How to Stabilize Finances of Healthcare Practices?

This is the 21st century. The healthcare rules are changed. Physicians don’t have the time to file claims with insurance companies due to administrative burden. Therefore, medical billing services stand next to healthcare practices to help them increase revenue. Certainly, it’s not time when physicians’ only had to worry about the well-being of patients. Now, the factors like patients’ satisfaction, implementation of engagement strategies, and innovation in the healthcare industry via MIPS have more points in making a physician’s reputation.

Thus, it is not wrong to say that it’s time to work smart! Therefore, technology comes to save the day for physicians and medical billing companies.

Medical Billing Services! If you’re looking to increase the collection rate for your clients, watch out for the following technology innovations.

These suggestions optimize medical billing and coding process, save time, and help increase ROI.

  1. Go Online

Leave paper behind. In this digital era, do you believe, sending invoices to patients via paper is a reliable or safe way? Well, No.

Most of the medical billing services still send bills via papers, and we must know this method is obsolete. Collection rate can be significantly increased if physicians allow a digital method of sending invoices.

  1. Ask for Payments While the Patient’s Visit

It is observed that the chance of collecting payment decreases by 20% when patients walk out of the physicians’ office.

In-house or in-office payment rate increases when medical billing companies or front-desk staff accepts credit/debit cards on the spot. But, first make sure you have a HIPAA-compliant setup and you obey Payment Card Industry Data Security Standards (PCI DSS) guidelines.

  1. Verify Patient’s Insurance Eligibility Beforehand

Verifying patient’s insurance eligibility before the treatment is an under-rated practice. However, when done, it makes bank accounts full. Some software can help in this task, and some of them are so advanced that they even notify physicians for the paid payments by the patients such as deductibles and copayments. In this way, medical billing services can proceed with medical claims without any difficulty afterward and even inform patients about their financial responsibilities.

It needs a big investment, but it is worth every penny.

Healthcare innovations are on the rise. So, it’s better to move forward instead of sticking to the old conventional methods. It is not only beneficial for introducing interoperability but also to level up the billing and coding standards.

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How to Verify Healthcare Insurance: Step By Step Guide for Medical Billing Services!

There is no doubt in it that physicians need revenue for their survival, and medical billing services work day and night to help them meet their expenses efficiently. They focus on developing a strategy for an efficient billing solution to maximize revenue.

Besides the other medical billing and coding procedures, verifying the eligibility of health insurance before the patient’s treatment also maps out a financial situation for physicians. Not only, it is an important revenue increasing practice for healthcare organizations, but is also beneficial for patients.

Given below is a guide on how medical billing companies can verify insurance eligibility in 10 easy steps.

Let’s check out!

Obtain Important Information from the Healthcare Provider

When a patient visits a doctor, it is the responsibility of the front-desk staff to accurately record patient’s information. The information includes,

  • Name of the patients
  • Date of birth
  • Social security number
  • Contact number
  • Information of insurance provider
  • Insurance ID & group number

Medical billing services need to access this information, if healthcare providers don’t provide them with the accurate patient’s bio; it would be difficult for them to verify eligibility.

Ask for Original Health Insurance Card from the Patients

Request the patient to provide with the photo ID and make copies of the original health insurance card for the future.

Contact the Respective Insurance Company

Make a call to the relevant insurance company or via electronic means, check if the insurance that patient claims, is valid.

Research If the Insurance Benefits Remain Valid on the Date of Treatment

Verifying the date of patient’s health insurance safes from unnecessary stress in future. This information has to be checked with the insurance company.

Check for the Insurance Benefits

By contacting with the insurance company, medical billing services also need to verify about the benefits that a patient can avail and the copayment that he has to pay by himself.

If there are charges that insurance doesn’t cover, make sure to inform the patient before the treatment, so that, he recognizes his financial responsibility before time.

Check If Your Healthcare Provider is included in the Patient’s Insurance Network

If the healthcare provider is not included in the patient’s insurance network, the chances are that the insurance company will not pay the whole reimbursement.

Know About the Deductibles

Before the insurance company pays for the services, the deductible is the amount that the patient pays. There is a different amount for different insurance plans. Medical billing companies need to ensure if the patient has paid the respective dues or not.

Verify Copayments

Collect copayment from the patient, give them a slip, and provide them with treatment details. In this way, patients can verify their insurance benefits by themselves.

Be Efficient with Customer Support Services

If patients need assistance in any matter, answer their queries efficiently. Generally, healthcare providers don’t have time to deal with patients regarding payment matters, so the front desk staff does it.

But, if the reception staff is not capable to provide such information to the patients, the medical billing staff has to take care of this responsibility as well.

Verify If the Patient Has a Secondary Insurance

Often patients have secondary insurance and a certain amount of charges is covered in that plan. It is advisable to verify secondary insurance information, the same way as above-mentioned.

Successful medical billing companies ensure practices that best suit the healthcare service provider and elevate his revenue cycle. And, insurance verification serves the same purpose. If the insurance verification process is completed beforehand the treatment, the rate of accounts receivable (AR) is reduced. Moreover, patients know about their financial responsibilities as well.

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Phases in Medical Billing Services for Podiatrists

There are several medical specializations and for each specialization, there is a certain set of rules and codes in medical billing services.

Not every medicine field has the same diagnostic and surgical procedures. Similarly, medical billing and coding guidelines and techniques are different for each specialization. Same is the case with podiatry. When a medical billing company claims for podiatry services, they work on a special dedicated plan.

