Our team of professionals can help with patient registration, determining financial responsibility, capturing codes, create the superbill, prepare and submit your claims, monitor payer adjudication, post payments, create patient statements, and follow up on rejections, denials and payments. 

We utilize the following best practices to optimize medical billing for you. 

1: Integrating your Electronic Health Records (EHR) and Electronic Practice Management (EPM) system reduces the necessity for manual data entry. This simplifies medical billing procedures and minimizes claim denials stemming from basic errors. Additionally, within a unified system, you can manage various aspects, including appointment scheduling, updating patient information, documenting office visits, and billing payers.

2: Highly Qualified Team: The success of your practice’s finances relies heavily on medical billing specialists, front desk personnel, and healthcare providers. When searching for medical billing specialists, we seek those with experience in your practice management system. These seasoned professionals can help your practice optimize reimbursement rates and streamline workflows to minimize claim denials and late payments.

A proficient front desk team also plays a crucial role in maintaining a smooth revenue cycle. Accurate collection of patient demographics and insurance details by front desk staff is pivotal in preventing claim denials. They can also assist patients in updating their insurance and other information, thus reducing the likelihood of claim denials. Collecting co-payments, deductibles, and co-insurance upfront helps minimize post-visit patient billing and outstanding account balances.

3: Simplify Patient Payments: Patient deductibles, co-insurance, and co-pays can lead to delayed payments. We can expedite accounts receivable by making it more convenient for patients to settle their bills. Traditional paper bills can get lost in the mail. Surveys indicate that patients prefer flexible payment options like online payments and prepaid cost-sharing.

4: Timely Submission of Claims to Payers: We ensure a daily submission to claims to payers in an automated batch mode and monitor metrics associated with timely submission.  

5: Monitor Revenue Cycle Metrics: EHRs and Practice Management Systems house critical financial data. Through integration, we can track accounts receivable, denied claims, and bad debts by payer. Utilizing a comprehensive dashboard, we can access key revenue cycle metrics for your practice. This report enables us to monitor payments, adjustments, denied claims, and accounts receivable categorized by days since billing. 

6: Resubmit Denied Claims: Despite robust medical billing processes, claim denials may still occur. Studies suggest that as much as 50 percent of denied claims are never reevaluated. By neglecting to resubmit denied claims, practices potentially forfeit significant revenue. Our Medical billing specialists diligently pursue the resolution of all denied claims, as many of these denials result from minor errors or omissions. Incorporating time for claim resubmission into our billing processes ensures that your practice receives the full reimbursement it deserves.

7: Foster a Culture of Continuous Improvement: We have implemented feedback loops to identify and address bottlenecks in day-to-day operations. Tools such as dashboards and reports help us monitor clinical, administrative, and financial progress, allowing for the early identification and resolution of issues. We encourage staff to report problems and propose solutions to cultivate a culture of adaptability and continuous improvement. We recognize that medical billing processes must evolve over time in response to changing technology and payer requirements. Our flexible and improvement-oriented culture will serve your practice well in the dynamic healthcare landscape.