Medical Billing and Coding Everything You Need to Know- A Quick Guide

What is Medical Billing and Coding Service, Cost, and what Reason to Outsource Medical Billing?

The busy medical practices must maintain a high standard of patient care while completing the necessary administrative tasks to keep doors open.

Medical billing can consume lots of time. It’s also challenging to locate and train staff to perform this important job. Additionally, if claims are not processed properly or on time, they could negatively affect your practice revenues.

Many practices use third-party medical billing firms to manage their claims.

WHAT IS MEDICAL BILLING SERVICE?

The independent medical billing service is utilized to submit, process, and monitor health insurance claims to reduce the amount of time spent by your staff.

These companies employ highly trained employees that understand specific customers to get a better payment rate in a short amount of time.

In addition, any medical billing service you choose can follow up with denied claims and seek to recover delinquent accounts.

WHAT IS MEDICAL CODING SERVICE?

The primary responsibility of medical coders is to examine clinical claims and assign codes standard by using CPT (r), ICD-10-CM, and HCPCS Level II classification systems. On the other hand, medical billers manage claims made to health insurance companies to ensure reimbursement of services.

Medical coders and billers could be the same person or work together to ensure that invoices are properly paid. To understand what the coding process looks like, check out this article, ” What Does a Medical Coder Do?“

MEDICAL BILLING VS MEDICAL CODING SERVICES

Medical billing refers to a specific service that is different from medical coding. Coding is assigning a standard code to particular services before submitting claims. Medical billing involves the process of submitting and following up on claims.

Most medical billing companies require you to write your code; however, some offer both.

If you have questions about billing or coding, our certified coders can assist you. They also help with medical codes for your clinic.

WHY DO MEDICAL PRACTICES OUTSOURCE MEDICAL BILLING SERVICES?

The advantages of working with companies that outsource medical billing are:

· Improvements in workflow for practices Office staff

· Eliminating any confusion regarding the specific payment policies of each payer

· Reduction in submission errors

· More rapid claims processing

· Improved Healthcare Revenue Cycle Management

· Access to skilled industry specialists

· Lower costs per patient

· Profitability increases

· Patient satisfaction is improved as claims are processed promptly

The main reason third-party medical billing companies are important is that they reduce stress for practitioners concerning billing issues.

Scribe Align LLC clients enjoy the following benefits as a result of our services:

· 100% HIPAA complaint process

· 98% claims payment on the first submission

· Increased efficiency owing to the certified coding team

· Shortest turnaround time and faster reimbursements Cycle management by billing specialists

· Reduced staffing issues and operating costs

· Denial follow-up and resolution by industry experts

· You will save almost 70% on operating costs

· No headache with staff training or update

· Quick response and answers to any billing query

· Dedicated practice manager for every practice to ensure streamlined communication

· Continuous and rigorous follow-ups on denied and pending claims

We also provide providers with current information about local, state, and national local fee trends so that you can adjust your fees on time to ensure your practice is on the same page as other practices.

HOW MUCH DO MEDICAL BILLING SERVICES COST?

Costs for medical billing services are determined by the number of claim submissions, a setup fee, a percentage of collection, or a monthly service fee. The costs vary widely between businesses.

Contact the prospective service provider to learn more about their specific pricing structure.

The best choice for you will be based on your company. For example, if you’re a small-sized practice with fewer claims to be processed, the cost per claim might be cost-effective. Many methods, however, prefer the model of a collection percentage, which means that to allow the billing firm to be paid, the practice has to be paid first.

Are you unsure about the medical billing service we offer? Feel Free to Contact Us at any time!

We at Scribe Align LLC are experts in medical billing and coding enrollment management services, including credentialing for your staff to ensure they have the right credentials necessary when it comes time for care coordination or insurance verification. We also provide claim denial/ acceptance processes as well as business intelligence reporting across various departments within our practice so that you can stay up-to-date on all aspects of running a successful clinic!

Differences between Physician Billing and Hospital Billing

Physician Billing vs. Hospital Billing: Understanding the Key Differences

Physician billing and hospital billing are the two types of medical billing that prevail in the healthcare industry. But what is the difference between hospital billing and physician billing?
This post will cover some essential points regarding the difference between physician billing and hospital billing, which will help you understand what factors come into play while learning about these two types of healthcare claims.

