In the world of medical billing solutions, there are several services that a company can handle for you, or your business, to save you time, money, and stress in the medical billing process.
The Top 5 medical billing solutions you can expect to have handled when you use a third-party medical billing company are the following:
1. UTILIZATION REVIEW
During the process of a medical billing company handling all of your individual or business needs, utilization review is used as a checks and balances of sorts for everything that has been included on the services rendered section of a medical bill.
As an individual, if you accessed treatment that a doctor recommended, or if you participated in a mental health or substance abuse rehab treatment program, the utilization review will determine what part of the costs endured were covered by your health insurance carrier, and which parts are left as your responsibility. A third-party medical billing company will investigate all ends of the situation with a utilization review to make certain your insurance company is covering what was promised.
As a business owner or operator, you have a lot to take care of on a daily basis. Adding the management of health insurance coverage for your clients is most likely unrealistic. A medical billing company will take care of the process for you, first by putting an appropriate utilization management system in place. If services are rendered that come into question, a utilization review will be used to determine what should be paid to your business.
After the medical billing company determines what is owed to you, your business, to the medical professionals, and by the insurance company, the medical billing company will also handle the collections process.
A good medical billing company has established positive and long-term working relationships with medical, mental health, and substance abuse rehab healthcare providers. Mutual trust, consistency, and real-time follow through creates a solid foundation for collaborating to streamline the medical billing process for you or your business.
When it is determined that you, or your business, are owed money based on the results of the utilization management and/or review process, the medical billing company will communicate on your behalf to collect funds owed to you.
3. ELECTRONIC BILLING
Once your account is setup with a third-party medical billing company, the team at that company will take care of all billing electronically. The company’s staff are fully educated and trained on all aspects of the medical billing process, which includes knowledge of billing codes that medical, mental health, and substance abuse rehab healthcare professionals use to communicate services rendered to the health insurance companies, who also use the codes to understand what portion of the cost applied to each code applies to the service user, the service provider, and to the insurance company.
The trained medical billing and coding specialists employed by a medical billing solutions company examine all parts of electronic bills sent from services providers, like doctors, hospitals, mental health facilities, and alcohol and drug rehabs. When everything is done electronically, the speed at which claims are processed is increased, and the time in which any errors are found and corrected can occur in real time.
4. FOLLOW UP & CLAIMS
Health insurance companies do not necessarily stop after you, or the third-party medical billing company has submitted claims. Generally there is follow-up needed throughout the claims process, especially when you have a high turnover rate among clients, based your business model. A good medical billing company will stay on top of all follow up needs with the health insurance companies and with your clients.
If the health insurance company denies a claim for any reason, the medical billing company will work directly with them to determine why the claim was denied, and where the problem lies. You will not have to be involved in any of that headache while utilizing a third-party medical billing company.
5. CLIENT CONFIDENCE & PATIENT CARE
A good medical billing company knows that you need to feel comfortable with the process, and that when running a client-intensive business like a mental health or substance abuse treatment facility, your clients need to be your priority.
When you build a relationship with a medical billing company, you will need to feel confident in the work of the company, and in the time, money, and stress it saves you in the billing process so that you can stay focused on best treating your clients.
Kenneth Gray is an expert at providing medical billing services for health care providers and individuals through his company A-Fordable Billing Solution.