Professional medical billing is an important career within the healthcare industry. The best thing that you can do to boost practice revenue and adhere to compliance regulations is to have a complete understanding of what it takes to be successful in the world of medical billing. From medical insurance verification to performing an annual fee schedule review, there are many different tasks that medical professionals must do to ensure that everything is being properly processed and submitted to a third-party payer or Medicaid and Medicare reimbursement.
Basic Billing Practices
It is important that each member of your billing staff understands every phase of the revenue cycle for professional medical billing. This is the most basic structure that includes every step that the practice takes from the time that an appointment is scheduled to the moment that the payment is received from the insurance company. In the middle of this process, additional steps are taken to collect information, co-pays, determine proper coding and make an accurate submission for reimbursement. If anything goes wrong within the revenue cycle, payments could be delayed or claims could be denied.
Making sure that your staff is well-trained and up-to-date on current billing codes, procedures for medical insurance verification, and submissions for Medicaid and Medicare reimbursement will go a long way toward maximizing a number of insurance reimbursements that your practice has the potential to receive. Ensuring that your front office staff is well-trained in collecting co-pay and deductible amounts from patients prior to the examination, will go a long way toward maximizing the revenue collected in the office each day. The goal is to stay on top of collections and reimbursements to keep revenue flowing at a steady pace into the practice.
How Insurance Companies Work
Another thing that professional medical billing staff needs to have a handle on is an understanding of how today’s insurance companies work. There are literally thousands of different companies and it is important to have an idea of what each company wants in the way of claims submission. Performing medical insurance verification prior to a patient’s appointment is also a very important step that can assist in receiving reimbursement in a timely manner. Your professional medical billing staff should be familiar with the types of insurance that your practice accepts, as well as Medicaid and Medicare reimbursement requirements.
It is important to note that Medicaid and Medicare reimbursement is different from any other insurance company or payer that you have ever worked with before. If you are not familiar with submitting claims to Medicare, you need to get training and support, especially if your practice has a lot of patients who use this type of coverage. Send your staff to training events or hire a healthcare consultant who can assist with a wide range of support for professional medical billing in addition to providing a Medicaid and Medicare tutorial for otolaryngology practices. Denials and rejections do not have to happen if your staff understands the requirements for medical billing and the payer-specific requirements for each individual entity.
Medical Billing Software
The best way to expedite reimbursement for claims submissions, outside of setting standards for medical insurance verification and performing an annual fee schedule review, is to use a top quality medical billing software program. The faster you can get a claim out, the faster the revenue will come in. Professional medical billing has been transformed by improvements made to medical billing software across the board. It can help to boost productivity, minimize errors, save time, and prevent common issues that can result in rejections or denials.
Contact MD Pro Solutions
If you or your staff needs a refresher on any area of professional medical billing, including Medicaid and Medicare reimbursement, medical insurance verification, annual fee schedule reviews, and credentialing or if you are dealing with claims rejections and denials, contact MD Pro Solutions. We specialize in working with otolaryngology practices and clinics to provide top quality healthcare consulting services, training, support and much more. Give us a call at 508-946-1665 to speak with one of our representatives about getting a FREE evaluation of your current medical billing practices and procedures.