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medical billing service, revenue cycle management process, medical billing company, medical billing outsourcing, RCM process, HIPAA medical billing

The ERAs and EFTs in Payment Posting for Medical Billing

As a medical billing service, it is our primary duty to look after the revenue cycle management process of physicians on board. We are on a mission to narrate billing obligations in a fashion that is fast and in the direct interest of clinicians. Some of our clients have recorded their detailed feedback on Clutch for any of you interested in reading client reviews.

The claimed and paid amount has to concur in an ideal state. It is the job of a medical billing company to comply in such matters that involve the speedy transfer of payments. Any hiccups in the billing process directly affect the practice besides tainting the reputation of the third-party billing vendor.

Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERAs) are documents that discuss the amount billed and the payment received. They also contain information about any discrepancies in both the amounts. The third term EFT refers to Electronic Funds Transfer which is the modern way to address the payment process.

Medical Billing Company Supports ERAs in an Age of Automation

Physician practices can save much time and money if their EOBs turn into ERAs that are electronic documents. Think of the time it takes for a medical practice to deal with payment details manually. Moreover, it involves a lot of manually-checked fields, dropping checks at the bank, and reconciling payments.

If payers can create digital documents like ERAs regularly, physicians won’t have to re-enter payments manually. The process of payment posting is crucial, and to make it easier, we’ll have to digitize EOBs right away.

Medical billing outsourcing requires accurate coding of claims in which there are no over coding and under coding errors. If EOBs reimburse amounts lesser than the claimed bill, our company investigates so that the RCM process keeps on running smoothly.

Benefits of ERA

  • Once the system of automation is in place, posting payments doesn’t involve manual intervention at all
  • It enables faster payments because you save time in the very instance
  • Makes way for improved and classic denial management

Electronic Funds Transfer (EFTs)

HIPAA medical billing says a lot about the medical billing service in line with the law and its provisions. Under HIPAA, EFT via the Automated Clearing House (ACH) is the only standard way to move funds electronically. Hence, we have to take note of that in every transaction we make on behalf of the physicians and specialty-specific doctors.

Just like the way an employee deposits their checks, ACH EFT also makes sure funds smoothly move between insurance companies and physicians.

Benefits of EFT

  • It is a payment mode that directly coordinates with ERAs
  • The staff members don’t have to be occupied, and there is less paper usage
  • The claims payments are deposited in a safe and secure manner
  • Saves time

21st Century After Effects of Electronic Cashflow

The healthcare industry brought into effect a new standard in the form of ANSI 835 for electronic insurance payments and reconciliation a few years ago. Both ERA and EFT are part of this act. And their role for each other is vital. When an ERA carries the details of the payment, EFT is the actual process through which the payment is made to their rightful owners upon adjudication of claims.

ERA merely forms a report by which benefits are explained. Both the technologies devise simplification of the payments to physicians while expediting the process in the spirit of better healthcare outcomes.

US healthcare system, Medicare and Medicaid programs, medical claims, Medical billing services, medical billing outsourcing, medical billing company, RCM process, healthcare IT, Provider medical billing services

Apply These 5 Secret Techniques to Improve Revenue Cycle Management

Practices receive payments for rendered services after weeks, and sometimes it takes months for them to get paid. It doesn’t have to be patients or doctors all the time; when it is time for payment, there is a third stakeholder – the payer – that comes into play.

The US healthcare system is made up of complexities. It is a system in which Medicare and Medicaid programs cover people with disabilities and above the age of 65. Thus, clinicians ought to make their financial cycles a priority. When it is the first thing on your to-do lists, medical claims approve at a much faster rate without having to worry about denials.

Before getting paid in full, providers have to spend time sending the remaining bills to the patients. It is critical to the life of practices to stay profitable and meet their monthly expenses. A much practical way to achieve those goals is to hire Medical billing services such as P3 and amplify the revenue cycle management process.

We bring five secret recipes for your practice to run as seamlessly as the wind itself useful even in times of COVID-19. As America realigns with the after-effects of the pandemic, make use of the following techniques:

  1. Bring medical billing services on board

Due to the disconnect between payments and physicians, going for medical billing outsourcing makes sense. A medical billing company becomes responsible for all their finances and the whole RCM process. Most physicians complain of the slow payment process from patients with High Deductible Health Plans (HDHPs).

To keep it simple and to the point, health IT firms like P3Care work on behalf of providers to get them what they deserve promptly. We believe an efficient billing company is central to the financial freedom of clinicians, for them to have a strong association with their patients, which is the most vital element in healthcare.

