Medical Billing Services - An Overview

Coding : We have certified coders to do the coding for all specialty services.

Demo Graphic & Charge Entry : : We have trained and experienced professionals to submit clean claims with 99% accuracy and a TAT of 36 Hrs.

Payment Posting & Denial Analysis : We have trained professionals to do the posting and analyze for the denials and take corrective measures which improves your Cash Flow.

A/R Follow Up : We have trained callers to reduce AR Days, to increase your collection ratio and to improve your cash flow through regular follow-up with the insurance carrier and patients.

Our Process

1. Super bills will be collected from your office daily, through FTP upload or pcAnywhere Access.

2. Patient Demographics and charges will be keyed in through the online or offline route. Medical claims process software will be used to submit claims electronically.

3.EOB (Explanation of Benefits) will be updated into billing software on a daily basis.

4. AR aging reports will be carefully processed and sent for your appraisal.

5. Insurance calling will be done for claims based on the AR report.

6. Reports on the work done will be sent on daily, weekly and monthly basis.

Step 1 : Collecting / checking / scanning of the required documents to our office

Step 2 : Required data i.e. Patient Demographics, Insurance Information, Super bill, Check copies and EOB copies. Charge Entry will be updated in our software. Expected TAT of this process is 36 Hrs.

Step 3 : Payment information will be updated to individual claims on a daily basis, based on daily document source – Check copies and Explanation of Benefits.

Step 4 : Unpaid / Denied / Rejected claims will be analyzed, accounted and acted upon by the AR crew, which will also call various Insurance Companies for follow-up.

Step 5 : Through our Office / Client, we will route the submission of secondary and tertiary claims, claims with attachments, patient bills and other documents to the Insurance companies.

Process Map

After analyzing the above steps, you can chose our medical billing services !

The Importance Of Medical Coding

The health care industry is growing extremely rapidly, each year that passes there is more of a demand for medical services, medical supplies, medical testing, and rehab. Because of this demand there is much more jobs that are available.

Medical coding is one of those jobs that need many positions filled. Medicaid, Medicare and insurance companies have put many new strict guidelines that need to be followed so that the doctor’s can get paid. So this is why it’s important that an experienced individual fill these positions.

If you are not sure what a medical coding job entails then let me explain. Medical coders are responsible for reading the doctor’s notes and transferring the patient’s information using codes into the patient’s medical records. If the patient had a special procedure done, then it would need to be put into a code in his/her medical chart. Another example, if the patient came in for a pap smear then it needs to be in her medical chart. These codes are universal alphanumerical. These codes are the first step to billing and if they are incorrect then they will be charged the wrong amount.

If you wanted to start a career in medical coding then you would want to take courses and get a certificate. I say it that way because it is not uncommon for people without a certificate in this field to get a job, but it will be harder and you wouldn’t get paid as much.

There are many codes that you would be responsible to know, as well as many strict guidelines that you would need to know. If you made one mistake, that you may think is a small little mistake, can cause the doctor a large sum of money that they cannot get because you put the wrong code in. So you can see the importance of having an in-depth knowledge of these standardized medical codes.

Completing the medical coding course can take you anywhere from 3 months to one year. It all depends on how much time you have to devote to completing the courses. But it’s a short period of time when you can get your certificate and begin potentially making a starting salary of $31,000. That’s a good starting salary wouldn’t you say? There are plenty of online courses that you are able to take and complete it at your own pace - Drexel or Allied Medical School are two good schools.

The courses you will take will teach you medical terminology, anatomy, medical procedures and much more. All of these courses are very important to complete the duties of a medical coder, and for them to complete them accurately.

History of Outsourcing

In fact outsourcing is said to have emerged a few thousand years ago with the production and sales of food, tools and other household appliances. As soon as small communities and societies began to form, people with specialized professions began to trade with each other for goods and services. In effect it can be said that each worker was outsourcing some activities to others. The history of outsourcing shows that even in the industrial age, a few thousand years later, very few companies outsourced any of their operations. Companies in the 1800s and 1900s were vertically integrated organizations, taking care of their own production, mining, and manufacturing from raw materials to finished goods as well as then shipping the goods to company owned retail outlets. These companies were often self-insures, handled their own taxes, employed their own lawyers, as well as designed and built their own buildings without outside assistance. This of course is not applicable to all companies during that time period, but it gives a general idea of the time.

