Most physicians dont even realize how much money they are losing to overworked and undertrained staff. 

Physicians generally blame the insurance companies for the decrease in income they are all experiencing.  Without a doubt reimbursements are down across all specialties.  This fact makes it so much more important to have reliable well-trained staff willing to fight for every penny.  Unfortunately most staff is either undertrained or overworked, or both.   It is a common practice for large and small company staff to write-off charges just to avoid a fight with the insurance companies, effectively throwing away hard earned money!

At PCL we won’t write off a payable penny.  Read through the website (http://www.medicalbillingpcl.com/methodology.php) and contact us; we will be able help you collect every penny of your hard earned money.

Medical Billing Software Features Your Next Practice Management Software Should Have

So now that you have decided to buy medical billing software, here are the features that you need to look out for. These things are an absolute must in the medical billing software that you will buy. The features cover several major areas of your medical facility, like administration, billing, scheduling and revenue management. Some features have overlapping categories but that is only a matter of perspective. All of them put together make the best medical billing software package for a medical facility.

Medical codes – These include CPT, ICT and HSPCS codes. The software should either come preloaded with these codes or the package should contain the codes on a disc. It is important to have these codes because they are one of the most tedious things about medical billing but they are also one of the most important things. Getting them wrong can really ruin your relationship with your client. Get a software package that allows you to simply point and click these codes whenever they are relevant.

Prescription Writing, Custom Report Writing and Patient Statements – These are the areas where the data supplied must be absolutely exhaustive because the patient’s further treatment depends on it. So having software that makes the supply and processing of data easier and more efficient is a good idea. By custom report writing I mean that the software should be flexible enough to let you switch between things like statements, reports or claims whenever you need to.

Medical Billing – Medical billing software is not of much use without a feature packed billing section. A graphical interface here will be of immense help here so that you can just point and click to edit or add anything you want. This will well and truly speed up the entire process for both you and your customer. Customers can now make quicker claims thanks to the fully featured electronic medical billing system.

Medical And Revenue Scheduling – Scheduling is one of the most important areas of a medical facility, be it medical or revenue scheduling. With advanced features in these areas, you will be able to instantly recall, change and reschedule appointments. It will also be helpful if you get to decide what information will appear along with the patient’s appointment. Choose a software that has these basic features.

Audit And Security – Audit is a very important administrative feature that allows the administration wing to track every action that is taking place. The security feature helps the administration to distribute duties and responsibilities amongst the employees. It also ensures that employees have access only to those areas that are individually relevant to them. Both these features work together to give you a better control over everything that is being done through the software. This also makes it possible to track individual performance.

Once you have found software that matches all these requirements, you are good to go. Of course, there are also quite a few other features that you might think are important to you. Add them to the list when you go out shopping for the perfect medical billing software.

How Medical Billing Solutions Help Your Medical Practice

Medical billing is often one of the most frustrating points of the medical industry, if you were looking at it from an administrative standpoint. Without funds coming in, staff would not receive their checks, new supplies would not come in, and specialty services of a doctor could go out the door. It’s not surprising that in the medical industry billing has fallen to its specialists in the field, for instance the medical coders, and medical assistants. However when payrolls are interfering in the care of the patients, billing had to develop, in some cases even as its own business model. Firms who practice this are often independent from the medical practice in question, and held in equal standards when it comes to client document handling. Medical billing solutions prioritize work, improve cash flow to the business, and improve the quality of healthcare most of all.

Any administrative expert in the medical field will know that paperwork rules all, be it legal, health, or payment wise. The professional has enough to worry about when you factor in affidavits, charts, subpoenas, laboratory results, referrals, insurance, information requests, transfer requests, paper forwarding’s and appointment scheduling on top of providing a safe place for patients and their procedural practice rooms. When these professionals need to dedicate time to getting the bill taken care of, they take precious minutes away from what they could be using to helping patients. Medical billing firms solve this issue, by lightening the load of the medical professional (at cost effective means).

Medical billing solutions do lighten the load of their clients, but they also do a fundamental thing for the office; they use their dedicated experience to collect money in a professional and timely manner. You may know that in the medical industry insurance groups are fickle in regards to claims policies, as well as reimbursements. There’s a two way street here, one requires legitimate papers to verify claims, while the other has to perfect the paper to get money for their building. The professional who is dedicated to billing tends to eliminate the guesswork when it comes to a denied form. Additionally the billing firm who values their business knows when not to step past what they can do when billing clients. Since billing firms dedicate their time to billing, they seek the appropriate means to get the clients money.

