Monthly Archives: October 2012

Nevada Medical Billers Help Increase Patient Payments

Though the Affordable Care Act has put medical insurance within the reach of many, healthcare costs continue to rise and patients are paying more money out-of-pocket than ever before. When patients are unable to cover the cost of care (whether it is due to high co-payments and deductibles or financial difficulties), it can make healthcare organizations experience disruptions in cashflow and even lose money owed for serviced rendered – and this is something that no Nevada physician wants.

The good news is that there are ways for providers to increase patient payments, and working with a Nevada medical billing service can help. Here’s how:

Monitor patient accounts and payment status on a regular basis.

When healthcare practices are understaffed, it can be difficult for employees to keep track of past-due accounts and late-paying patients. However, continuously following up with these patients is the only way to ensure payment. By hiring a Nevada medical billing service, physicians can focus on the medical side of the business while billing experts handle billing and collections. This can involve working out payment plans with patients and monitoring accounts to ensure that payments are being made on time.

Appeal denied claims.

When an insurance company denies a medical claim sometimes the healthcare facility ends up writing it off, but other times the responsibility falls on the patient. With either scenario, the medical organization can end up losing money. Not all denied claims are rightfully denied, however, and medical billers should know how to spot ones that can be resubmitted for appeal. By using electronic claims processing software, for example, experienced medical billing companies are able to track all submitted claims, find the reason why certain ones are denied, and collect the information necessary in order to appeal them.

Check if patients qualify for Charity Care Assistance.

Uninsured and underinsured patients who receive medical treatment at hospitals are often left with large medical bills to pay and don’t have the resources to do so. This means that very often hospitals bill for services but never receive reimbursement, as patients are financially unable to make payment. There are, however, government funds which can help patients and hospitals in these types of situations. The problem is that many patients do not know about these programs, and therefore never apply to see if they are eligible for aid. Hospitals who wish to increase patient payments should work with patients facing financial difficulties to verify charity care eligibility. In order to qualify, patients are typically required to meet all three of the following requirements:

  • Have no health coverage or partial health coverage
  • Do not qualify for private or government-sponsored coverage
  • Meet specific income and assets eligibility criteria (varies)

Third-party billing companies often help healthcare organizations determine patient eligibility and can also set up payment plans for patients who do not qualify for charity care or only qualify for partial assistance.

Are you looking for a medical billing company that can help get your organization’s accounts in order? Contact 5 Star Billing Services at 480-821-1371 to learn more about the benefits of working with our five-star billers.

Third-Party Medical Billers Facilitate Collections for Iowa Providers

Iowa medical billing service rep

Are you an Iowa provider struggling to meet your practice’s billing demands while providing high-quality patient care? Many small physician practices find that working with a third-party Iowa medical billing service is the best way to maximize revenue streams while focusing on care delivery. Here are some of the reasons why Iowa physicians choose third-party medical billers for their billing and accounts receivable processes.

When billing departments are understaffed, it slows down incoming cash flow. By outsourcing medical billing to a third-party service, however, Iowa healthcare providers do not have to worry about employee shortages or gaps in the collections cycle. Instead, third-party billing professionals ensure that billing processes are carried out on time and that incoming cash flow remains constant.

The hiring process can be never-ending for practices with a high employee turnover rate. Not only that, but constantly recruiting and training medical billers wastes organizations’ time and money. This is not a problem, however, for Iowa physicians who employ medical billing services that handle the hiring and training themselves. Plus, having a large network of billers at their disposal ensures that no work is ever left undone – whether an employee is out sick, on vacation, or decides to leave the company.

Experienced medical billers can bring in more money to the practice. Not all medical billers possess the same knowledge and skills – and one biller may not be capable of bringing in the same amount of money for your practice as the next. This can be due to a lack of experience working with a certain medical specialty, insurance company, or software. By working with a third-party medical billing company, however, providers can ensure that the people handling their practice’s billing processes have the necessary knowledge to get claims paid on time.

Learn more about the benefits of using third-party medical billers, such as 5 Star Billing Services.

Medical Billers Help Colorado Physicians Maintain Healthy Accounts Receivables

Not even the best doctors can run a medical practice on their own. That’s because the success of any healthcare organization is dependent on the health of its accounts receivables and not just on the medical services that its physicians provide. In fact, even if a doctor provides the best medical services in Colorado, if he has inexperienced billers, chances are his practice isn’t going to be around long. In order to prevent this from happening, many Centennial State physicians have chosen to partner with experienced Colorado billing services and have seen positive results.

What do medical billers do?

Medical billers receive information from physicians about the services that patients received and the procedures that they underwent. Billers use these codes to submit claims to insurance companies and other payers in order to receive payment for services rendered. An expert biller should understand standard billing procedures used by most insurance companies, as well the different classification systems, ICD and CPT. ICD codes are used to describe what was wrong with the patient (diagnosis), while CPT codes describe the services that were performed (i.e. administered flu shot or performed physical examination).

What functions does a medical biller perform?

Billers are largely responsible for a medical practice’s financial stability, as whether or not a physician gets paid can depend on how effective the biller is at submitting complete, accurate claims in a timely fashion. Some of the other functions that medical billers perform include:

  • Reading and understanding EOBs (explanations of benefits)
  • Reviewing physicians’ codes for potential downcoding
  • Following up on claims that have not been paid after 30 days
  • Reviewing denied claims and gathering information in order to appeal them
  • Billing secondary and tertiary insurance providers
  • Sending bills out to patients for services that were not covered by their insurance

If you are a Colorado physician and you need assistance with any of the aforementioned billing tasks, consider hiring a third-party billing service in Colorado. Contact us today to learn more about the benefits of medical billing outsourcing, and we will tell you all about the services we provide and the physician specialties that our billers have worked with.