Medical billing and coding is an important step in the physician’s payment model. Depending on the compiled claims by the medical billing outsourcing services, insurance companies decide if the rendered services are valid and if physicians should be reimbursed. Therefore, the accuracy of the claims and medical billing services holds a crucial place in the healthcare industry.
Why do Experts Stress on Accuracy of Claims?
If physicians want to get reimbursed on time, the accuracy of the claims should be maintained. The wrong documentation or manipulation of data results in denied claims, even when the physician has provided the service to the patient.
Another issue is the under-coding when physicians are not paid as much as the service cost because of coding errors. Over coding can also dent the reputation of your healthcare organization. You can be charged with fraud and can bear financial and legal complications.
The survival of the medical practice can become difficult if medical billing companies don’t pay attention to the accuracy, resulting in revenue loss.
It’s also about the reputation of the medical billing companies, the high claim acceptance rate they have, the more revenue they generate, and the smoother revenue cycle management process become.
Is Medical Billing and Coding Complex?
Medical billing services are a serious profession. The sensitivity of this field can be analyzed by its impact on healthcare professionals. There are several code sets and monitoring authorities, from which billers and coders can take guidance. Anyone, who is responsible for creating claims, must know about the exact diagnostic procedures, surgeries, documentation of symptoms, age, gender, pre-existing conditions, and all. Not just the claims must be accurate but also the HIPAA-compliance needs to be there to ensure the confidentiality of the information.
Staying up to date with the latest knowledge and creating claims accordingly is the skill and handling the bulk of claims at the same time is tricky. It is also a fact that leaving medical billing and coding responsibilities to in-house staff can cause financial problems.
Check and Recheck
Before filing medical claims with insurance companies, it is wise to check and recheck since there is no room for mistakes. A slight error could easily result in denial; and, denied claims use up time to get reimbursed, eventually, leading to delayed collections. Hence, a practice needs trained people to work on their claims for a breezy cashflow. One of the ways to achieve that is to look for billing companies with EHR knowledge.
Clean Documentation or Technology-Driven Documentation
EHR (Electronic Healthcare Record) technology is a savior in making the medical billing process smooth. It works on the basic formula:
- EHR allows physicians to document details accurately
- Medical coders can accurately error-free claims, which can be billed easily
Thus, medical billing services can create clean claims with precise available information. Ultimately, it takes lesser processing time at clearinghouses. As a result, physicians can get timely reimbursements with a reduced rate of account receivables.
So, What Option is Left.
We suggest outsourcing to medical billing services is the best option for a seamless revenue cycle. They have dedicated staff to handle all the accounting information and tasks, which certainly, can’t be managed in-house when you have patients to take care of.
P3 Healthcare Solutions is a professional medical billing service that has years of experience in creating claims and helping hundreds of physicians in maximizing their revenue cycle. It is our way to share their administrative burden.