Medical billing is a crucial health care service that supports physicians by submitting and collecting the payments from insurance companies and patients. One needs to be an expert to ensure that the bills are collected fully and in a timely fashion. It is quite common for over 20% of a practice's potential revenue to remain unclaimed because of improper coding and weak collection strategies.
Outsourcing medical billing is growing in popularity as an approach for addressing this tremendous loss of practice income. The range of outsourcing options runs from extremely large organizations to individual freelancers who work from home to provide medical billing services.
In thinking through the billing options available, it is crucial to understand that medical billing is complicated and requires deep expertise and broad experience. When a specialty is involved, such as surgical billing, the requirements for success become even harder to achieve. Success requires that the medical billing company have a team that is well versed with the complex rules utilized by insurance companies to adjudicate surgical medical claims.
With surgeons facing ever increasing costs they must insure that money is not being left on the table because they have a billing company that is not a surgical billing expert. Surgeons must also be aware that that many billing companies that claim surgery billing expertise actually outsource their surgery billing to work at home billers. Situations like this are fraught with the risk since the remote workers are not working in a controlled and monitored environment.
Deep familiarity and comfort with surgical procedures and terminology does not come from serving one or two surgeons. Surgical billing success requires both broad and deep expertise in order to collect all of the money owed the surgeon and successful appeal claims which have been denied or answer questions the payers may have about a claim.
A typical sort-coming with medical billing services that do not specialize in surgery billing is the inability to properly track and pursue insurance underpayments. These underpayments cost most surgeons about 10% of their potential income. If a medical billing company does not understand the mult-procedure rules and have a system that can track underpayments (and does not flag every payment on a second procedure as underpaid), they will find it difficult to capture this lost revenue is a systematic manner.
It is not only insurance billing that is more complicated for surgeons; patient billing is also more difficult. The patients often have high balances, complicated explanations from their payers and do not understand all of the invoices they are receiving from their surgeon, the hospital or ASC and the anesthesiologist. A billing company that has strong surgical billing experience has spoken with patient about these topics many times before. A less skilled patient collection effort could leave the surgeon with less money and unhappy patients.
The bottom-line is that is not worth the risk for a surgeon to use a billing company that is not as focused as he or she is on surgery. Just as a patient should not go to a family doctor for surgery, a surgeon should not go to a generalist billing company for medical billing.
Copyright 2008 by Carl Mays II - 14915
Outsourcing medical billing is growing in popularity as an approach for addressing this tremendous loss of practice income. The range of outsourcing options runs from extremely large organizations to individual freelancers who work from home to provide medical billing services.
In thinking through the billing options available, it is crucial to understand that medical billing is complicated and requires deep expertise and broad experience. When a specialty is involved, such as surgical billing, the requirements for success become even harder to achieve. Success requires that the medical billing company have a team that is well versed with the complex rules utilized by insurance companies to adjudicate surgical medical claims.
With surgeons facing ever increasing costs they must insure that money is not being left on the table because they have a billing company that is not a surgical billing expert. Surgeons must also be aware that that many billing companies that claim surgery billing expertise actually outsource their surgery billing to work at home billers. Situations like this are fraught with the risk since the remote workers are not working in a controlled and monitored environment.
Deep familiarity and comfort with surgical procedures and terminology does not come from serving one or two surgeons. Surgical billing success requires both broad and deep expertise in order to collect all of the money owed the surgeon and successful appeal claims which have been denied or answer questions the payers may have about a claim.
A typical sort-coming with medical billing services that do not specialize in surgery billing is the inability to properly track and pursue insurance underpayments. These underpayments cost most surgeons about 10% of their potential income. If a medical billing company does not understand the mult-procedure rules and have a system that can track underpayments (and does not flag every payment on a second procedure as underpaid), they will find it difficult to capture this lost revenue is a systematic manner.
It is not only insurance billing that is more complicated for surgeons; patient billing is also more difficult. The patients often have high balances, complicated explanations from their payers and do not understand all of the invoices they are receiving from their surgeon, the hospital or ASC and the anesthesiologist. A billing company that has strong surgical billing experience has spoken with patient about these topics many times before. A less skilled patient collection effort could leave the surgeon with less money and unhappy patients.
The bottom-line is that is not worth the risk for a surgeon to use a billing company that is not as focused as he or she is on surgery. Just as a patient should not go to a family doctor for surgery, a surgeon should not go to a generalist billing company for medical billing.
Copyright 2008 by Carl Mays II - 14915
About the Author:
Carl is affiliated with a medical billing company that is 100% focused on billing for surgeons. To learn more about how a specialized billing company can help your practice please visit Surgical Billing Partners website of their Surgical Billing Blog. If you have specific billing questions please feel free to contact Carl through either of the two sites mentioned above.
1 comment:
Hi,
Thanks for the information about Medical Billing Service.I like very much your blog.This is nice collection and references information.
Keep it up.
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