First, learn what is Podiatry?

Podiatry is the branch of medicine, which is concerned with the diagnosis, treatment, and study of diseases and disorders of the foot and lower extremity. Treatments are related to regular healthcare treatments, neurological, metabolic, and other underlying issues along with injuries, wounds, and infections.

Rules Regarding Medical Billing Services for Podiatrists

The Center of Medicare and Medicaid Services (CMS) has defined rules and procedure for each discipline of medicine. There are clear instructions of what should be covered under an insurance plan for podiatrists. New medical billing outsourcing companies can take notes from their official website.

Insurance Don’t Pay for Non-Medically Necessary Services

Under CMS rules, insurance companies will only pay for medically necessary foot care services.

A regular foot care service falls into the following categories.

  • Additional
  • Mandatory
  • Supplemental
  • Optional supplemental

What Exclusions Are Involved in Podiatry Medical Billing?

There are certain cases in which fighting with insurance companies for reimbursement is straightaway lost war. There is no point in sending claims for the following cases.

Straight away rejection cases include:

  • Initial care service
  • Existence of metabolic, neurologic, or other peripheral vascular diseases
  • Mycotic nails
  • When a patient is already receiving primary healthcare
  • Dislocation of ankle joint
  • Subluxation of structures within feet
  • When a patient wears orthotic shoes
  • When a diabetic patient wears special shoes

To higher the acceptance rate of medical claims, medical billing services should precisely state the name of the podiatrist, who diagnosed the disease. Moreover, the severity of the condition should be reported not just the diagnostic procedure.

New medical billers and coders often get lost in the maze of instructions and guidelines. Medical billing for podiatry indeed requires a great level of accuracy as insurance companies don’t pay for these services very easily.

However, with little care, necessary paperwork,  just like we do, there will be no problem in the claim submission process. We, P3 Healthcare Solutions, Ontario, CA have carefully devised medical billing methods for different specialties and offer specialty-specific services to physicians.

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Healthcare Information and Management System Society –HIMSS each year showcase new ideas and technologies to support the healthcare industry. By viewing these technologies or adopting these methods, physicians can actually progress in MIPS in healthcare, medical billing and coding, and health IT sectors.

HIMSS19 conference offers hundreds of opportunities for clinicians with the latest tools and tactics to improve the quality of healthcare services. Moreover, the ideas and innovative methods presented in such forums give insight to strengthen revenue cycle management. In addition, MIPS in healthcare and other incentive payment programs can be facilitated in term of reducing cost-expenditure and efficient data storage system. All of these efforts contribute to the advanced healthcare system.

What was there in the box by the vendors in HIMSS19, which may move this industry in upcoming years? Let’s review.

  1. IoT-Enabled Platform

VivaLNK is a popular name in the health IT industry. It has developed a wearable sensor platform with Internet-of-Things that consists of a number of items such as,

  • Sensors
  • Internet of Health Things (Data cloud)
  • Computing technologies

What Does this System Do?

The function of this technology is to capture patient’s or human’s biometric data and input it to the edge computing technology or the cloud computing service for analysis.

This technology will be a great addition in the healthcare industry and will support MIPS in healthcare and medical billing and coding services regarding data collection. It has the capacity to work wonders when deployed completely to its full potential. It will modernize proactive healthcare services and will predict flawed areas in a human body by analyzing symptoms and data.

The Purpose of This Technology

As with modern digital technology, the healthcare industry needs to change its curing methods. The focus should be on preventive healthcare procedures instead of treating a patient after a disease. Moreover, the complexity of diseases has doubled since the last years, making a challenging environment for physicians. The detection or seeing early symptoms of diseases has not remained easy.

This technology will help healthcare providers to identify diseases before they turn serious. Consequently, it will result in bringing positive impact in the value-based services that MIPS in healthcare promises.

The success of this system lies in the accuracy of the data. Machine learning and artificial intelligence will come from user-fed data. This task is daunting and may not work as precise as one may expect. Thus, sensors-equipped platforms will assist in this regard, providing medical-grade data directly from the patients and will be shared across the network via IoT.

This system is the next-level healthcare solution that benefits MIPS in healthcare and medical billing on larger grounds. According to physicians, healthcare service providers will be able to accelerate health IT efforts, especially for chronic diseases.

The system perfectly integrates health IT and value-based healthcare service for the patients’ betterment.

  1. The platform for Increased Patient Engagement

Another promising innovation at HIMSS19 was by TriFin Labs, named as Enlyt Patient Engagement Platform.

This system is designed to extend the application of the patient’s engagement via state-of-the-art technologies. It serves to save money and time while connecting physicians and patients in a reliable environment.

How Does It Work?

It a HIPAA-compliant and customizable platform to provide a one-to-one connection between patients and physicians.  It enhances customer-relationship management and has the potential to integrate with the electronic healthcare record (EHR) technology.

Its ability to provide customized operations allows clinicians to manage their systems as their requirements. Moreover, patients will be free to access their medical records whenever they want along with the other information i.e. a list of medication and treatments.

This system also holds opportunities for pharmacists to review past and present medicines at any time, ensuing value-based MIPS in healthcare.

Its other advanced features include a coordinated in-app connection that helps patients in remembering their appointments.  Thus, it makes perfect sense in terms of promoting interoperability and increasing healthcare workflow.

What do you think about these technologies? Do these seem like progressive steps to reduce healthcare cost? Share your thoughts with us at