Rules Governing Health Practice
The rules governing the healthcare practice are very elaborate and pertain to various classifications. Medical, surgical, and diagnostic reporting procedures rely on the CPT and HCPCS codes. ICD-10-CM is used to classify and code diagnoses, symptoms, and treatments. OIG guidelines are there to help providers avoid penalties. The objective of MIPS and HEDIS is to measure and incentivize quality in patient care. While all these rules cover several functions within the healthcare organization, one area affected by all of these codes and guidelines is medical billing. Often healthcare providers cannot manage all of these requirements for billing by themselves and take help from healthcare billing companies.
The Medical Billing Process
The medical billing process comprises the following steps (step number 7 and 8 may not be needed for clean claims):
- Patient Check-in
- Insurance Plan Verification
- Coding of Diagnosis and Procedures
- Billing against the Services Rendered
- Claims Submission
- Follow-Up on Claims
- Denial Handling
- Payment Posting and Updating the Patients
A Thorough Approach to Medical Billing
The billing process is the same if you do it in-house or get it done through a billing company. However, not every billing company is the same. Some companies indulge in fraudulent activities that can result in hefty fines once detected. Others focus on the ICD-10-CM codes and punch in the data for you at an affordable cost. P3 Healthcare Solutions is different. We follow a thorough approach to the billing process. We have a team of highly competent medical billing professionals who prioritize to stay up-to-date on the various regulation changes.
Effective Follow Up and Denial Management
A small mistake during the billing process may result in the claim being sent back for correction. If the error or omission is not rectified to the satisfaction of the insurance company, the payment may be partially or completely denied by the insurer. Most payers have a 90-day time-limit on claim submission. Payment might also be denied in case there isn’t proper follow-up on claims that require correction. Thus, by adhering to the various legal requirements at every step, we ensure your revenue cycle runs as smoothly as possible.
For questions out of this service, or on instructions on how to get started call a medical billing service expert today at 1-844-557-3227 (1-844-55-P3CARE) or email at email@example.com.