Medical Billing Company

                                     A Medical billing company works as an extended office to the providers and hospitals.  Core objective of a medical billing company is to provide outstanding billing and coding services. Every medical billing company should pride themselves with outstanding customer services and accurate data processing. In order to run a successful medical billing company, it is vital to have excellent billers, coders and advanced user friendly medical billing software.

A medical billing company should ensure all the services performed and documented by the providers are billed accurately. They should provide best services at reasonable cost. A perfect combination of expert billers and advanced billing software help them to provide good services. As each client is different it is very important for the billing company to understand they need to provide customized client services.

A medical billing company needs to provide outstanding services by ensuring all the claims are paid on time.  It should also ensure cash flow for the client is maintained at optimal level. Most medical billing companies offer flexible pricing models like pay per claim, pay percentage of collections. This helps the providers to keep their administrative expenses under control, as they are able to estimate what they need to pay and when they need to pay.

Usual medical billing services includes provider credentialing, benefits verification, demographic entries, charge entries, electronic and manual claims submission,  Insurance and patient claims follow-up, denials management and more.

As providers depend a lot on medical billing company’s performance for their cash flow, it is very important for them to choose the right medical billing company. Providers usually look at different aspects before choosing their billing office, which includes:

• References – Does any of my peers use your services
• Experience – Do you have the experience in billing my specialty
• Pricing – Fee structure / Upfront Fees
• Software – Access & Easy to use
• Customer support and services
• Compliance – Efforts and procedures in place to protect PHI

Medical billing company reduces and in some cases eliminates majority of the administrative expenses incurred by the providers. Providers need not spend thousands of dollars in consistently changing technologies. Provider’s expenses on recruiting, training and retaining experienced billers are eliminated. 

    Each client is different. Some clients like to participate more on each process whereas other clients just focus on results. It is very important for the medical billing company to understand this and facilitate the client requirement.   Transparent process and customized reports are absolutely necessary in order for the client to understand their practice performance.

Medical billing is a complex process involving ICD, CPT & HCPCS codes. Medical billing company helps the providers to handle many complex processes easily.  Its experience billers and coders’ process and follow-up on all claims and receivables on time.  Medical billing companies need to keep up with all the changes involving latest technology, health plan, security and more to provide outstanding services to their clients.

Medical billing company’s main task is to reduce the paper work for medical staff and recoup lost efficiencies caused by inexperienced staff.

Inter dependency of Healthcare providers and insurance companies

            A healthcare provider is a person which introduces various healthcare services like preventive, curative, promotional or rehabilitative to an individual or a community.  It can be a surgeon, obstetrics, dentist, nurse, pharmacist, psychologist or any other allied health professional. Healthcare providers and insurance claim are the two important terms nowadays, both are interdependent on each other. Insurance company is an entity with equitably transfers the risk of loss between other entity in exchange of money.

Relationship :

              The relationship between the healthcare providers and insurance companies can be explained as vendor and subcontractor. The healthcare services are provided after the contract has been made between healthcare providers and the insurance companies. It all starts with a visit to the physician’s office or merely by meeting the staff, followed by getting update on the patient’s health record. After examining the patient the physician provides the diagnosis and procedure codes which helps insurance company determining the insurance claim.

Services :

          The healthcare examiners assist the insurance companies in processing the claim. After approval the claims go through several billing services. For few years the entire process was executed on paper, as a result which gave lots of errors and difficulty in handling claims in large amount, hence the term was introduced “Medical Billing Outsourcing”, to avoid this load the billing is outsourced to the third also known as Medical billing services. A part of the revenue generated by practice was taken by these billing services as payment. It was done to achieve to goals first to reduce the burden of paperwork and increase the efficiency which was reduced because of workload surfeit. Another major reason to opt this method over normal way of medical billing is the difficulty of keeping staff and billing systems up to date as latest billing rules becomes a distraction for health care providers and executives.

             The expertise of billing is the mind and this method of outsourcing is body as it’s their responsibility to study the case and process the provider’s claim   properly to maximize insurances payment. They are the one who are responsible of taking codes and preparing bills without errors as it is to be further forwarded to the insurance companies now it’s the task for expertise of medical billing to execute the billing process so that the denials of insurance companies is avoided. Trend is also another factor of medical billing outsourcing as it reduces the cost in potential manner.

Medical Coding Services

              We offer flexible medical coding services helping our clients to reduce their denials and optimize their revenues. Our Medical Coding team of professional coders are well experienced in procedural and diagnostic coding. We ensure all performed / documented procedures are coded accurately. Our medical coding services will reduce your compliance risk and help you stay focused more on your core activities. We clearly understand the liability issues associated with incorrect coding and thrive to deliver with high quality.

            We have been preparing well to face the challenges related to ICD-10 transition. Our team is trained and ready to take up ICD – 10 coding. We have a detailed action plan to handle ICD-10 transitions for our clients. We will ensure our clients cash flow does not get affected during ICD-10 transitions and claims get paid on time.

            Our certified medical coding professionals focus to avoid any down coding or up coding. We strive hard to be accurate and assign our coders to any project based on the specialty. We can assist you immediately on your short term or long term coding assignments. We are one of the best Offshore Medical Coding Company.

Our Medical Billing Outsourcing Services includes:.

Offline Medical Coding Services:

              We receive reports through our secured FTP site (256 Bit Encryption) and provide you with the report consisting of Patient Name, Date of Services, ICD & CPT codes with necessary modifiers.

Online Medical Coding Services:

             We access your medical records online through a secured VPN connection. We instantly code them directly into your Medical Coding software.

Our team of well experienced AAPC certified Medical coders strictly follow the guidelines of:

• National Correct Medical Coding Initiatives
• Local Coverage Determinations & Medical Policies
• Local Medical Review Policies

Our certified coders are well experienced in:

• CPT, ICD and HCPCS coding
• Payer specific coding requirements
• Insurance and governmental regulatory requirements

Our tools:

• Medical Coding Books
• On-line Software
• Desktop Coding Software
• Continuous on-line training programs