Billing services
From primary claim submission to payment posting and everything in between, our team can make sure your practice is reimbursed properly and quickly through our comprehensive billing services. With a proven track record across medical billing, skilled nursing billing, aba therapy billing, speech therapy billing, occupational therapy billing, physical therapy billing, mental health including counseling, and more we can customize a plan to ensure you achieve consistent cash flow for your practice while minimizing overhead costs associated with in-house billing. No matter the insurance you accept be it, Medicare, Medicaid, Blue Cross, United Health Care, HAP, Cigna, or any of the other agencies we can handle the billing, verify eligibility, and request authorizations for you so you can focus on what you do best, taking care of your patients.
Services Offered:
- Eligibility verification
- Authorization request
- Claims submission
- Claims follow-up
- Payment posting
Clearing up some medical billing questions
What is medical billing?
Medical billing is an integral part of the healthcare system. A medical biller is responsible for keeping the balance between the patients, the service provider, and the insurance companies. The Healthcare system is a large, intricate, interconnected web but we can simplify it to the patient, the provider, and the insurance company. Even though it primarily connects the patients with the healthcare providers, there are usually insurance companies involved as a third party to every interaction the patient and provider have. The medical billers job is to ensure the insurance companies get all the required information from the providers in order to provide the best care to the patients.
Is medical coding the same as medical billing?
Even though medical coding and billing are interconnected, they are two very different activities. Medical coding is about translating the health conditions in the patients medical records into codes that the insurance companies understand.
Medical Billing takes the work from the medical coders and puts it into the claims that get sent to the insurance companies. During this process, the biller needs to validate the codes match what each insurance company expects and submit all the relevant information that each insurance company requires. The billing process doesn’t stop until the insurance company pays the healthcare provider.
What do medical billers do?
Medical billers are engaged throughout the entire claim process. Their work can encompass staying in touch with patients, healthcare providers, and insurance companies. They work closely with all of those parties to ensure that the whole process goes smoothly and nothing gets missed which can cause headaches for all the parties involved.
Medical billers must keep up to date with all the changes happening with all the different insurance providers they interface with. This allows them to ensure all the proper information is gathered from the patient at the time they receive their services. They will verify and cross check the information is valid for the insurance claim they will submit and submit the claim once the visit is complete.
Medical billers will continue to follow up with the insurance companies and make sure any questions or adjustments can be made for a claim to be successfully processed.
The medical billing process
The billing process starts when the patient enters the hospital or any healthcare provider and get registered. While they receive the treatment they need, medical billers can start working to cross-check all the patients data and ensure that they bill the insurance company and patient correctly.
Completing the whole process within the time limit for each insurance company can be confusing but is extremely important. Each insurance company has different deadlines for submitting claims and completing the payment process. This is one reason why medical billers must submit claims as soon as possible. This makes sure you have enough time to do necessary follow-up and receive payment as soon as possible.
Front-End vs Back-End medical billing
The billing process has two ends covering different stages, the front end and the back end. Both have separate tasks with various levels of complexity.
Front-end billing covers but is not limited to the registration process, starting when the patient registers in a hospital or office until they check out and pay their portion of the services rendered. They work closely with the health provider and the patient to ensure back end billers have all the necessary data to successfully submit a claim to the patients insurance. This includes having the doctors fill out the required forms to help the verification process go smoothly.
The work for the back-end biller starts even when the front-end is still at work. This is because the back-end works to verify the patient data ensuring everything is properly setup to submit a claim to the insurance company. The back end biller does many tasks, some of those include:
- Verification of coding and claim compliance
- Preparation and submission of claims
- Determination of payer Monitoring
- Creating patient statements or bills
- Allocating patient payments
- Organizing collections
With all the complexities of navigating the back end insurance process you want to make sure you have experts to ensure you are able to spend your time interacting with your patients and receiving timely payments rather then resubmitting claims and fighting with the insurance companies.