The history of outsourcing shows that through specialization contracting began to be more popular, especially in the service industry. This in turn led to the first wave of outsourcing during the industrial revolution pushing the large-scale growth of services such as insurance services, architecture and engineering services, among many others. At this time the companies doing the outsourced work were mostly located in the same country, often in the city, just like the customers.

The history of outsourcing portrays that as onshore outsourcing continued manufacturing outsourcing of low-tech items such as toys, shoes and apparel goods began to take place. After this manufacturing higher value items like high-tech components and consumer electronics began to appear. In fact outsourcing history demonstrates that manufacturing was the first activity that began to move to offshore destinations in a quest for lower costs. Through the development of infrastructure as transportation and logistics improved, the costs decreased and offshore manufacturing increased. As the education and skills on lower wage countries developed, outsourcing manufacturers gained more value. More recently, in the US during 1970s, it was common for computer companies to export their payrolls to outside service providers for processing. This continued into the 1980s, when accounting services, payroll, billing, and word processing all became outsourced work.

Towards the end of modern day history of outsourcing, the trend has moved into the world of information technology, data transcription and call center operations. Studies on the history of outsourcing conclude that outsourcing is clearly not just about payrolls and call centers. This can be seen by simply looking into your medicine cabinet. It is very likely that the R&D of your daily medicine was outsourced to companies in India. Your insurance company which covers the costs of your medications may have their claim processing to offshore transcription providers. And your medical clinic may easily be outsourcing the administration of your confidential medical records to India, Russia or the Philippines.

Medical Billing is the Fastest Growing Opportunity in Health Care

On February 16, 2006 the Health Insurance Portability and Accountability Act was finalized, and enacted. This law is designed to establish national standards for all health care transactions, and to ensure the security and privacy of all health related information. The motivation behind this law is to improve the performance, and efficiency of our health care system. This type of reform has created a need for qualified individuals who can utilize the tools of this legislation, and assure full compliance, and maximum reimbursement. It would therefore be a prudent move for health care facilities to employ such individuals in order to avoid mistakes that could have dire consequences.

The proliferation of medical knowledge following World War II brought about an explosion of diagnostic, and treatment procedures. As a result, there became a need to organize, and standardize all these developing technologies. Here is where the foundations of medical coding were born. Medical coding met these challenges, and allowed for a more uniform way of communicating health information under a common language. By January 1979, standardized definitions, and codes were adopted, and used by health care providers, and insurance companies. Since improvements and refinements of medical procedures are constantly being developed, codes must be added and updated to reflect these changes. Today, the number of medical and surgical procedures have become enormous, so too have the codes to describe them. These overwhelming numbers of codes and protocols have made outsourcing medical billing the standard.

Medical Billing and related occupations continue to be the fastest growing opportunities in health care. Insurance institutions and government agencies are investing huge resources to control claims’ fraud, abuse, and establish some degree of reimbursement parity. As a result, more insurance companies, and health care facilities are looking to medical billing experts for help. These companies and practices are looking for experienced and educated individuals; the legal consequences of incorrect billing could be devastating. There is a movement in the industry to make medical billers responsible for inaccuracies, much they way accountants are for tax returns.

At present, there are no standards for educational requirements for medical billers and coders. However, more employers are looking for some formal training at an accredited career training institution. These schools range in training time from nine months to two years, anything less would not be considered adequate. There is a move for certification, and several organizations are sponsoring certification examinations in medical billing and coding. Medical billers and coders earn as much as $8 to $10 per hour in the beginning, and could potentially realize $30 to $40 per hours with experience and additional responsibilities.Today, evolutions in the health care industry are happening at a very high pace. It is only with the assistance of sophisticated computer programs, and standardized coding procedures that medical coders are now able to describe and characterize the tremendous number and various kinds of medical and surgical procedures. These realities coupled with government regulations, and health insurance guidelines have contributed to the strong demand for experienced medical coders and billers.

