One of the most important things that you can do for your Ear Nose and Throat practice or clinic is to hire a healthcare consultant to evaluate your medical billing system. The methods employed by your staff for everything from medical insurance verification to professional medical billing must be done according to industry regulations and requirements. Medical billing and coding are two of the most essential components in any type of medical practice, but they have become even more important in recent years.
Many practices, clinics, and hospitals have hired healthcare consultants to ensure that they are properly adhering to all of the coding changes and federal regulations that have been added. Accuracy is the key to success in all areas of patient safety, care, payment, and practice operations, so office managers and clinic administrators need to stay on top of training and support at all costs. MD Pro Solutions only works with clients in the ENT field, so we are better equipped to provide valuable services and solutions to make improvements to your practice or clinic.
Essential Skills for Medical Billing
It is easy to see why billing is so important. After all, a medical practice is a business just like any other, and it depends on a steady cash flow to keep things working. Accuracy is essential to professional medical billing. However, with all of the new coding requirements, many practices are not performing as well as they should. Your team needs to be well versed in medical insurance verification and the coding requirements of ICD-10, Medicare, Medicaid and other third-party payers. They need to be able to read, interpret, record, and track complex details concerning medical information quickly and have a strong eye for details.
Patient confidentiality is also critical to the success of your practice. Each team member needs to be properly trained and understand the need for maintaining patient confidentiality. As part of the overall medical billing system, your billing department will need to have access to detailed information about diagnoses, treatments, procedures, medications, and equipment used so they can translate them into the required codes. Working with a healthcare consultant who has experience working with codes relevant to Ear Nose and Throat practices is very beneficial when it comes to the training and support provided to your team.
Some of the information provided for professional medical billing includes:
- electronic records
- lab results and assessments
- medical notes
- diagnoses and treatment records
Coding Can Impact Medical Care
Many professional medical billing team members do not realize the impact that the work they do can have on the medical care provided to the patient. In particular, it can affect the way that the insurance company reimburses the physicians, labs, and other medical professionals. If not done correctly, delays in payment can occur, which can result in delays for treatment. The healthcare industry has undergone many changes in recent years and has become a fee-for-service business.
Specialists are now required to list any underlying conditions, preconditions, and untreated diagnoses along with the issues that they are licensed to treat. When the proper coding is done, the insurance companies have all of the codes that they need to make an accurate payment and ensure that the patient continues to receive the best quality of care available. In addition to medical insurance verification, professional medical billing and proper coding is also a critical step in developing accurate assessments for the study of treatment outcomes and accountability-based systems. The more you can do to provide complete information for your patient, the better they will be served both now and in the future.
Federal and Industry Compliance
Another reason why accurate coding is essential is to ensure that the practice stays compliant with industry requirements and federal regulations. Medical coding can fall under a wide range of guidelines for both the state that the practice operates in and the overall federal government. HIPAA is one of the most significant regulations, as it protects the confidentiality of the patient and requires all practices to safeguard and protect patient information. Other regulations, such as the International Classification of Diseases (ICD-10) uniform diagnostic codes from the World Health Organization (WHO), are also covered by HIPAA guidelines and other federal regulations.
Training and support through a qualified, licensed, and experienced healthcare consultant who knows your specialty inside and out is essential to the ongoing success of your practice. Contact MD Pro Solutions by calling 508-946-1665 and speak with one of our representatives to learn more about our education, training and support services for professional medical billing. We can provide you with a wide range of options and custom solutions that you can use to improve your medical billing system and ensure accountability for every required regulation that covers your practice or clinic.