With physician billing and hospital billing, there are specific differences to tackle. For instance, physician billing is based on the percentage of the remuneration earned through procedures or a price for different services rendered. As for hospital billing, its based on the pricier reimbursement model, where the hospital charges the patients insurance plan for the services required and received.

Professional billing relates to physician billing, and institutional billing refers to hospital billing. In the healthcare industry, professionals differentiate between these terms depending on the purpose of the billing process and the services involved. The two methods, however, fall under the general medical billing process.

To highlight the key differences between physician and hospital billing, lets find out how they are used in both cases.

Physician billing: What is it?

Physician billing, or professional billing, refers to the billing process. Where claims submitted by physicians and healthcare providers are reimbursed when performing medical services or procedures on patients covered by insurance, once you decide to become a physician billing service provider, you must help the physicians or healthcare providers with claim submission and other related billing and collection tasks.

CMS-1500 or 837-P is the claim form used for physician billing. The only difference between these forms is that the CMS-1500 is a paper document, and the 837-P is an electronic document.
• Some insurance companies, like Medicaid, Medicare, and others, only accept electronic claims as payment methods. P stands for professional configuration on the 837-P claim form, an electronic version of CMS-1500. Most of the time, expert physician billing services have more to do than institutional or hospital billing services.
Billing a doctor is an important administrative task that controls many other tasks in a medical office, like making appointments, greeting patients, registering patients, and collecting payments.
To make sure that the organizations overall financial and operational goals are met, people who work in medical billing and coding need to know a lot about the policies and practices of physician billing. Because physicians bill insurance companies directly for patient services, a medical offices billing department relies on the accuracy of coding and claims processing to ensure that payments are made promptly.
The organizations ability to stay in business depends on how much money it gets for each service it provides. Medical professionals can improve their ability to collect payments by learning the basics of physician billing.
• Both inpatient and outpatient services can be billed under physician billing; both types can only be billed after patient verification.
• All outpatient and inpatient services will be billed based on the patients insurance policy, so its important to check.
• It is important to keep in mind that physician billing includes medical billing and medical coding as well.
Therefore, medical billers need to learn both billing and coding procedures. Healthcare professionals offices and hospitals employ medical billing and coding teams to handle everyday billing.
The process of physician billing is complicated and detailed. It is also time-consuming and requires a lot of effort and time. Scribe Align makes it easy by connecting healthcare providers with hospitals and insurance companies so they can focus on patient care instead of insurance claim submission. By outsourcing the billing process to a healthcare billing service provider like Scribe Align, you can focus on the doctors practice and patient care instead of worrying about getting paid for the medical services.

Hospital billing: What is it?

• The hospital or healthcare provider submits claims for inpatient and outpatient services in hospital billing. For the same reason, hospital billing can also refer to institutional billing.
• A hospital billing system also accounts for the services provided by skilled nurses. They also bill claims for medical facilities and medical claims for laboratory services, medical equipment, radiology, supplies, etc.
• An institutions configuration is indicated by I. Hospital billing is performed using forms UB-04 or 837-I. In contrast, the UB-04 is a paper-based form, while the 837-I is a computer-based form.
• A physicians billing is similar to a hospitals billing, except that hospital billing only deals with the medical billing process; it does not deal with medical coding. However, physician billing also includes medical coding.
• The hospitals appointed medical biller is only responsible for billing and collection in hospitals. It is challenging to handle hospital billing as compared with physician billing.

Billing for Physicians and Hospitals: how to increase revenue?

• Hospitals and physicians have different billing models when it comes to revenue reimbursements. But their processes have a significant impact on preventing denials and fraud.
• Keeping track of unbilled and unmissed claims and services becomes the physician billers priority. However, the staff should be aware of any billing or coding errors when submitting claims. Technical errors can also cause mistakes for various reasons.
• Outsourcing healthcare billing and coding services is often the best option for hospitals and healthcare providers to avoid errors and payment losses.
• The hospital billing process is quite different from physician billing. A hospital or institutions billing function includes collection and billing.
• As a result, institutional cases are handled only by coding experts because hospital coding is considered more complex than physician coding.

It is essential to avoid violating HIPAA privacy and security rules since physicians and hospital billing staff have access to private and confidential patient health information.

Thank you for reading about Physician Billing and Hospital billing. I am pleased to provide you with information on physician and hospital billing.