  1. Effective financial policymaking

For a patient, getting well is everything. However, before they get well, it is important to understand the cost of care. A financial policy means your practice receives payment before treating the patient. Except for a clinical emergency, if they are unable to pay, reschedule their appointments to another day. Lobbies and waiting areas should have this policy stated on their walls for public awareness. And, if you have a website or social media channels for that practice, pin it to the top of the page. Get the patients to sign it, so their acknowledgment comes in writing.

  1. Spread the word categorically

When someone calls for an appointment, inform them of your financial policy, i.e., collect payments before checking the patient. The automated message that goes out to different patients should include the recorded statement of your financial policy when new patients call in or sending out appointment reminders.

Keep the policy in the loop of communication whether it is at the front desk in the form of a hard copy, through email, or the messenger so there are no surprises.

  1. Calculate upfront costs before checking in

Some tools help practices calculate out-of-pocket costs for the care delivered. They collect data from payer contracts, physician and facility charges, and patient’s health information to calculate upfront costs accurately. We recommend the use of such tools for the sake of financial security. Build self-check-in kiosks in one corner of the waiting area to speed up the care process. They also have an option to accept payments.

Not only do such tools add to the patient experience because of their quick check-ins, but their application speeds up the payment process.

  1. Train front desk staff in insurance programs

When front desk staff is trained in applying for Medicaid and other patient assistance programs, it is an additional skill they can use to motivate the patients. Train staff in scenario-based scripts in which they are face-to-face with a real-time situation before it happens for copayments, cost-sharing charts, and outstanding balances.

Regardless of what the US healthcare seems like, the cost of care is inevitable. Whether we can afford it or not, physicians have the right to earn what they just delivered. Provider medical billing services help you get paid faster and execute a result-oriented revenue cycle management process. For that, we prepare claims according to ICD-10 and CPT coding guidelines by CMS and AMA, respectively as early as the patient leaves the doctor’s office.

5 Hurdles Physician Credentialing Experts Can Help You Avoid

Credentialing specialists and those working to validate doctors in healthcare setups have a huge responsibility on their shoulders to come through as trustworthy partners. Because, if they fall short of certain requirements, not only does it jeopardizes their position but puts physicians’ careers at risk as well.

Medical credentialing is the process of validating and revalidating physicians to be part of a professional healthcare network. Doctors go through re-attestation and revalidation with the help of credentialing experts after they carry it to good effect. P3’s credentialing services make use of rules in favor of physicians so they aren’t penalized in any way.

Overcome the following hurdles with the help of physician credentialing experts.

  1. The Critical Stage of Physician Verification

A new provider who is about to join a hospital needs 60 to 90 days to be fully verified. Once physician credentialing experts give the green signal, the providers start to see the patients. As the process involves microscopic verification related to education, work, past cases, and medical license, a tiny mistake can undermine the process further.

  1. Furnish Peer References on Time

When you have P3 as your medical credentialing service, tenacity to complete the process comes by default. Due to the physician’s busy schedule, it is hard to find time for such matters. Don’t think twice when it comes to hiring trained HIT consultants for credentialing. It makes the job at hand, easier.

Peer references are part of the process but finding spare time to address them and for peers to respond accordingly is the real issue. Don’t fret, because P3 Healthcare Solutions, Ontario, CA has got you covered. We assist you in health IT and credentialing is not any different.

  1. Address Physician Credentialing from Time to Time

The process is not a one-time effort, but a continuous one. For instance, clinicians in ambulatory surgical centers require reevaluation every 1 to 3 years. Constant work is required of their profiles to stay updated.

Since physicians have different portfolio renewal dates, the ASCs have a hard time keeping up with them. Therefore, we, as credentialing specialists, offer healthcare providers the best of solutions. Subscribe to our annual plan at this number 1-844-557-3227 and get rid of the stress forever.

  1. Unified Approach for Patient Health Plans

With the inclusion of the state exchange and federal health plans, credentialing undergoes another knot of complexity. Physicians’ practices, to stay current and updated, have to take up plans of their patients into consideration. There has to be a certain balance between the number of patients visiting the practice and the revenue generated as a result.

  1. Enrollment with Patient’s Exchange Plan

Due to several stages in the process, the right tactics need to be in place. Otherwise, physicians will experience a delay in payments. For instance, as medical credentialing experts, we make sure physicians enroll with the exchange plan of their patients. As a result, they are paid for rendering services.

Third-party medical credentialing services simplify the process of enrollment and credentialing. Sometimes when trust takes the backseat, it is difficult to rely on outsourcing companies. RCM process improvement comes as an additional perk with P3 as an emerging medical billing service according to a survey by Clutch.co. Discover your true potential to cross the maximum revenue benchmark as we don’t settle for anything less.

