Category/ Medical Billing
Medical billing companies: Helps you streamline your Medical Practice
Category/ Medical Billing
Medical billing companies are a helpful resource that can help you streamline your practice and get paid faster. But how do you choose the right one?
There are a few things to consider when looking for a medical billing company. First, decide if you need full-service or do-it-yourself billing. A full-service firm may take over your RCM processes completely, handling the day-to-day and reporting to you regularly. Or you can hire an independent biller—someone who will find potential errors and reconcile bills for you on a monthly or quarterly basis. Either way, you’ll want to make sure your prospective firm has experience with your type of practice.
A medical billing company can help healthcare providers adjudicate claims and provide many other services. Claim-related tasks include entering data, checking a claim’s details, and filing it electronically or on paper. Many companies also provide RCM support, including claims patient billing, follow-up and appeals, and cash posting.
A medical billing company specializing in this area is likely to provide software and services to help with all of the above and more comprehensive solutions. These might include credentialing software, schedule management, and electronic health records.
Medical Billing companies offer services in a variety of ways at different levels. In some cases, full-service firms handle your RCM needs completely and provide regular reports to you. You may also find companies that offer software and solutions to help with the billing process. Other companies provide hybrid solutions that employ solutions that enhance your workflows and engage professionals to help with overflow.
Benefits of Medical Billing Companies
There are several benefits available to medical billing companies. With a medical billing company, you can focus on your clients, which is the most important part of your business. You can give them the best service possible by handing off the billing and collections process to the medical billing companies. This allows you to grow your business in several ways.
Medical billing companies offer two primary services. The first is to help doctors and physicians save time and money by managing their practice, including the mechanics of submitting claims to insurance companies. The second service is the creation of invoices and statements that show a patient how much they owe. This can be useful for helping a patient budget their expenses, or it can be helpful for patients who are paying their bills over time. The following are some options:
Expertise at your fingertips: Medical billing companies help medical offices with the more labor-intensive aspects of running a medical practice, from electronic claims filing to payment collections. Whether your office is a single provider or you have thousands of medical professionals on-site, medical billing companies can lighten the load.
A scalable capability: Most medical practices are small enough that the doctor and staff can handle the paperwork themselves. There are many advantages to working with a medical billing service, especially in a busy practice like yours. They’re much better at filing claims than you are because they have more workforce and years of experience under their belts.
Your office will be more efficient: Many small medical offices don’t have the time to track medical billing but also to check and verify the accuracy of bills received, determine insurance coverage, and follow up on underpayments or late payments. A medical billing company can provide all these services, freeing up your staff to focus on patient care.
Medical billing companies are in high demand. If you run a medical practice, this is your opportunity to provide a convenient and affordable billing service to your patients without investing in a large set of resources.
What to Look for in a Medical Billing Company
Medical billing services are something that professionals in both the medical and for-profit arenas need. Medical billing services providers can vary greatly; however, choosing the right one for you is crucial to both your health and your business’s success. To feel comfortable trusting the provider with your patients’ data and revenue, you should make sure you get satisfactory answers to the questions listed below.
Medical billing companies house a wide range of pricing models. Understand whether you’re getting charged per claim or hour, a flat rate for services, or a percentage of revenue collected. While the terms can vary from company to company, the most important thing to know is that healthcare professionals are typically charged per claim, not on an hourly basis.
If you’re looking to hire a medical billing company, consider two things: their skills and their experience.
The best medical billing companies will have a staff that includes Medical Billing Coders and Certified Medical Assistants. They’re trained to properly document all of your patient visits, emphasizing coding and insurance reimbursement.
Medical billing companies should always have these experts available 24/7 to get help with an insurance claim, especially if your patient is about to be discharged from the hospital or in the office for a regular visit.
While you can train your personnel to do medical billing, it’s not always feasible. Many medical billing companies can provide you with emergency help if you need to care for a patient coming in after-hours or being admitted as an emergency case.
Do your staff do some of the work before the billing partner takes over, and how is the data translated between the two parties?
Medical billing companies need to be HIPAA-compliant as a part of medical billing compliance. HIPAA compliance is necessary for the medical industry, but what do you know about HIPAA and its effect on your business?
To ensure patient confidentiality, your medical billing company needs to be HIPAA-compliant.
“Finding the right medical billing company can be a challenge.” Your business is unique. When it comes to medical billing, you need to find a company that understands how your workflow works and how to file claims in your specialty.
The Cost of Medical Billing Company
Fees for medical billing and coding companies vary widely. Flat fees, hourly rates, and contingency are the most common means of billing for medical billing and coding companies. Flat fees have no relation to the time spent on a specific case. The flat fee may be charged on a per-transaction or per-claim basis. Some companies may charge a set amount for work done by an individual scribe, while others may charge a set amount per total claim processed, regardless of how many hours or transactions it took to process the claims. Not all companies charge the same fees, which is something to look into before selecting one.
