Healthcare providers have been struggling with constantly evolving clinical reporting practices. The healthcare industry’s shift to result oriented payments in the form of reimbursements is likely to continue expanding. This does not automatically imply outsourcing billing to a third party. Electronically recording clinical data through EMR software has generally been looked upon as a positive shift in medical practice since it results in an empirical approach to understanding data and transmitting it between various stakeholders. With a majority of practices currently using EMR software, clinical and documentation errors have started to minimize and as more and more doctors join the trend, such mistakes will keep getting lesser and lesser. As a result, accurate claims will be filed with insurance carriers which will have a direct impact on the number of claims rejected.
In addition, an efficient billing team would keep itself updated on changes in rules and laws regarding insurance payments hence handling claims in an efficient manner. With persistent analysis based on updated information, a billing team can keep evolving better and successful methods and processes of filing successful claims.
Furthermore, debts from patients need to be kept in check at all times. Quite a few practices group accounts from a particular time period and come up with a method to bill them. In this regard, varying follow-up methodologies could be created based on value of the debt and the time since the debt is outstanding. In most cases, if a particular account has remained unpaid for over four months, there is a high probability that the provider’s staff or the insurance company has committed a mistake. According to one source, around 19% of all claims that are denied turn out to have been a mistake by the insurance carrier.
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A time of four months in accounts receivable is not so uncommon for physicians. More than 10% of debts for a majority of providers go over four months and are unfortunately written off as bad debts. Medical billing services, on the other hand, are much feistier in their attempt to recover debts, often turning out to be successful in cases where in-house billing teams tend to fail. Therefore, providers facing outstanding debts for longer times have much to gain by outsourcing their billing to a renowned medical billing company to experience higher revenues and much shorter billing cycles.
The writer is a leading Health IT analyst contributing regularly on some of the most pressing topics like Electronic Health Records, Practice Management, eRx, Patient Portal, Billing Services, Compliance and Privacy and Security.
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