Lastly, medical billing solutions extend past optimization. Their ability to free up billing allows the medical professionals to work on their trade of care, healthcare. Furtherly, paperwork disappearing contributes to a brighter atmosphere in terms of relieving stress, not to mention letting others listen to the yells that are an unfortunate matter in the field of bill collecting. Medical professionals are more optimistic and have a brighter self esteem, befitting the kind of people that medical organizations need to have in order to run a successful medical practice.

For more information visit: http://www.medical-billing.com/services.php

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What all Medical Billing Consultant Can Do For Your Practice

Being a doctor is a gift and a matter of great privilege and pride. But it is also a way of making a living. It is important to take all the necessary steps to maintain profitability and credibility of your medical practice. You can effectively and efficiently handle the consultation and treatment part but when it comes to medical billing, you need medical billing services to put into practice skilfully designed billing solution to perk up your earnings. Only an expert medical billing consultant can show you the accurate process of filing claims to make your medical billing competent as well as effective for your patients. So why waste time struggling with the medical billing when you can put it to a better use by treating people?

All general practitioners know that outstanding office management is much more than ensuring that your medical billing practices are efficient. When your needs extend beyond medical billing services hiring a good medical consulting firm can make sure that your office runs like clockwork. Active Management is one such veteran medical consulting firm that helps you get the business end of the office in great shape.  Born out of exasperation of doctors trying to balance patient care with managing a practice, medical billing consultant of Active Management can help you tweak your trouble areas or overhaul your existing system completely to make things run much more smoothly.

Rules and regulations of insurance industry keep changing and becoming more complex and confusing. In such a scenario, keeping tab on increasingly difficult insurance industry can be overwhelming unless you are trained and experienced in medical billing practices.  A seasoned medical billing consultant from Active Management will not only sort out medical billing woes but also help you find the best people for your available openings, and also advise you on how to train them for maximum efficiency.

Active management helps you surmount the most challenging facet of healthcare industry which is to achieve effective organisation and profitability within the rigid constraints of the “managed care” billing environment while sticking to high standards of legal, ethical and professional standards.

Efficient Medical Billing Practices Vital For Blooming Medical Practice

Medical billing practices need precision which can be a painstaking process if you are not skilled in it. You will then need to employ staff to work exclusively on medical billing and end up paying fat salaries to them. Not only this, you also need to see to it that the employees working on medical billing are doing their job properly. This can be additional responsibility and will take a major chunk of your precious time. In fact, Medical billing practices can cost you time, money and peace of mind. Many doctors now days, have started realizing the importance of handing over their medical billing practices to professionals who have the expertise to deal with it. But it’s a big question as how to find a reliable and affordable medical billing service provider? It’s also very important that the medical billing consultant you hire should be able to tackle your specific needs. Well, your search ends at www.activemds.com.

Medical billing practices can be frustrating if you fail to understand the complexities of medical billing. It does happen that when you try to manage the Medical billing practices in house, on your own you realize that you seriously lack much needed expertise. You may also not have sufficient number of employees needed to run the whole electronic billing system. Your employees may have limited knowledge and may not be aware of the latest changes happening in the industry. When working with Active Management this will never be the case. They have all the expertise, software and hardware available to provide you with the best possible options and medical billing solutions. To know more about their systems and procedures, visit www.activemds.com.

Active Management has a clear advantage over others when it comes to medical billing practices. They not only have the latest knowledge but also constantly keep upgrading themselves as per industry needs. This enables them to make accurate recommendations in organizing your medical billing and other billing related systems like insurance claims etc. Active Management is capable of offering variety of Medical billing practices because of the large number of employees they have. They offer variety of services like Medical billing, electronic submission of bills, electronic medical claim services, accounting and medical records. Medicare is another essential part of medical billing practice. Active Management can provide complete consultancy in medicare insurance of all types, let it be Part A, Part B or Prescription Drug Coverage.

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Choosing the Right Medical Billing Service for your Practice

Outsourcing their billing tasks helps medical practices reduce voluminous paperwork, as well as the expenses involved in managing an additional workforce and infrastructure to do the process in-house. Choosing the right medical billing service provider is important, considering the fact that you need medical billing solutions to suit the specific needs of your medical practice.

