to save yourself from shoveling out huge amount of money. If you are hearing about this policy for the first time, it is not your fault since most of the companies dealing with insurance do not highlight the non owner auto insurance and its benefits. As an individual involved in driving cars that do not belong to you, finding out more details about such policies is definitely your job. Lead a peaceful life and let the owner of the car breathe peacefully too!

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