Outsourcing Medical Billing – Medical Billing Services

There are many medical billing services in the market competing for clients. However, with the new healthcare legislation and aging of today’s baby boomer population, there is a huge need for medical billers in the healthcare field. Healthcare provider needs to first determine their own needs, and then look for a billing service that serves their purposes. Most providers offer only billing services. They collect bills by submitting claims accurately and follow up on the payments. Some providers work only for small businesses, which are usually individual setups that offer specialized medical services. Large practice management companies offer comprehensive medical billing services that can include administrative services.

Outsourcing Medical Billing

Traits of a Good Medical Billing Service Include:

The billing service provider must follow up on payments aggressively and persistently. Insurance carriers can reject or deny claims on administrative technicalities. The provider needs to ensure forms are filled in correctly so that insurance carriers do not have an opportunity to reject them, monitor government programs to ensure accurate payments and pursue all billing collections with enthusiasm.

The Health Insurance Portability and Accountability Act (HIPAA) mandates the privacy, security and protection of patient data. Medical billing providers are also privy to confidential patient information, and should comply with HIPAA regulations, and all acceptable business practices set forth within the industry for collections. Medical billing providers should be familiar with the billing system, software, types of forms and the deadlines for each type. Claims must be filed within specified timelines or the insurance company will reject them. Additionally, knowing the rules and requirements of each payer is mandatory for successful medical billing.

Some billing services providers have a specialty focus in a particular billing protocol. They promise better collections than general medical billing providers do because they know the field intimately well.

By: Dawn Moreno, PhD, CBCS, CMAA, MTC. Lives in the beautiful Southwest United States and has been an instructor for medical coding/billing for the past 7 years. Interested in quality medical billing training?  

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