Compliance & Responsibility: Improve ENT Account Management

The best way to ensure compliance with healthcare industry regulations and responsibility to patients, is to ensure that your staff is properly trained in comprehensive record-keeping, billing, coding, and has an accurate understanding of the job required for medical billing. Healthcare consulting is a big industry, as practices and clinics need to stay on top of all the changes that have occured in the medical field in recent years. ICD-10 changes, the Healthcare Reform Act, HIPPA regulations, technology requirements of medical billing software – it can be difficult to stay on top of everything if your staff is not properly trained.

MD Pro Solutions offers a wide range of healthcare consulting services, education, training, and support to help improve account management at otolaryngology practices and clinics. The process of medical billing involves many working parts, including contributions by administrators, receptionists, medical billing and coding staff, as well as office managers. In order to provide seamless and professional service to your patients, it is important to have an understanding of every step required in the process for ENT billing and coding. Working with a consultant can help provide you and your staff with all of the information you require to get the job done right and to the best of your ability.

What is Your Job?
Depending on where you work within the medical practice or clinic, your job might be related to providing patient healthcare, medical billing and coding, managing the office, scheduling appointments, checking insurance eligibility, or any number of other essential duties. It is important to understand the job of the medical billing staff if your goal is to improve account management and billing procedures.

The job of a medical billing department is to:

• have an overall understanding of patient responsibility for payments, as each situation is different depending on a number of unique factors
• be able to prepare accurate billing forms after careful evaluation of insurance coverage and related medical charges
• collect payments from patients and third-party payers accurately through co-pays, deductible payments, claims submissions, and more
• provide comprehensive record-keeping that adheres to healthcare industry regulations, safeguarding patient data and payment information

Compliance Starts at Check-In
When your patients come to the office for an exam or emergency services, the journey to compliance and responsibility begins. When the patient arrives, your front desk staff should handle the pre-registration portion of intake. However, before the patient checks-in for an appointment, the receptionist should have started collecting information over the phone when the appointment is being made. Information should include the name of the patient, the current address of the patient, the birth date, the reason for the visit, as well as the insurance provider and policy number. All of this information can be used to start verifying coverage and setting up the patient file. For pre-existing patients, this information can be used to update the patient file to ensure that everything is current.

While all of this information might seem to be a little much, the more you can get started in the patient’s file with regard to verifying information and setting up the amount that needs to be paid for co-pay and deductibles at the office level, the easier it will be during check-in for the actual appointment. This groundwork helps to make your entire office more efficient and works to reduce errors or problems that can commonly occur during intake. Taking the time to confirm the financial responsibility of the patient and their insurance company will help to avoid any confusion during the appointment about what needs to be paid and when. Because insurance coverage can be different for each patient, even if they have the same insurance company, it is important for ENT practices and clinics to improve account management by becoming familiar with the coverage for each patient.

How ICD-10 Changes Affected Account Management
While most practices were training in advance of the ICD-10 changes, there were still many who were caught off-guard that required healthcare consulting services to get them on track. The ICD-10 changes didn’t just change the codes that medical billing staff used to submit claims to third-party payers, Medicare, and Medicaid, but it also changed the way office staff was forced to view testing, procedures, and diagnosis with regard to billing for services. Comprehensive record-keeping is key to success in any medical field. If you feel that your staff could use a refresher or some additional support to improve account management, consider hiring MD Pro Solutions. Our team can help your team become more effective and efficient, while showing you how to maximize the potential of your existing medical billing system.

Contact MD Pro Solutions by calling 508-946-1665 and ask to speak with one of our healthcare consulting experts. We can assist in a number of ways, providing your staff with education and training, real-time support, and implement procedures that will help to improve account management across the board. Call today for a FREE evaluation and consultation.