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Medical Billing Careers

Since time immemorial, a career in medicine has been looked upon with prestige, and people consider it humanitarian and noble. A career in medicine calls for a lot of responsibility and the ability to update one’s knowledge on the evolving medical technology. With the passage of time and innovation in the field of science, the medical profession is becoming very challenging. There are a number of fields within the medical career, such as Health care Administration, Health care Management, Medical Insurance Billing, Medical Office Billing and several others.

Basic Requirements For Medical Billing

The job of medical billing involves a lot of hard work and vast knowledge of medical terminology, anatomy, coding and proper completion of forms. In addition, you need to have basic computer knowledge and a typing speed of at least 35 words per minute. A good temperament is another important characteristic that the person needs to possess, since he is required to deal with a number of patients, their attendants, doctors, medical representatives and other office personnel.

Job Outlook And Employment Opportunities

Medical billing is one of the fastest growing careers in health care. The importance of medical billing personnel is on the rise, since several insurance companies and the government are continuously spending substantial time and money to nix fraud and abusive practices. Due to this demand, various companies and practices are constantly on the lookout for trained and experienced medical billers. Personnel could find positions with doctors, hospitals, nursing homes, insurance companies, legal offices, rehabilitation centers, legal offices and consulting firms or they could also work independently.

They could set up an electronic billing system through their personal computers. Independent medical billers can also work as insurance specialists and consultants. The job is lucrative and revolves around helping patients and medical professionals calculate their insurance bills.

Some of the other job opportunities that are included within medical billing are as follows:

 - Billing Specialist
- Coding Specialist
- Medical Collector
- Patient Account Representative
- Claims Analyst
- Claims Processor
- Reimbursement Specialist
- Claims Reviewer
- Electronic Claims Processor
- Billing Coordinator
- Claims Assistant Professional

Work Culture
The work culture of medical billers is usually part of an office setup. More often than not, the personnel do not work in close proximity to where patients are diagnosed. They generally have billing offices and services in large corporate buildings, in small suburban offices and in the offices of doctors. They usually work during the day, from Monday to Friday, forty hours a week. However, there are times when, in insurance companies, they are required to work late at night. They are paid well for working overtime and their services are much appreciated by the medical establishment and patients alike.

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What’s the Point of Medical Billing Services?

From time to time readers ask about the wisdom of hiring medical billing services to help deal with what can become the bane of any practice: too many accounts receivables and too few dollars in the revenue stream.

A good medical billing service can be a boon to your practice, because its staff: know the billing codes of the different carriers; stay up-to-date on changing rules and regulations; and do follow-up when a claim is delayed or denied. As such, you’re likely to get more claims paid, in a shorter amount of time, while allowing your staff to handle other matters in the office.

But medical billing services need to be hired with care. Currently you can outsource to three different types of services: at-home workers, CPAs who do billing as part of their services, and medical billing companies. Some at-home workers are excellent, but the profession is now being advertised as a “get-rich-quick” home business opportunity, so it’s best to look for someone who has had real training in the area, is certified, and understands your particular specialty. If you’re hiring a CPA to do your billing, make sure he or she truly knows the business — and can spend the time necessary to do it thoroughly. And if you’re signing on with a medical billing services company, look for an established company with a low turnover in staff and, again, experience in your specialty. You don’t want a fly-by-night outfit handling your billing.

How much does it cost? Some medical billing services charge a flat monthly fee. Others charge as much as eight percent of your claims. It’s possible that you could hire an in-house employee for less than that, but remember that you’ll also have to pay to train that person (and his or her replacement down the line), as well as buy billing software (or a subscription to an online billing service) if you don’t already have it. If you decide to keep the billing in-house, you’ll also need to have a lot of confidence that your employee is leaving no rock unturned in the quest for getting reimbursement.

Of course, hiring an outside consultant also requires trust—which is why you need to be very careful about who you hire. Talk to your colleagues, interview several different people, and watch whoever you hire with care. You only want to spend the money on an outside service if it really helps your practice boost its profits.

At Billing Paradise, we’re always open to new ideas, new channel partners, new possibilities … and of course new clients.

