What is medical billing?
It is the process of generating healthcare claims and submitting them to insurance companies to obtain payment for services provided by healthcare professionals. The medical biller follows the claim of medical billing after translating the services of a healthcare professional into a billing claim to ensure received reimbursement for the work of the physician performed.
What does a medical biller do?
A medical biller navigates between patients, healthcare professionals, and insurance companies to ensure receipt and arrange the reimbursement of healthcare services. In the beginning, the medical biller collects necessary information like demographic (patient name, date of birth, patient social security number, medical history, insurance coverage, and what services or procedures the patient received).
Gathering this information is very important to verify insurance coverage. After verification of all necessary information, the medical biller sends the claim to the payer for reimbursement. The accuracy of data reduces the denial rate of claims. Then a medical biller generates a claim and submits it to the correct payer for payment. Once the insurance company approves the claim, it is returned with the agreed amount to the biller.
The whole medical billing process is not easy. It is a very complicated and long process. Many payers paid the claim within a month or deny the claims with proper reason. Without any reason, any insurance company does not deny the claims. Many providers and small practices get red from this headache with the help of medical billing outsourcing. A medical billing company has an expert team that leads the whole medical billing process.
Benefits of medical billing outsourcing: –
Medical billing is a challenging task for healthcare professionals and healthcare institutions. Such healthcare institutions hire staff for medical billing. However, such practices get help from medical billing outsourcing by a professional medical billing company.
There are many advantages of medical billing outsourcing. Some of them are as follows:
- Medical billing outsourcing allows a practice or healthcare professional to more focus on patient care. Many physicians cannot give proper time to their business because their main focus is on reimbursement rather than patient care. Revenue and income are very important for the life of any business in this world. Like others healthcare system is also based on revenue. Without revenue, a healthcare professional cannot grow his business even if he will also unable to give proper attention to the healthcare of his/her patients. A professional medical billing company can help small practices to grow their business, increase revenue and reduce the rate of denials. So, after getting the red of the revenue cycle, a healthcare professional will have more time to keep the focus on patient care.
- Medical billing outsourcing help healthcare professionals reduce cost by saving thousands of dollars in salaries for employees. It also reduces costs by saving the expense of offices, computer systems, furniture, and many more. A professional medical billing company charges a percentage rate on each claim or a flat rate on the reimbursement of every claim. In conclusion, it is less costly than in-house medical billing which provides the same services provided by outsourcing medical billing companies.
- Medical billing outsourcing improves your cash flow. A steady cash flow is important for the growth of your business and it is very better for your practice. In medical billing outsourcing, professional companies have experienced staff. However, with in-house billing, you have only a few trainee people. And what happens when a medical biller goes out for some vacation? It may affect the cash flow of your practice. Then the bad effect of the cash flow will disturb your whole practice.
- Medical billing outsourcing also helps medical professionals to improve patient satisfaction. Proper check-ups and flow of patients increase patient satisfaction. Patient satisfaction also increases if the provider gives proper attention during treatment. Ask questions about the disease of the patient. And their satisfaction also improved if your hired staff’s manners are good and your billing team doesn’t disturb patients without any reason during the process of revenue generation.
- There are many other advantages of medical billing outsourcing over in-house billing. It is very important thing for a medical biller to stay updated about the regulations of the payer. Medicare, Medicaid, and many other third-party insurance companies make changes in their requirements and regulations about the payment protocol of medical claims. A professional medical billing company always stays updated on the latest changes in regulations and requirements because their main purpose is to ensure the clean submission of claims.