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.