Facilitating Prompt Submission of Medical Bills

Medical billing is a lengthy, time-consuming procedure that needs to be done with great accuracy. In fact, any flaws in processed medical bills or claims would lead to denials and rejections. Choosing the right medical billing service enables you to submit error-free medical bills and insurance claims promptly, which definitely goes a long way in maximizing the revenue of your practice. Further, these services considerably lessen your managerial responsibilities and help you concentrate on your core competencies, especially providing high quality medical care for your patients. Outsourcing your medical billing tasks to a reliable outsourcing company ensure an array of benefits including:

• Secured file transfer in 256 bit encrypted forms as email or FTP
• Excellent quality assurance
• HIPAA compliance
• Status reports on daily, weekly and monthly basis
• Minimum turnaround time
• 24/7 technical assistance and customer support

Customized Medical Billing Solutions

Established medical outsourcing companies have skilled experts and advanced technologies working to deliver customized medical billing solutions. With excellent know-how in the latest medical billing and claim processing rules, and the use of medical billing software such as Lytec, NextGen, Medical Manager, Misys and more, these professionals process bills and claims accurately and quickly. Important services covered in medical billing include:

• Patient enrollment
• Insurance verification
• Scheduling and rescheduling
• Insurance authorization
• Billing and reconciling of accounts
• Medical coding
• Payment posting
• AR collections

Before outsourcing the medical billing jobs of your practice, it is advisable to first search online and get information on reliable service providers, core services offered and pricing. This will help you to choose the right medical billing service which guarantees consistent solutions in rapid turnaround time at affordable rates.

What a Medical Billing Company Can Do for Your Practice

Just because a doctor owns his own practice does not mean that he is doing particularly well.  It might be true, but it also may not be.  A physician does not necessarily have the right business skills to run his office and will not be very successful monetarily.  They can be the best doctors in the world but they must have the right skills in billing for their practice to reap the rewards.

If the doctor is smart enough to recognize this weakness, he can hire the services of a medical billing company to take care of all his office needs.

Trained professionals who know all the ins and outs of insurance and medical billing staff a medical billing company.  They are capable of handling all aspects of making claims to the insurance company and getting the payments in on time.

Insurance companies don’t make things easy for the medical practice.  They have a tendency to deny claims at the drop of a hat. 

If the practice is very busy and sees a great many patients there will be a lot of claims that need to be submitted to the insurance company.  If only one member of the practices staff is handling this they will have to manually fill out and submit the claims for every patient that goes through the office.  If there is one mistake on these claims the insurance company will deny it immediately and send it back.  Now that one person has to refill out the form correctly in addition to the new claims that they must do every day. 

Even when everything is done right it can still take the insurance company a very long time to send the payment.  For a small practice this can spell disaster.  If there are a couple of denials and late payments this can effectively put the practice out of business. 

A medical billing company can put all of those worries to rest.  The staff of the practice will no longer have to do all of the work that is required for the insurance companies.  The billing company utilizes professionals who will be able to get all of the claims filled out and filed in a timely manner.  They will also be able to use electronic means to file the claims.  This gets rid of the manual method of submitting claims.

The professional at the medical billing company will also make sure that the claim makes it all the way through to the insurance company and is paid.  They take the time to monitor the claims all the way through the process.  Medical billing companies have a very high success rate for getting their claims paid.

When a claim is submitted electronically it will be denied or accepted immediately.  When it is accepted the funds will be sent to the practice within a few days instead of the months that it could take with a manual system. 

For a smaller practice this is a big deal.  To get their money in a timely manner is the one factor that will decide if they are in business in a week.  For practices that think a medical billing company is too costly to justify, they should sit down and figure out what it is costing them to do it in their current manner. 

This type of billing company will be beneficial for any practice, regardless of the specialty.

Use Electronic Medical Billing Software and Make Your Medical Practice Easier

This technology helps medical practitioners in lessening their workload. This may be good because this allows them to focus on matters that are more important such as the client’s health. This is a great tool for organizing and managing hospital billings of clients. This is also a great help for those who are involve in the medical market even if it is just a small medical practice. This can make the billing for a client a lot easier than the manual way. It also insures the billing will have no errors, which have been a problem before due to lost records or wrong records.

