In a pandemic-ridden age, hospitals are struggling to put up with constantly changing health care regulations and evolving revenue cycle management requirements. As a result, they are finding it difficult to have effective billing and tracking procedures in place. This has led to such serious errors that their service abilities have taken a hit and slowed down growth opportunities. To negotiate these challenges, hospitals need to team up with a specialized third-party partner with end-to-end knowledge of Affordable Care Act (ACA), Medicaid and other healthcare programs,
MedBillingExperts has the expertise to help you adapt to changing times and needs. Our professional and efficient offshore hospital billing services is designed to help hospitals get rid of minor and major errors and reach their full potential. Our end-to-end knowledge of billing and coding processes will assist hospitals to augment revenue and at the same time improve customer satisfaction levels.
We follow a well-defined and structured process workflow that is the secret behind our simplified but accurate service delivery.
As part of this process, we check whether the patient is eligible for insurance benefits under their policy and whether there is any requirement for pre-authorization or referral. After verifying, we calculate all the deductible and the co-payment that needs to be made by the patient.
The medical coder goes through different sources of a patients file such as doctor′s transcription, diagnostic test reports, imaging reports and other sources to verify the services rendered and then assign appropriate codes.
We enter charges from patient documents into the patient’s account. If the patient is newly enrolled, we create a new patient account and fill all other pertinent details captured from forms filled up during registration.
We go through the scanned EOBs (Explanation of Benefits) to ensure that every minute details pertaining to the payment are filed into the system. This is followed by updating the data appropriately into patient accounts.
We identify the reason for denial, fix the issue and re-file the denied claim. If the claim is denied due to issues such as lack of adequate information, then the gaps are filled promptly. If the claim is denied due to shortcomings on the patient side, then the claim is billed to the patient.
We resolutely pursue unpaid claims to keep the AR days to the minimum. Our accounts receivable management team also ensures that denied as well as underpaid claims are appealed within the shortest possible time to ensure that they are processed and reimbursedon time fully on time.
Our patient follow-up process ensures that pending balances due after processing an insurance claim issent to the patient for collection. We also ensure that full statements for patients are prepared and filed every week/month as per the requirement of the client.
We offer credit balance processing for both payer as well as patient, after validating that an overpayment has been made. This service ensures that timely and accurate refunds are received by the appropriate stakeholder.
Our comprehensive service is designed to make hospital billing codes more accurate. Our services include:
As one of the reputed hospital billing companies, we have a robust and detailed insurance verification process to assist hospitals understand critical insurance aspects like primary and secondary coverages, deductibles, co-insurance, out-of-network benefits etc. It is during this stage that we verify and re-verify pre-authorization requirements by the payer to ensure there is no denials. Our fool proof verification process is one of the reasons for which our clients prefer to outsource hospital billing services to us.
Our medical billing and coding experts have in-depth understanding of ICD-10, DRG and procedural coding. We leverage this understanding to deliver medical coding services which is in abeyance with standard HAAD coding manual and HAAD adjudication rules. We code for different specialities and sub-specialities such as surgery, radiology, anesthesiology emergency etc. Our coders stay updated with the changing rules of coding compliance which is why we guarantee complete coding accuracy.
Our hospital billing denial management service is designed to assist you uncover the exact reasons for denial of claims. We track and analyze denials and suggest fixes for every denied claims. Aside from this, we set up a tracking mechanism to identify top denial categories, top payers in denying claims and list departments that get most affected by the denials. We build a multidisciplinary team for our clients to post-mortem every denials,get insights into trends, identify the categories that need to be addressed first, and find out the resolution.
We identify the reasons for the AR backlogs and help you improve your RCM process end-to-end. Besides, we provide custom-specific solutions for AR that require special treatment. Our experts stay in constant touch with insurance firms to follow-up on denied or pendingclaims, track accounts receivables balances, investigate claims denials etc. We also help you segregate collectible and non-collectible amounts to bill deductible/co-insurance charges from patients.
Track Accounts ReceivablesOur payment posting service provides your practice a snapshot of your financial position, thus empowering you to identify issues such as denials for non-covered services and prior authorization and resolve them fast. The snapshot gives you daily visibility into insurance payments from EOBs, checks from electronic remittance advice, patient payments, write-offs, adjustmentsetc. As a result, you will always be in a position to identify opportunities to increase revenue by nipping errors in the bud.
We are a HIPAA compliant hospital billing company and abide by all HIPAA requirements such as superior documentation, well-defined processes, and carry out regular audits.
We guarantee complete data security to our clients. We bank on firewalls VPNs, robust wireless networks systems, SSLs and encryption techniques to make data sf end secure.
We provide regular training to our coders to keep them aware of the constantly changing rules of the regulatory-bodies and other insurance payers.
We carry out routine claims audits to find flawsin existing processes so that they can be weeded out to guaranteefull reimbursements.
We guarantee high accuracy levels with the help of multi-level quality check process for each critical aspects of hospital billing.
We bank on superior technologies such as MediTouch, Nextgen, eClinicalWorks to streamline hospital billing processes for uninterrupted revenue flow.
We establish patient eligibility by checking their insurance policy for name, sex, age, address, and other relevant information
We seek prior authorization from the insurance provider by corroborating policy coverage and other necessary requirements
We eliminate billing errors by minimizing coding mistakes with quality checks and re-evaluating the codes to ensure it complies with standard coding requirements
"A reliable medical billing service provider like MedBillingExperts can help you focus on patients and provide seamless medical billing services. They are very easy to work with and help in expediting a clean claim. Once we chose to outsource medical billing services, we knew we were on the right track. In addition to making our billing process simpler and accurate, they ensure that the service is consistent, reliable, and advanced. Their team leaves no stone unturned to reduce claim denials. Each and every error is checked and analysed, and I have had them coming back to me with the reports to keep me updated. They are incorporating advanced technology in billing and you stand to reduce overall costs while getting the best medical billing services."
"The easiest way to reduce operational costs is to outsource medical billing services to a reliable provider and focus on core business competencies. Once I started my own practice, I had the option to opt for an in-house billing team or avail medical billing outsourcing services. I choose MedBillingExperts, to outsource medical billing services, and the team has been very helpful. They are a diligent team of medical billing experts and coders who deliver the best. I have reduced overall costs and increased the cashflow with my decision to outsource. Timely submissions of bills and professional billing teams can streamline your business productivity. I therefore, recommend MedbillingExperts for medical billing outsourcing services."
Go through this infographic to understand how outsourcing can assist your business with greater ROIs.
Learn moreThe easiest ways to gain efficiency and improve staff productivity is by outsourcing hospital billing services to a third-party service provider.
Read MoreA US-based hospital leveraged our billing services to cut AR days by 50% and reduce their overall receivablesby less than 10%.
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