Increase Claim Approvals for ENT Medical Billing Services

While it has never been simple, today’s medical billing and coding process is extremely complex. New patients with complicated or significant medical histories can cause medical billing services to take weeks or months to finalize, resulting in delays for processing and payment. Learning how to coordinate practice flow between the front desk and the billing department can be challenging. This is especially true when the healthcare industry keeps making drastic changes. The recent ACA and ICD-10 changes were particularly eventful for most Ear, Nose, and Throat practices and clinics, resulting in confusion, delays, and rejections of claims across the board.

However, there are ways that you can improve the billing and coding process for your ENT practice or clinic. Hiring a healthcare consultant or choosing to outsource ENT billing services are just two of things that can help to make your office more efficient and effective. The real goal is to provide quality care services for your patients, which can be difficult to do when you need to spend many hours each day ensuring that claims are coded and submitted properly. MD Pro Solutions can work with you and your team to create a custom solution that targets the areas where you need the most education, training, support, and services. Whether you choose to continue doing it all in-house or you want to learn more about outsourcing, we can help you to achieve your goals.

Efficient Claims Processing

Once a comprehensive review of your current medical billing services has been completed, your healthcare consultant will begin working on ways to make processing claims more efficient. By focusing on medical billing and coding, coding support, and claims submissions, we can help you to increase cash flow and boost revenue. A medical practice is a business, and just like any other business, it is important to keep an eye on the bottom line. If you aren’t getting paid by patients co-pays, deductibles, and third-party payers, then you won’t remain in business for long.

Some of the things that you can do to make improvements include:

• Provide Training for Staff – If your team needs help with getting up to speed on the latest ICD-10 changes, billing requirements, or insurance company rules, a healthcare consultant can make a big difference. We can provide the training, education, tools, online coding help and support that your employees need to succeed. Each insurance company has different rules. Knowing which requirements must be met for claims to be approved and payments to be made is crucial. While one company might want chart notes with claims for new patients, another company might only want chart notes for follow-up visits and non-standard treatment protocols. We can develop a training program that will help your billing department to meet all insurance requirements and quickly provide the information necessary to expedite the process of each claim.
• Effective Patient Files – The best way to ensure that you don’t get a denied or rejected claim is to make sure that your patient files are current and up-to-date with all of the latest information. This is why your front desk team needs to be trained to update insurance information and verify patient data with each visit to your ENT office or clinic. There are many reasons why carriers and coverage limits might change from one visit to the next. Staying on top of patient files can help to create a much more efficient claims process, ensuring accurate information and meeting the needs of the specific insurance carrier to expedite claims submissions.
• Improve Quality Control Measures – If you do experience claim errors or have other problems with your medical billing services, it is important to learn from your mistakes. While choosing to outsource ENT billing to a company like MD Pro Solutions can eliminate issues with denied or rejected claims, many practices still prefer to do it all in-house. Stay on top of all claims submissions by implementing account practices that will help you to quickly see submitted claims and posted payments in an easy-to-use log. The log should include the name of the patient and their account number, the check or cash receipt number for accountability, the amount paid, and the date of service or reference number attached to the charge.
• Collect on Unpaid Claims – Whether the amount due should have been paid by the patient or by the insurance company, follow-up on all delinquent claims and include the data on your quality control log. Is there a delay in payment due to a billing error? Was there a problem with coding or other medical billing services? Are your patients having trouble understanding the amount that is due? If your practice is experiencing high delinquency rates or other delays in payment, you need to make a change. A healthcare consultant can help you get the training and support necessary to make improvements or provide you with information on how to outsource ENT billing and take control over your claims submissions.

Contact MD Pro Solutions

Our team focuses on providing quality medical consultation services to doctors, office managers, practices, and clinics that are dedicated to serving patients within the Otolaryngology field. Medical billing services is a very broad spectrum with a wide range of needs and requirements. By placing our focus on creating solutions for ENT doctors and practices, we can provide the very best possible services for our clients. Give us a call at 508-946-1665 and speak with a healthcare consultant about your needs. Whether you just need help navigating the recent ICD-10 changes or if you want to outsource ENT billing, we can help you to achieve your goals.