Author Archives: dr21b

Increasing Practice Revenue by Outsourcing Billing

Outsource medical billingClinics busy with patients, doctors and staff can gain considerable benefits by thinking about how to streamline their workflow and make key elements of the practice more efficient. One area to consider is the revenue process and whether the needs of the practice are best met internally, or through the utilization of an external billing service. Practices need to ensure that they are getting the highest amount of revenue possible, and it is a worthwhile exercise to evaluate the billing system and processes. It’s a decision that requires some thought, weighing up the individual needs of the practice and considering the pros and cons of outsourcing before making the decision about which approach is most suitable.
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Successful Medical Billing in 2018

new year medical billingBilling in the new year, 2018, can come with a range of challenges for any size practice. From the extensive administrative burden of billing, to the time taken to get authorization from insurers, and preparing complex patient statements; it can be a difficult time that feels like a heavy weight on your back with ‘significant challenges’ being recognized in industry reports on billing.
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How to Turn Your Revenue Cycle Management Process Around

Revenue Cycle ManagementThe efficiency of the your practice’s revenue cycle can have a critical impact on financial performance, and effective management of the cycle is of utmost importance to your practice. However revenue cycle management within health practices is becoming increasingly difficult, with greater administrative responsibilities and regulatory pressures. This article outlines the problems practices are facing and how to turn the revenue management process around.

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Why Outsourcing Your Medical Billing Process Makes Sense For Private Practices

Transform Your Practice Into a More Efficient One With Higher Revenue

Stethoscope on top of medical billing papersBilling is an extremely important part of operations for a medical private practice, and a quick and efficient billing process is a key driver of revenue. In order to ensure that your doctors are paid for their services, two main things must happen: First, the claims for services must be submitted in a timely manner. Second, the claims for services must contain the correct codes for procedures, treatments, and other services.
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3 Tips For Choosing a Podiatry Billing Service

Podiatry Billing ServiceWhen your podiatry practice outsources its medical billing, you can help maximize claims payments and keep your practice compliant. Billing services accomplish this through aggressive collection practices, efficient and accurate execution of billing tasks, and current knowledge of documentation regulations.

If you’re managing a podiatry practice that’s thinking of outsourcing billing services, keep these three major points in mind:
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What to Ask a Medical Billing Service Before Hiring Them

Medical Billing ServiceHiring a skilled medical billing service can help your practice by greatly reducing administrative costs, ensuring an uninterrupted cash flow, increasing your bottom line, and — most importantly — allowing you to focus on medicine and patient care. But first, you have to choose the right team to work with. Here are the three most important questions you should ask before choosing your medical billing service team.

1. How much does your service cost?

This is probably the first question on your mind when choosing a medical billing service.  It is important to obtain complete information on a few key facets of cost in this discussion:

  • What the monthly bill amounts to, and whether it’s a flat rate or a percentage of charges collected: Because medical billing services should help you to increase collections, the percentage option is a good one as it aligns the service’s incentives with your practice’s goals.
  • Additional fees: On top of the monthly cost, billing services may charge additional fees for initiation, termination, or data conversion. It’s important to factor in these extra costs when you are comparing billing service price tags.
  • What services are included: Medical billing services aren’t always made equal, and a cheaper service may be a less comprehensive service. Find out exactly what kind of billing assistance is included and excluded, and ask about different packages that may be available to determine which one best suits your needs.

2. How will my account be handled?

From patient data security to reporting frequency, there are a few things to consider with respect to how a medical billing service will work with you.

  • HIPAA compliance: The HIPAA law dictates that all covered entities (providers) and business associates (any companies you contract) adhere to regulations. Everyone who handles protected health information is responsible for ensuring that patient data remains private and is kept and transmitted securely, and committing to breach notification practices. Ask about the medical billing service’s HIPAA compliance plan. What measures do they take to keep your data safe?
  • Reporting: Outsourcing a key function of your practice can induce stress if you’re not kept in the loop. Ask about the frequency of reports, and what each report will include. For example, 5 Star Billing provides monthly practice analysis and collections reports, in addition to customized and on-demand reports. Knowing what kind of information you can expect to receive on an ongoing basis and what you can request can help you choose which service you will be most comfortable working with.
  • Billing software: What billing software does the medical billing service use? You want something that will work well for your staff and your patients, and make the transition as smooth as possible.
  • Account manager: Who will actually be handling your account, and what happens when the person is out of the office? Because medical billing is time sensitive, you want to make sure that you’re always covered, preventing surprises for your practice and  your patients.

3. What qualifications do your service and staff have?

Is the billing service you are hoping to contract professional and good at what they do? When you ask about qualifications, be sure to cover the following.

  • Billing experience: Skilled medical billing involves in-depth knowledge of medical codes and experience working with patients and doctors, and it is especially helpful to work with someone who knows your specialty. This means that your biller understands the conditions and procedures in your field, and can use this expertise to help you maximize collections. A medical billing service with an established portfolio and experience in your medical specialty is the best choice.
  • References: Who can give you a better idea of what it’s like to work with this medical billing service than a doctor who has hired the same service before? Asking for references can give you an idea of what other providers’ staff and patient experiences were like.

Offering healthcare providers customized medical billing services across over 30 medical specialties, 5 Star Billing bundles billing, collection and administrative services — helping you to maximize the time they spent doing medicine. Start the conversation with our specialists at 5 Star Billing online or by calling 480-821-1371.

Why is Medical Billing Training and Certification Important?

Medical Billing Training and CertificationMedical billing professionals play an essential role in healthcare. Their work is complex, detail-oriented, and directly affects the financial well-being of healthcare practices. The demand on healthcare providers is increasing, and ambiguity among payers can make claims processing a frustrating process. For this reason, many practices are enlisting the help of trained, certified medical billing professionals to ensure efficiency of their revenue cycle management.