Today, there are many medical billing software available in the market. They are widely used for automated reports. The variety is good since we can choose from these programs that suits our needs and budget. Some of these programs are more suitable than the others when it comes to our medical billing processes. It is best to choose the one that can meet all our needs. They may cost more than the others may but they can perform better and allows us to do the proper billing on the clients. On the other hand, some of these applications may be too accessorized for the billing processes. Therefore, it is best to choose the one that fits your billing processes.

With just the click of the mouse, you will be able to see the needed information on the client. In can display information such as history of the client’s ailments, personal data, done treatments and medicines consumed. This makes the billing process a lot easier than ever before. You just have to put some data send the billing claims to the patient.

The software also eliminates the usual paperwork that piles up in the office. All the data are saved electronically within the software. This saves up office space and up money used in creating and storing files of patients the old way. This also ensures that the data on the patient will not be misplaced or lost. It is also easy to make a mistake in the information from the old way of billing. With the software, you can simply edit the wrong information easily.

It can save us time in billing customers. Other things such as insurance related companies can sometimes prolong the billing process. There is lots of paper works that needs to be completed first before you can send the final billing to the patient. This in return, will prolong the payment of the patient. The software helps eliminate this by creating an organize way in billing the customers and incorporating the insurance companies related automatically. It can also present the eligibility of a patient to be covered by an insurance company on the medical procedure. This may eliminate the century old verification process through the phone. All the verification process can be done with just the use of the medical billing software.

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In House or Outsourced Medical Billing: Which Model is Right for your Medical Practice?

The decision to change an existing medical billing model should not be taken lightly. After all, it’s only cash flow right? Even the best case scenario involving a change to/from an in-house or outsourced medical billing model will involve some degree of short term cash flow disruption and we won’t even bring up the worse case scenario.

A health care provider’s first step is to determine whether or not his/her current medical billing model is achieving the desired financial result. Although financial analysis is beyond the scope of this discussion, the provider, accountant or other financial professional must be able to compare actual financial data to revenue and operating budgets. Assuming the integrity of the practice’s financial data is intact though accurate and timely data entry, the provider’s medical billing software should possess the capability of generating actionable management reports.

In the end, basic financial analysis will shed light on the strengths and weaknesses of the provider’s medical billing model. Some things to consider when evaluating a medical billing model: the inherent strengths and weaknesses of in house and outsourced medical billing models; the provider’s practice management experience & management style; the local labor pool; and medical billing related operating costs.

In House versus Outsourced Medical Billing Models

No medical billing model is without unique advantages and pitfalls. Consider the in house medical billing model. Approximately one third of independent health care practices utilizing an in house medical billing model experience cash flow issues ranging from periodic to persistent. The degree of action required by a provider to resolve his/her cash flow issues may range from a simple adjustment (adding staffing hours) to a complete overhaul (replacing staff or switching to an outsourced medical billing model).

The provider with an under performing in house medical billing model has a clear advantage over the provider with an under performing outsourced (also known as third party) medical billing model: proximity. An in house medical billing model is within walking distance. A provider has the opportunity to observe, assess and address – observe the process, assess the system’s strengths and weaknesses and address issues before they become full blown problems.

Consider the provider with an outsourced (also referred to as “third party”) medical billing model. The relatively low entry barriers of the third party medical billing industry have led to a proliferation of medical billing services scattered throughout the United States. Chances are the provider’s medical billing service is located in another geographic area making first hand observations and assessments impossible.

The role of management reporting in a third party medical billing model is critical. A provider must regularly review charge entry, posting, write offs and account receivable balances to insure his/her cash flow is properly managed. A report as basic as 30, 60, 90 days in receivables will quickly give a provider a good idea of how well their medical billing and account receivable processes are being managed by a third party medical billing service.

A common mistake for many providers with an outsourced medical billing model is to gauge the effectiveness of the process in the very short term, i.e. week to week or month to month. Providers maintain a vague and informal sense of their cash flow position by keeping mental tabs on the checks they received this week versus the prior week or if they deposited as much money this month as last month. Unfortunately by the time a weakened cash flow gets the provider’s attention a much larger problem may be looming.

What causes a slow down in cash flow in the outsourced medical billing model? The most commonly cited scenario is lack of follow up on the part of the medical billing service. Why? Like any other business, medical billing companies are concerned first and foremost with their own cash flow.