So we want to hear from you! Give us your thoughts and we’ll get back to you.

If you need to contact us urgently, please call us at Toll free number: 1-(877)-323-4707

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How To Choose A Medical Billing Specialist ?

When considering how to choose a medical billing specialist, you must consider the skills and abilities of a good one. If you know what you are looking for, making the right decision as to which billing specialist to use becomes fairly obvious. Take a look at what a medical billing specialist should be familiar with and what they have to do so that you can choose the right medical transcriptions

First of all when considering how to choose a medical billing specialist, you should make sure you find one that understands medical transcription. Medical transcription is the transferring of medical information from audio recordings to either paper or electronic format. Your billing specialist should be aware of this because of the information contained in the transcripts. The transferred data becomes an electronic medical record, which just shows how much everything the billing specialist works with is interconnected.

The job of medical transcription is usually outsourced to a third party company or done through the use of medical transcription software. Each part of the process, though, must be overseen by someone with training to do the transcription so as to catch all potential errors.

Secondly, you want your medical billing specialist to be familiar with the various medical codes. Additionally, he or she should know about governing record keeping, billing, and certification. This allows the billing specialist to be familiar with the important standards that control how a medical billing specialist actually performs his or her job. Knowing how the codes function and what they say is crucial to being a good and an effective medical billing specialist.

When you look at how to choose a medical billing specialist, you should also make sure he or she is familiar with electronic medical records (EMR). The information in such records is coded and means that a billing specialist must be able to decipher the information in order to make sure billing is done correctly. Additionally, the specialist must be trained due to the fact that all EMR’s must be managed, backed up, and stored with great care so that everything is kept secure. The information is very sensitive.

In an age of software and computers, it is vital that your medical billing specialist knows how to use medical practice software. The software is made to allow a database of EMR’s to go along with access to medical codes with which your billing specialist should also be familiar. The software helps practices to cut their IT expenses by only forcing them to pay monthly secure hosting for the system. Medical billing specialists are some of the people authorized to use the programs to get information via computers or PDA’s off the server.

Deciding how to choose a medical billing specialist is not easy. You must have an understanding of what all a good billing specialist knows and understands. The information above helps you get a feel for what you should look for when choosing your medical billing specialist.

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Saving Time and Money with Electronic Medical Billing

Physicians are rejoicing in their new found freedom and benefits of electronic Medical Billing Service. Eliminating the worries of in house Medical Billing . Medical Billing Companies are taking over doctor’s office hassles of data entry, insurance billing and responsibility of all of the government regulations and laws that are constantly changing.

A New Era for Medical Claim management

Physicians can now concentrate solely on their patients and their practice and spend less time tracking down insurance companies who are not sending in their claims. Previously, with paper billing and snail mail, claims would take time to get to an insurance company, and then the claim would take more time to process there and then more time to send payment back to the office. With the new electronic computer age, the time it takes to send a claim and receive payment takes weeks now instead of months. The paper trail, exchanged between several hands is limited because the same claim can be looked at by several people online and not by several people with one copy of a bill. With electronic Medical Billing service, all a doctor needs now is a computer with internet to access the same dashboard as their Medical Billing Company and they are able to monitor all of their patients claims online. It is a secure site, only accessible to the medical biller and the physician, allowing for any small adjustments to be made quickly in real time.

Other Features The medical practice management software that is often included with your electronic Medical Billing Service by itself is very expensive. That’s because it does so much more than accounting. It helps your office track claims, manage scheduling and is able to generate a range of reports on all of your patients. The other nice advantage to medical billing software is that it is HIPAA compliant, and automatically updates your software when you sign up for the service, without a Medical Claim management service to outsource your medical billing to, you will have to take pains to keep up with all the changing regulations.

By making your medical practice management more efficient, you improve a lot more than your billing in your office. Having smoother running software, ensures happier staff and increased productivity. Better access to personal information and more accessible scheduling improves customer satisfaction.

For more information about electronic Medical Billing Service , Medical Billing Company , Medical Claim management , Medical Coding, go to Billingparadise.

