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Why Outsourcing Medical Billing Services Has Become so Important in the US Healthcare Industry

 

Why Outsourcing Medical Billing Services Has Become so Important in the US Healthcare IndustryOutsourcing medical billing services in the US has become very important as more and more healthcare practitioners, doctors and physicians are outsourcing their medical billing. Why should you opt for outsourcing your medical billing services? Is it because it makes more sense? The answer is not as simple as it seems. Does outsourcing your medical billing services seem like a more logical choice for hospitals, private clinics and healthcare facilities? Is outsourcing medical billing less expensive in comparison to  in-house medical billing?

Outsourcing medical billing services,  for  medical practices, can be an astute choice. By outsourcing your medical billing, you can save you cost on staffing.  You can also save on other office related services such as  IT-related costs.  Professional medical billing vendors, with experience and knowledge can properly manage all aspects of your medical billing whether it is regarding medical claims, EHR software, scheduling appointments, patient kiosk, clearinghouse, smart dashboards, or customizable templates. Or simply keeping up to date   information regarding a patient’s medical history, medical prescriptions, appointment reminders and so much more.

Most importantly, an experienced and professional medical billing vendor would effectively demonstrate financial reporting analysis for your practice and recommend actions to improve your revenue management system.

Knowing about the Best Vendor for Medical Billing Services in the US

It is crucial that you find the best vendor for your medical billing services, to allow complete transparency into its billing functions. By outsourcing your medical billing services, you would have access to state of the art medical billing software programs which provide detailed financial information about your practice performance, the number of patient visits, lab tests and much more analytical data. An outsourced medical billing company would not involve you in a long-term contract with legal obligations to make things difficult for you or your medical practice.

Essential Functions of Medical Billing Services

Advances have been made in medical billing services, which lead to more informed decision-making and effective treatment plans in healthcare. Outsourced medical billing is very promising especially in the areas of EHR software integrated with billing functions, telemedicine, ePrescription, patient portal and so much more. Without proper medical billing services, doctors won’t get paid.

Since the healthcare industry in the US mainly depends upon medical data, collecting huge amounts of medical data in real-time can be frustrating. That’s when outsourced medical billing services play an important role in collecting patient-related information such as medical history, diagnostic tests, preliminary or lab test reports, etc. With EHR software integration, such data can be easily collected in a matter of seconds and generate meaningful information to better assess patient’s medical condition and treatment. Medical billing services play a very crucial role in the healthcare industry, in which medical data and analytics can come together for continuous improvements and innovation. Here are a few aspects of medical billing services:

  • Medical Billing Claim Submission and Resolution

There can be more than 40 different fields that must be filled out appropriately. With so much information depending on the type of payer, medical service or specialty, mistakes are bound to happen. Therefore, it is important that a claims filer fills out all the necessary information appropriately in the right field or else the medical claim will be denied. Medical claims can be sent through different routes, depending upon the type of payer or provider, type of medical services or items issued. Sending a claim to a wrong clearinghouse will eventually end up as a denied claim or will delay payment. Both incidents can affect cash flow.

  • Payment Processing

As medical billing companies are submitting claims and bills, it is important that, once a payment is processed and collected, it should be posted and adjusted quickly otherwise your accounts will not be up-to-date and may cause additional confusion for patients and staff members if the records are showing an unpaid balance.

  • Medical Coding

The American Medical Association (AMA) has developed different coding sets, known as the Current Procedural Terminology (CPT) coding system. There are a lot of health care services and procedures, which are provided by different health care specialties. Furthermore, there are many other groups outside of the healthcare practice who need to understand these medical services. So, to make things easier, a standardized language is used known as medical coding so that everyone understands what services are provided through which specialty. All medical coding staff must  be properly trained in coding services.  There is a large variety of medical coding practices for different payers. There are also a lot of frequent changes in coding requirements.

  • Verification and Eligibility

It is a common practice to ensure and verify that a patient has active insurance. And that the medical services which are being provided are covered under the patient’s insurance plan. It is important to ensure that the medical services are being covered by the payer.

One needs to determine the standards of medical billing services which can be provided by the outsourced vendor to take care of denied claims, billing follow-ups, compliance with regulations, financial reporting and analysis.


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