A medical billing company generates 99.99% of their revenues on the front end of the medical billing process – the data entry process that generates claims. Medical billing companies that devote nearly all of their manpower to data entry will be understaffed on the backend of the medical billing process – the follow up on unpaid claims. Why? Every hour of data entry generates an additional one to two hours of claim follow up. Unfortunately for the provider, a medical billing company that ignores does not devote enough manpower to the diligent follow up of 30, 60, 90 days in receivables can mean the difference between a provider making a profit or suffering a loss during any given time.

Practice Management Experience & Management Style

Providers with practice management experience will be able to effectively manage or recognize and resolve a problem with his/her medical billing process before the cash flow crunch gets out of hand. On the other hand, providers with little to no practice management experience will more likely allow his/her cash flow to reach a critical stage before addressing or even recognizing a problem even exists.

Whether a provider with medical billing issues chooses to retain and fix their current medical billing model or implement an entirely different medical billing model will depend to a great extent on his/her management style – some providers cannot fathom having their medical billing staff out of sight or ear shot while other providers are completely comfortable with turning their medical billing process to a third party medical billing service.

Local Labor Pool

Whether a provider chooses an in house or outsourced medical billing model, a successful medical billing process is still contingent on the people involved in executing the medical billing process. On a side note, choosing office staff for an in house medical billing model is similar to choosing a third party medical billing company. Regardless of the model, a provider will want to interview the potential candidates or an account executive of the third party billing service for experience, motivation, team oriented personalities, highly developed communication skills, responsiveness, reliability, etc.

Providers with an in house medical billing model will have to rely on their human resource and management skills to attract, train and retain qualified candidates from the local labor pool. Providers with practices located in areas lacking qualified candidates or with no desire to get bogged down with human resource or management responsibilities will have no other choice but to choose an outsourced medical billing model.

Medical Billing Related Costs

As a business owner, the provider’s primary responsibility is to maximize revenues. A responsible business owner will scrutinize expenditures, analyze returns on investments and minimize costs. In an in house medical billing model, costs associated with the medical billing process range from the Internet access used to transmit claims to the office space occupied by the medical billing staff.

The most effective way to manage medical billing costs is for the provider to think of the sum of those costs as a percentage of the practice’s revenues. The provider’s accounting software should allow for him/her to classify and track medical billing related costs. Once the medical billing related costs are identified, dividing the sum of the costs by total revenues will convert the medical billing related costs to a percentage of revenues.

The exercise of converting medical billing related expenses to a percentage of revenues accomplishes three things: 1) gets the provider, business manager or accountant in tune with the medical billing related costs of the practice; 2) provides a basis for more in depth analysis of the practice’s cost and revenue components; and 3) allows for easy comparison between the cost impact of the in house versus outsourced medical billing models.

The cost of an outsourced medical billing model is fairly straight forward. Since the fees of the vast majority of medical billing outsourcing services appear to be a percentage of a provider’s revenues, the annualized cost of the medical billing service’s fees will be a fairly close approximation of the provider’s medical billing related costs for this model.

In the event a provider is considering an outsourced medical billing model, he/she should keep in mind that this model is not necessarily the silver bullet to ending all medical billing related costs and headaches that medical billing services tend to advertise. True the medical billing company will acquire some of the costs associated with the medical billing process but the provider will still need staff to act as the intermediary between the provider’s office and billing service, i.e. someone to transmit data to the billing service.

Costs will further increase for the provider if the billing service charges additional fees for add-on services such as on line access to practice data, practice management software, management reports, handling patient inquiries, etc. The actual cost of the service will increase even more if claims 30, 60, 90 in receivable are not properly worked to facilitate adjudication.

Summary

In summary, the provider must carefully weigh the pros and cons of each medical billing model prior to making a decision. If the provider is not comfortable or experienced analyzing financial data he/she must enlist the services of an accountant or other financial professional. A provider must understand the costs as well as the inherent pros and cons of each medical billing model.

Providers employing an in house medical billing model need to understand the true cost of their process. Determining the true cost not only requires accurate financial data and accounting but an objective evaluation of the components of his/her current process, i.e. technology and staff. Why? Outdated technology, under staffing, turnover, or unqualified staff may contribute to the appearance of a low cost of ownership but those shortcomings will ultimately cause a loss of revenues.

In the event a provider is determined to utilize a third party medical billing service, he/she should invest the time to thoroughly familiarize him/herself with the medical billing outsourcing industry prior to interviewing prospective billing services. The provider must understand the hidden costs associated with the outsourced medical billing model in order to make an informed decision.

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