Why Choose Us
Our medical billing experts provide billing and coding services for your practice. We take care of every aspect of your account to ensure claims are filed timely and accurately. With a proven track record of reliability and effectiveness, we offer a full range of medical billing services to support any practice size.
Contents
Differences between Physician Billing and Hospital Billing
CPT Coding: History, Background and How Does CPT Coding Work?
10 steps to find the Best Medical Billing and Coding Companies
Why is Digital Marketing Becoming the Industry Standard?
What is CPT VS ICD 10 & HCPCS Coding? Future of Medical Coding?
What Does a Medical Coder Do? Starting Your Career as a Medical Coder!
What are CPT Codes? Understanding CPT Codes
CPT is a standardized set of codes used to report medical, surgical, and diagnostic procedures and services to various entities, including physicians, insurance companies, and accreditation organizations. Medical bills are billed electronically using CPT codes combined with ICD-9-CM or ICD-10-CM numerical diagnostic codes.
The CPT codes are used to submit claims to federal and private payers when rendering healthcare. As CPT codes provide a detailed description of a procedure or service, they eliminate subjective interpretations of what was delivered to the patient.
The American Medical Association (AMA) developed CPT® codes in 1966 to standardize reporting of medical, surgical, and diagnostic services and procedures provided in hospital and outpatient settings.
The evolution of healthcare – including the availability of new services and the retirement of outdated procedures – is a significant consideration. Every year, the AMA releases new, revised, and deleted CPT® codes and changes to coding guidelines. The AMA also releases more minor updates to various sections of the CPT® code set.
Moreover, the AMA updates CPT® terminology or medical language to reflect advances in medicine. Though the AMA owns the copyright to CPT®, it invites participants to contribute to the ongoing maintenance of the code set and welcomes feedback on the codes and code descriptors.
Understanding CPT® codes
CPT® codes are composed of five characters. In general, codes are numeric, but some codes include a fifth character, such as A, F, T, or U. These are some examples:
92526 Oral function therapy
0638T Ct breast w/3d bi c-/c+
CPT® Code Types: A Quick Guide
Providers assign codes to every service or procedure they perform. It even includes codes for services and procedures not specifically named in another CPT® code, called unlisted codes.
The AMA has organized CPT® codes logically by classifying them into three types based on the wide range of services and procedures they cover:
CPT® Category I: Codes commonly used by providers to report their services and procedures comprise the largest body of codes
CPT® Category II: Additional tracking codes used in performance management
CPT® Category III: Emerging and experimental codes for reporting services and procedures
CPT® Category I:
Most CPT® codes are in Category I. There are a variety of existing services and procedures that are widely used and, where appropriate, approved by the Food and Drug Administration (FDA).
In general, Category I codes, which are typically represented by five characters, are arranged numerically. Codes are resequenced in one discrepancy from the expected order. In order to facilitate quick access to related codes – and help coders select the best codes – the AMA groups similar codes together. Resequenced codes occur when a new code is added to a family of codes, but there is no sequential number assigned to it.
Another exception to numerical code order involves evaluation and management codes (E/M codes). Although E/M codes begin with 9, they are printed first in CPT® code books, as you can see below in the code outline for Category I. E/M services are among the most frequently reported healthcare services, so the AMA chose this order. As with resequenced codes, this arrangement is intended for coding efficiency.
Codes for CPT® Category I fall into six main categories:
Evaluation & Management (99202–99499)
Anesthesia (00100–01999)
Surgery (10021–69990) The code range is further divided into smaller groups by body area or system
Radiology Procedures (70010–79999)
Pathology and Laboratory Procedures (80047–89398)
Medicine Services and Procedures (90281–99607)
CPT® Category II:
Four numbers and the letter F make up Category II codes, which providers can assign in addition to Category I codes. There is no reimbursement associated with Category II codes, unlike Category I codes.
The CPT® code book typically places Category II codes after Category I codes. These codes are listed as follows:
Composite Measures (0001F–0015F)
Patient Management (0500F–0584F)
Patient History (1000F–1505F)
Physical Examination (2000F–2060F)
Diagnostic/Screening Processes or Results (3006F–3776F)
Therapeutic, Preventive, or Other Interventions (4000F–4563F)
Follow-up or Other Outcomes (5005F–5250F)
Patient Safety (6005F–6150F)
Structural Measures (7010F–7025F)
Nonmeasure Code Listing (9001F–9007F)
CPT® Category III:
Category III codes, characterized by four numbers and a letter T, usually follow Category II codes in the code book. Category III codes are temporary codes used to identify new technologies, services, and procedures.
In Category III, temporary codes describing new services and procedures can remain for up to five years. They must meet Category I criteria, including FDA approval, evidence that the procedure is widely practiced, and evidence that it has proven effective. A new Category I code will be assigned to them. Providers can also eliminate Category III codes if they do not use them.
The AMA releases new or updated Category III codes semiannually via its website but publishes the deletions of Category III codes with the full list of temporary codes annually.
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