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What Makes a Good Medical Billing and Transcription Company

“In the recent years, the outsourcing industry has expanded to include not just call centers but also companies that provide administration support such as medical billing and medical transcription services. Their promise of lower costs and greater convenience means that more and more health care professionals and organizations are outsourcing some of their back office needs. More than half of transcription needs in fact, are outsourced to offshore companies in countries like the Philippines and India.

With the increasing popularity of outsourcing these allied health professions (it is estimated that more than half of these jobs are outsourced), more and more companies offering medical transcription and medical billing services have started to sprout.

The question now is, how do you find the right outsourcing company for you? What traits do you look for in a company to ensure that you get only the high-value service you expect?

Here is a list of the different traits every good medical transcription and billing company should possess:

§ An effective medical transcription company should have a quick turn around period. Ideally, they should be able to finish a project within 24-72 hours.

§ It should be able to guarantee your privacy and the safety of the information you send them.

§ A good transcription company and billing company should provide nothing short of high-quality work. They should have keen attention to detail and be able to provide accurate transcriptions.

§ Its workforce should be composed entirely of experienced professionals with extensive knowledge of medical terms and technology. The medical transcriptionists should also be able to decipher and understand different accents to ensure greater proficiency and a more accurate output.

§ A good medical billing and transcription company should be able to provide you with 24-hour customer service. They should have capable and knowledgeable customer service agents able and willing to answer your questions any time of the day.

§ To be able to claim that it is able to consistently provide good-quality work, a company must be supported by stable and reliable technology. It must have the capacity to efficiently download and play everything from cassette recordings to digital audio recordings.

§ One of the main reasons (if not the sole purpose) why companies outsource is to cut costs, so a good medical billing and transcription company should be able to provide you with good-quality output without burning a hole in your wallet. Superior service at low costs— this is what you should get (and expect) from the outsourcing company you plan to hire.

Not all outsourcing companies are created equal, so some will definitely provide better service than others. Look for these different traits when you’re planning to search for an offshore company that can provide you with the medical transcription and medical billing services you need and always get reliable and good-quality service.

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Full Fledged Medical Support Services

If you business has large customer business then you definitely need to provide efficient customer service to keep them happy. Many small and large multi-national companies such as banks, insurance companies or electronic companies, who enjoy the large customer base, need prompt and efficient customer service to handle customers’ inquiries and grievances. Customer service reflects organizational behavior and its strengths and weaknesses. Inquiries from customers should be given priority and must be attended courteously. Failure to do so may cast shadow on the market reputation of the company.

Having less time at the disposal, many multi-national companies now resort to outsourcing customer service jobs. This not only reduces their labor cost but also help in saving tremendous amount of time, which they can utilize in their core competencies. Many voice and data based customer service jobs are now being outsourced to India and other Asian countries due to abundance of cheap well-educated workforce. They are even ready to work in shifts to help U.S. and western companies. Hence, Call Centers are ultimate answer for the wide customer based companies for all their customer service problems.

Outsourcing companies invest heavily in its infrastructure and staff. Their staff and well-educated and experienced, companies are well equipped with required infrastructure to meet the requirements of their client’s needs. Many voice based call centers are now using automatic answering machines, which are doing most of the job for answering the overseas client’s inquiries. These machines are technically so advanced that you can program it with the most frequently asked questions. Even if caller does not find answer to question, then call will be automatically directed to operator who will assist in getting right person. Sometimes calls may also be linked to a corporate data network.

Call centers not only attend the calls but they also help in solving problems satisfactorily. Even difficult matters such as high-tech matters are discussed and solved on phone. In any case, your calls are not answered properly, and then it will be answered by senior employee in a detail email. Now voice and data network are being interlinked, thanks to network technologies, which help providing data information to clients without hassles. On the other hand, contribution of internet has added tremendously. Call enters employees can now have a chat with clients, exchange files do video chatting and so on.

This article has been published by Managed Outsource Solutions, a leading US-based outsourcing company. We specialize in outsourcing work related to Medical Transcription, Medical Billing, Medical Accounts Receivable, Medical Coding, . View a complete listing of our services or visit us at www.billingparadise.com.

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