About P3 Healthcare Solutions, Ontario, CA:

We are a medical billing company that works for providers while they work for patients. The end-to-end revenue cycle management process activates the true potential of practices. It is an effort to generate for you and utilize the boundaries of the healthcare system in the best interest of physicians and their patients. In the end, every practice deserves high revenue and reduced losses.

Healthcare, HIPAA medical billing service, Medical Billing, Medical Billing Companies, Medical billing service companies, Medical Billing Services, outsourcing medical billing, RCM process, Revenue Cycle Management

4 Qualities of Medical Billing Services Benefiting Healthcare

What do you think is the main reason behind hiring or outsourcing a medical billing service?

In the end, payments that you derive as a healthcare professional are the reason behind your survival, both socially and morally. If you are famous among your patients, it gives you satisfaction, but not for long if the revenue stream is unstable. The reimbursements are the lifeline of any practice, and hence, the role of a billing company becomes vital at this point.

Outsourcing medical billing improves the net collection rate as it gives a push to reimbursements. It also speeds up the RCM process by not delaying the billing and coding of claims.

However, you should choose medical billing solutions cautiously, when you are in the right frame of mind. It means when you have nothing against them in any sense.  Read reviews, carry discussions, talk to co-workers, and the best way is to use Google for the best services nearby. The qualities below will keep you on the right track.

1. Top Medical Billing Services are Specialty-ready

Any company you’re looking to hire for your finances needs to be aware of your specialty. For instance, if you are a heart specialist, the HIPAA medical billing service company has to be familiar with the right billing codes and other standardized information.  Since there are constant changes in the system, it is not easy to keep up with it.

If they are a bunch of trained individuals who have experience with specialized healthcare practitioners in the past, it can be your best bet.

Some billing companies manage finances only for general practitioners such as physicians and physician assistants. Sometimes, it also goes to show their inexperience in medical billing.

Specialty medical billing services in the US are elaborate in their skills and work areas. They manage insurance companies by understanding the work process that goes into the acceptance or rejection of claims. The billers know their way around payers; understand them in a way better than the inexperienced billers.

It brings both the payer and the billing company closer to a point where they can produce better results. In addition, they also know how to avoid denials by creating insurance-friendly claims.

2. What Is Your Take On The Experience?

The answer to this question clears up any doubts about the ultimate selection. It is inadvisable to ask a newbie to handle your finances.

Your revenue cycle management is best suited in the hands of a veteran company with a multitude of satisfied clients. You need someone dependable who knows their way around the constantly changing healthcare system. It can only be someone with experience, the right attitude, and downright skills.

Given the current frequency of complex updates in the healthcare industry or Meaningful Use (MU) Stage 3 payment risks, it is sensible to find experienced medical billing services. In addition, they must provide 24/7 support and be at arm’s length in case of developing situations.

Furthermore, if you need to talk to a person about a specific issue, the right technical person should always be reachable.

Ordinarily, with experienced companies, most bills see the light of approval rather than an outright denial.

3. Bear Advanced Software and Hardware Systems

Since an electronic health record (EHR) system has become a mandatory part of practices since 2017, you must be sound in practice management systems (PMS) and the use of EHR technology. It is clear that once both the systems corroborate with each other, the expenses drop and your practice prospers. It shows in the form of charged-up reimbursements.

When three systems come together (PMS, EHRs, and Patient billing systems) and form a solid alliance, there are fewer errors and the visit-to-billing cycle starts to roll.

Some medical billing services in the US have the latest machinery to keep an eye on the future and are flexible enough to adapt to situations. Become one of those enterprises which use advanced computers and communication tools to meet the dynamic and ever-changing medical billing field.

Medical billing outsourcing companies also offer denial management plus follow-up services. In-house billers and coders may not be enough to do this task professionally. Certainly, they require a whole lot of time to analyze each patient’s record and follow up accordingly.

Medical billing services do this job efficiently. As they have dedicated staff for this purpose.

This approach is particularly useful for improving the reimbursement rate and overall revenue cycle management, added with the transparency level and secure data transmission, without which healthcare organizations may suffer in the long run.

4. Ready to Share Knowledge with Staff

The medical billing service companies not following the rules or adhering to the contractual agreements are not a good option. Despite the fact they are a professional team of billers, they must be ready and willing to bend a few rules just for your sake to make you feel well supported.

They should train the staff on the premises working for you. Moreover, the company has to be more than willing to educate someone in your staff that may help relieve the billing stress. Resultantly, when a situation builds up in real-time, there will be someone to offer a potential solution.