One of the biggest mistakes made by medical practices is attempting to handle medical billing solutions and ENT account management as a one-person job. The truth is that it takes an entire team to properly handle medical billing, especially with all of the requirements for comprehensive record-keeping, clinical coding optimization, and knowledge of the demands made by Medicare, Medicaid, and third-party payers in order to receive reimbursement of claims. Everyone in the office, from the administrators to patient care providers, as well as the office staff and medical billing department, should all be working together to ensure the best possible results for ENT billing and coding.
The Job of Billing & Coding
While everyone in the office plays a part in the overall job of ENT account management and billing, the person who handles the medical billing and coding for the office has unique responsibilities. They take all of the data that is collected by the rest of the staff and translate it into medical billing solutions that determine responsibility for payment. This responsibility can be drastically different from one patient to the next, as some payers require different billing forms, coding and submission rules than others.
The job of billing and coding personnel is to evaluate and analyze the insurance coverage provided by the payer and the medical charges provided by the patient care team to prepare the billing forms accurately for reimbursement. The recent changes in the healthcare industry have compounded the duties of ENT account management considerably. New coding requirements and changes to medical billing solutions software brought some practices and clinics to a dead halt. Fortunately, there are services that provide online and telephone support, as well as education and training, to keep office staff on top of the new requirements.
Professional Consultation & Support
Hiring a company that specializes in otolaryngology practices to assist with organizational skills, outsourced billing services, as well as clinical coding optimization training and support, can be vital to the continued success of your practice. If there are billing errors occurring due to problems with comprehensive record-keeping, medical coding and submission procedures, claims will start getting rejected or denied, seriously impeding cash flow into your practice. While patient care is certainly your main focus, your practice is still a business and the employees who work there depend on it being profitable to stay in business.
The three primary duties of medical billing solutions staff include:
- evaluating and analyzing insurance coverage for each individual patient
- properly preparing accurate billing forms for medical charges
- collect accurate payments from individuals, insurance plans and other third-party payers, such as Medicare and Medicaid
If your staff is unable to rise up to the challenge of today’s ENT account management requirements for proper billing and coding, you can rely on the professional services of healthcare consultants, training, education, and support staff at MD Pro Solutions. It is our goal to help your ENT practice or clinic to be as successful as possible by offering training, support, and solutions to your staff. During training, we can provide you with outsourced medical billing services to help keep payments flowing into your office. As we complete the education for your staff, we can provide them with the necessary support to help them take the billing and coding services back into your office.
Improving ENT Account Management
They key to successful clinical coding optimization begins when a patient calls to make an appointment and completes the check-in at the office visit. Training your reception staff to verify insurance, make copies of insurance cards, and collect co-payments and deductibles prior to the actual appointment will go a long way toward improving cash flow and revenue in the office. Once the patient is seen, the billing and coding department should receive comprehensive record-keeping of the visit for proper clinical coding optimization and billing purposes. The medical coder translates all procedures and diagnoses that were performed during the visit into healthcare industry medical codes. Once the coding is complete, the bill can be created and charges can be submitted to the insurance provider.
MD Pro Solutions can help you and your ENT practice make key improvements to ENT account management, clinical coding optimization, and record-keeping skills across the board. If you are interested in learning more about all of the medical billing solutions, services and opportunities available to otolaryngology specialists through MD Pro Solutions, give us a call at 508-946-1665. Ask about our services for credentialing, auditing, reviews and more!