Medical
billers should be highly attentive to details and follow best medical billing
practices to generate good revenues for the healthcare providers. The aim of
the medical billers should be to submit clear medical claims that get appropriate
and timely reimbursement from the insurance providers that help in improving
the collections for the healthcare provider. Medical billing can be a lucrative and satisfying career and there
are many companies that provide medical
billing jobs in Hyderabad.
Medical billing along with the
collection process is one of the most important factors in determining the
success and profitability of a medical practice. Here we will discuss few tips
to improve medical billing practice.
Initial
verification: Medical billers should always verify the insurance eligibility for
the patient before providing medical services. Many times inaccurate or
incomplete insurance information are the major reasons for the claim denials.
Vital information regarding patient’s identity and insurance card should be
collected from the patient at the time of check-in. It is advisable to keep a
copy of the patient’s identity proof and insurance card in the records to be
able to quote them in claims when required.
Benefit
verification: Ensure to verify the benefits applicable to the patient before
giving medical service. Contact the insurance provider if necessary and
cross-check the details. Double check the details regarding.
- the effective dates and validity period for the insurance
- deductibles
- copayments
- co-insurance
- prior authorization for any procedures
Coding
correct: It should be ensured that all the charges pertaining to the services
provided have been coded appropriately and billing is done for all the
services. It helps medical billers to understand the ICD 10 codes and identify
any errors committed by medical coders. In case of any mistakes, they can be
communicated to the coders to help them rectify those errors. This is a must
follow procedure to ensure that collections are not falling short for the
services rendered as wrong coding leads to denial or underpayment of claims in
many instances.
Appropriate
submission: It should be made sure that medical claims are submitted on
appropriate forms in accordance with the specific medical policies for insurance,
government regulations and guidelines. Get a hold on various insurance companies’
requirements for every kind of claims and provide all the required details.
Ensuring that the claims are submitted correctly at the first time itself makes
the claims recovery process easier.
Timely
submission: The insurance claims should be submitted as soon as possible
without any delay. It is a good procedure to set a deadline of 72 hours to
submit a claim from the time of patient’s arrival. Have a review of the
documentation of the treatment or service provided as early as possible to
mitigate any chances of incomplete information. In case of any omissions or
ambiguities, clarification should be sought from the physician immediately.
Payer
Contracts: Familiarity with payer contracts gets your claim processed more
quickly with lot more accuracy.
Follow up: Set
some standard procedures for follow-up and appeals for claims rejected or
claims not paid as expected. Ensure that these procedures are followed and
include the patient in the follow-ups if necessary. Including patient in the
follow up brings positive results many times.
Few procedures
systematically followed by medical billers can drastically improve collections
for a healthcare provider. If you are interested in joining the brigade of
medical billers, then, join Avontix, the best medical billing company in Hyderabad.
Visit: Avontix
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