But what exactly are the advantages of hiring a trained and certified medical biller?
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How Will the Change From Fee-for-Service to Value-based Care Affect the Revenue Cycle?

Graphic explaining revenue cycle management through health insuranceThe Centers for Medicare and Medicaid Services are phasing out fee-for-service care and replacing it with a value-based model in an effort to improve the quality of care for patients. This transition is promoting changes that will ensure better care at a lower cost. But exactly how will this affect the revenue cycle?

We outline a few important changes occurring in the move to value-based care in order to help you prepare a value-based revenue cycle.

RCM is Now An End-to-End Process Where Customer Service is Essential

The patient experience is more than just clinical care. Providers will need to change their approach to patient intake by having staff members take on more of a customer service role. This is especially important for recurring patients. Sit down with each patient and help them understand the financial details of their health care, from pre-admission through the entire care process. Increased interaction, patient education, and patient assistance through this hands-on approach dramatically improves the patient experience, and in turn, increases revenue for your practice

Additionally, front-end revenue cycle processes are now more important than ever, meaning that collecting the correct patient data before service is critical to ensuring clean claims. In order to improve revenue, providers should emphasize eligibility authorization, collection of copayments, and collection of patient deductibles.

The Process of Care is Shifting to Slow Spending

Patients with chronic disease, such as diabetes and congestive heart failure, require the most resources when providing care. This is because they are most likely to be repeatedly admitted into the hospital and frequently visit their physicians or emergency care centers. In other words, they are the most expensive patients to care for. In order to reduce hospitalization and emergency costs allocated to this population, providers must focus on providing a different kind of care with a different objective, that of a preventative approach.

In this care model, the focus shifts to identifying gaps in care delivered to patients with chronic disease in order to reduce total-care spending, increase the value of care by reducing unnecessary readmissions, and increase revenue for providers. By implementing a new care model for patients who are at risk of hospitalization, total care spending slows for this population, leading to savings and more sustainable revenue cycle management.

Data is King

Data is the most important asset when it comes to value-based care. In a value-based environment, it’s critical for providers to have as much information as possible on patient medical history.

Additionally, it is important for providers to have the ability to analyze their performance of quality reporting measures. Understanding performance is key to determining whether providers are performing sufficiently enough for a positive reimbursement payment or if their performance is in line with a negative reimbursement payment.

If you have been using EMR software and meeting the necessary requirements to fulfill Meaningful Use, then you are already obtaining and maintaining comprehensive information.

Partner With The Right EMR

5 Star Billing is dedicated to helping practices streamline operations in order to achieve value-based care. With the right EMR and practice management software, practices can ensure accuracy in patient data as well as an improved patient experience through the entire cycle of care.

To learn more about how we can help ensure clean claims and maximize your revenue, contact us online or call us at 480-821-1371.

Tips for Choosing a Surgical Medical Billing Service

Surgical Team Discussing Medical Billing

Outsourcing medical billing services for surgical practices can help maximize claims payments and keep your practice compliant. This is accomplished through aggressive collection practices, efficient and accurate execution of billing tasks, and current knowledge of documentation regulations.

In this post, we outline important tips to keep in mind when searching for the right medical billing company to handle your practice’s accounts receivable.

Do They Focus on Your Specialty?

Each surgical discipline requires distinct guidelines, policies, and regulations when it comes to billing. Look for a medical billing company that has existing surgical practices as clients and that also has experience in your specific subspecialty. Make sure the company has certified, professional, and experienced medical coders and billers that will keep your practice compliant with HIPAA and OIG, maximize payments, and drive up revenue.

Do They Work With Your Current EHR Software?

Surgical medical billing services should streamline your practice’s operations. A medical billing company dedicated to making your revenue cycle more efficient, and as a result, your practice’s operations more efficient, should be able to work with your current EMR software.

Working with a medical billing company that can manage your revenue cycle using your EHR is key to achieving long-term profitability and productivity. Additionally, contracting medical billing professionals that can work with your EHR ensures that your office staff does not need to be re-trained on a new software, meaning they can keep doing business as usual.

Do They Invest in Customer Service?

When choosing a surgical medical billing service, one of the most important things to consider is customer service. It’s important to know that you will be able to access support when needed and that your phone calls and emails will be answered promptly the same day. Ideally, the medical billing company you choose will assign at least one individual that will be dedicated to your account.

Important Questions to Ask Before Choosing a Surgical Medical Billing Service

When comparing surgical medical billing services, it’s very important to prepare a list of questions that will provide you the information you need to make the most informed decision.

Some questions you may want to ask when researching medical billing companies include:

  • How many clients are you currently working with within my specialty?
  • How much experience does your personnel have working with my specialty?
  • What systems do you have in place to protect personal health information?
  • How many people will be assigned to my account?
  • What fees do you charge?

Consider 5 Star Billing Services For Your Surgical Medical Billing Services

5 Star Billing Services can help your surgical practice maximize claims payments, drive up revenue, and dedicate more time to value-based care for your patients. To learn more about our medical billing services, contact us online or call us at 480-821-1371.

How Smarter Medical Collections Can Improve Your Practice’s Finances

Medical CollectionsAccording to the America’s Health Insurance Plans’ Census of Health Savings Account – High Deductible Health Plans, the number of individuals enrolled in a high deductible health plan reached 19.7 million in January of 2015. This number is a dramatic increase from the 17.4 million reported in 2014.

With payment responsibility heavily shifting toward the patient, physicians need to change their strategy for collecting payments.
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