Medical billing directly impacts the financial health of a medical practice. If the practice failed to submit claims on time, reimbursements will also be delayed. Medical billing involves everything it takes to get a healthcare provider or a physician paid. This includes submitting and following up on claims as well as payments from both the patient and the insurance carrier.
There are several processes involved in creating a medical bill. Whether you’re doing it personally or you just want to learn the tasks of the medical biller in your practice, you have to consider these five important things when making a medical bill:
- Medical coding
People involved in medical billing should be familiar with medical coding. This is the process of translating diagnosis codes and procedure codes to ensure proper billing. You also need to be well-versed on HCPC codes, which are used to identify drugs and medical supplies used for the patient. For additional healthcare services or procedures rendered to the patients, the medical biller makes use of modifiers in creating the billing to receive additional reimbursement for the extra services.
- Accurate patient information
With all the processes involved in medical billing, the patient’s information should be the least of your concerns. To avoid hassles, make sure that your front-desk staff will get accurate and correct patient information particularly the full name, birth date, complete address, work information, and multiple contact numbers. Asking for the patient’s Social Security number is also a good practice as it can be very useful should the patient ignore requests for payments and when a collection agency takes over the case of non-payment.
- State-of-the-art software
Even if your old billing system still works for you, using updated software can be very advantageous on your part as it can make you or your medical billing staff more efficient and productive. Up-to-date software also reduces your chances of getting denied claims as it can tell you right away whether your claims are likely to be accepted or rejected based on the current billing policies for insurance claims, Medicaid, and Medicare. By using the latest software, you can receive automatic updates should there be changes in the rules. This software will also become particularly useful when the payer or insurance company accepts electronic medical billing for faster transactions and processing of claims.
- Copays, deductibles, and coinsurance
These three factors affect the patient’s healthcare expenses, so the medical biller should know very well how each of them works and when each of them kicks in.
- Fair and legal debt collection regulations and practices
To reduce risks, practice managers, physicians, and medical billers should have in-depth understanding of Fair Debt collection practices and clean claims. They must also be knowledgeable enough on professional courtesy regulations, guidelines on timely filing of claims, requirements for refund, and other important regulations.
By considering these five factors, the medical billing system in your practice will become more efficient and effective, thereby ensuring good cash flow.
Contact TukkoMed today and let us share with you the many ways we can make your Medical Office jobs more efficient and convenient.